Early and exclusive enteral nutrition in infants born very preterm.

IF 3.9 2区 医学 Q1 PEDIATRICS
Jacqueline Razzaghy, Vivek V Shukla, Emily Gunawan, Audrey Reeves, Kelly Nguyen, Ariel A Salas
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引用次数: 0

Abstract

Objective: To characterise the effects of early and exclusive enteral nutrition with either maternal or donor milk in infants born very preterm (280/7-326/7 weeks of gestation).

Design: Parallel-group, unmasked randomised controlled trial.

Setting: Regional, tertiary neonatal intensive care unit.

Participants: 102 infants born very preterm between 2021 and 2022 (51 in each group).

Intervention: Infants randomised to the intervention group received 60-80 mL/kg/day within the first 36 hours after birth. Infants randomised to the control group received 20-30 mL/kg/day (standard trophic feeding volumes).

Main outcome measures: The primary outcome was the number of full enteral feeding days (>150 mL/kg/day) in the first 28 days after birth. Secondary outcomes included growth and body composition at the end of the first two postnatal weeks, and length of hospitalisation.

Results: The mean birth weight was 1477 g (SD: 334). Half of the infants were male, and 44% were black. Early and exclusive enteral nutrition increased the number of full enteral feeding days (+2; 0-2 days; p=0.004), the fat-free mass-for-age z-scores at postnatal day 14 (+0.5; 0.1-1.0; p=0.02) and the length-for-age z-scores at the time of hospital discharge (+0.6; 0.2-1.0; p=0.002). Hospitalisation costs differed between groups (mean difference favouring the intervention group: -$28 754; -$647 to -$56 861; p=0.04).

Conclusions: In infants born very preterm, early and exclusive enteral nutrition increases the number of full enteral feeding days. This feeding practice may also improve fat-free mass accretion, increase length and reduce hospitalisation costs.

Trial registration number: NCT04337710.

早产儿的早期纯肠内营养。
目的研究早产儿(孕 280/7-326/7 周)早期纯母乳或捐献者母乳肠内营养的效果:设计:平行分组、无掩蔽随机对照试验:地区:三级新生儿重症监护病房:102名2021年至2022年间出生的早产儿(每组51名):干预:被随机分配到干预组的婴儿在出生后 36 小时内接受 60-80 毫升/千克/天的喂养。主要结果指标:主要结果:主要结果是婴儿出生后 28 天内完全肠内喂养的天数(>150 毫升/千克/天)。次要结果包括出生后两周末的生长和身体成分以及住院时间:平均出生体重为 1477 克(标准差:334)。半数婴儿为男性,44%为黑人。早期和完全肠内营养增加了完全肠内喂养的天数(+2;0-2 天;p=0.004)、出生后第 14 天的无脂肪体重-年龄 Z 值(+0.5;0.1-1.0;p=0.02)和出院时的身长-年龄 Z 值(+0.6;0.2-1.0;p=0.002)。各组之间的住院费用存在差异(干预组的平均差异为-28 754美元;-647美元至-56 861美元;p=0.04):结论:对于早产儿,早期纯肠内营养可增加全肠内喂养天数。结论:对于极早产儿,早期完全肠内营养可增加完全肠内喂养的天数,这种喂养方式还可改善无脂肪质量的增加、延长身长并减少住院费用:NCT04337710.
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
9.00
自引率
4.50%
发文量
90
审稿时长
6-12 weeks
期刊介绍: Archives of Disease in Childhood is an international peer review journal that aims to keep paediatricians and others up to date with advances in the diagnosis and treatment of childhood diseases as well as advocacy issues such as child protection. It focuses on all aspects of child health and disease from the perinatal period (in the Fetal and Neonatal edition) through to adolescence. ADC includes original research reports, commentaries, reviews of clinical and policy issues, and evidence reports. Areas covered include: community child health, public health, epidemiology, acute paediatrics, advocacy, and ethics.
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