Effects of rapid enteral feed advancement with early human milk fortification in very low birth weight preterm infants > 30 weeks gestation in a resource limited setting- a randomized controlled trial.

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Perinatology Pub Date : 2024-11-07 DOI:10.1038/s41372-024-02164-2

Anitha Ananthan, Ganesh Bhatkar, Haribalakrishna Balasubramanian, Muthu Vijayanathan, Lakshmi Srinivasan

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引用次数: 0

Abstract

Objective: To study the effects of rapid enteral feed advancement with early feed fortification in stable very low birth weight (VLBW) infants >30 weeks gestation.

Study design: Preterm infants (N = 92) were randomized to a) rapid feed advancement-early fortification - REF group (enteral feed advanced at 25-30 ml/kg/day, fortification at 50 ml/kg/day) or b) slow feed advancement-late fortification-SLF group (feed advanced at 15-20 ml/kg/day, fortification at 100 ml/kg/day).

Results: The primary outcome-time to regain birth weight was significantly lower in REF group (9 days vs 13 days, P = 0.02). REF group reached full enteral feeds earlier (6 days vs 9 days, P = 0.001), had lower rates of sepsis (13% vs 38%, P = 0.007) and shorter hospital stay (10 days vs 15 days, P = 0.01). At one year, the median Z-scores for weight [-1.5 vs -2.2, P < 0.001] and head circumference [1.1 vs 0, P < 0.001) were significantly higher in the REF group.

Conclusions: In VLBW preterm infants >30 weeks, rapid feed advancement with early fortification resulted in early postnatal regain of birth weight with positive effects on growth at one year.

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在资源有限的情况下，对妊娠期大于 30 周的超低出生体重早产儿进行快速肠内喂养和早期母乳强化的效果--随机对照试验。

研究目的研究设计：研究设计：早产儿（N = 92）被随机分为 a) 快速进食-早期强化-REF 组（肠道进食量为 25-30 毫升/千克/天，强化量为 50 毫升/千克/天）或 b) 缓慢进食-晚期强化-SLF 组（进食量为 15-20 毫升/千克/天，强化量为 100 毫升/千克/天）：结果：REF 组恢复出生体重的主要时间明显较短（9 天 vs 13 天，P = 0.02）。REF组较早实现完全肠内喂养（6天 vs 9天，P = 0.001），脓毒症发生率较低（13% vs 38%，P = 0.007），住院时间较短（10天 vs 15天，P = 0.01）。一岁时，体重 Z 值中位数[-1.5 vs -2.2，P 结论：-1.5 vs -2.2]与一岁时的体重 Z 值中位数[-1.5 vs -2.2，P 结论：-1.5 vs -2.2]相比，均有显著下降：对于大于 30 周的 VLBW 早产儿，通过早期添加营养强化剂快速增加喂养量可在产后早期恢复出生体重，并对一年后的生长产生积极影响。

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

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.