Associated factors and clinical outcomes of feeding intolerance in preterm extremely low birthweight infants.

Feeding intolerance (FI) is a major challenge among extremely low birthweight (ELBW) preterm infants, impacting their growth, development, and overall clinical outcomes. We aimed to identify factors associated with FI in ELBW preterm infants and examine the relationship between FI and respiratory support modalities. Our retrospective review of medical records of all ELBW preterm infants between 12/2016 and 12/2021 revealed that 78 (58%) of the 133 ELBW infants (median gestational age 26.5 weeks, median birth weight 809 g) had FI. FI was more common in infants with bronchopulmonary dysplasia and periventricular leukomalacia (n = 69 vs. n = 24 and n = 11 vs. n = 2, respectively, p < 0.001). Non-invasive positive pressure ventilation (NIPPV) had the highest FI rate (7.8 per 100 device-days) compared with other noninvasive ventilation modes (p < 0.001). Infants with FI required longer to achieve full enteral feeding (median 18 vs. 14 days for infants without FI, p < 0.001) and had longer neonatal intensive care unit (NICU) stays (median 89.5 vs. 47 days, respectively, p < 0.001). We conclude that provision of NIPPV support was associated with higher FI rates and longer NICU stays in preterm ELBW infants.