Effect of parenteral nutrition duration on patterns of growth and body composition in very low-birth-weight premature infants.

Abstract

BACKGROUND  Parenteral nutrition (PN) is essential to support premature infants' growth and varies with enteral nutrition (EN) advancement rates. Data on PN duration's impact on premature infants' growth is limited. The aim of this multicenter observational study was to determine early PN duration effect on body composition at term corrected gestation (CGA) in very low birth weight (VLBW) premature infants. METHODS   VLBW infants exposed to PN in the first week of life and exposed to significantly different EN regimens, were divided into two groups per early PN duration. Infants with a birth weight (BW) < 1000g and PN duration < 28 days, and those with a BW 1000-1500g and PN duration < 14 days were assigned to the 'Short-PN' group. Infants receiving PN for longer durations were assigned to the 'Long-PN' group. Body composition was assessed at term CGA or prior to discharge via air displacement plethysmography. RESULTS 62 and 53 infants were assigned to the short- and long- PN groups respectively. The two groups were significantly different in BW and gestational age (GA), so a nested case-control study was conducted after matching 36-infant pairs. Infants in the long-PN group had significantly lower fat-free mass (FFM) z-scores but both groups had comparable fat mass (FM) z-scores. Long-PN was a significant negative predictor of FFM z-score in the multivariate regression analysis. CONCLUSION  In VLBW premature infants, PN duration is negatively associated with FFM z-scores at term CGA without affecting FM z-scores. This article is protected by copyright. All rights reserved.