Luc P Brion1, Charles R Rosenfeld2, Roy Heyne2, Steven L Brown3, Cheryl S Lair3, Patti J Burchfield2, Maria Caraig2. 1. Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA. luc.brion@utsouthwestern.edu. 2. Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA. 3. Parkland Hospital and Health System, Dallas, TX, USA.
Abstract
BACKGROUND: Preterm very-low-birth-weight (≤1500 g) infants exhibit disproportionate weight-for-length growth in the Neonatal Intensive Care Unit. LOCAL PROBLEM: High frequency of body mass index (BMI) > 90th centile at discharge and 1-year postnatal age associated with elevated blood pressure and serum leptin in infancy and adolescence. METHODS: Single-institution quality improvement project in appropriately grown infants born at 230/7-286/7 weeks gestational age and discharged home. INTERVENTION: Adjustable feeding protocol based on valid serial length measurements (board or caliper). RESULTS: The average monthly percentage of weight-for-length disproportion at discharge decreased from 13% in Epoch 1 to 0% in Epoch 2 (P < 0.05). Although the average Z-score for BMI at discharge was lower in Epoch 2 versus Epoch 1 (P < 0.01), this was absent by 1 year follow-up (P = 0.91). CONCLUSIONS: Adjustable feedings plus use of accurate serial length measurements decreases weight-for-length disproportion at hospital discharge but not at 1 year.
BACKGROUND: Preterm very-low-birth-weight (≤1500 g) infants exhibit disproportionate weight-for-length growth in the Neonatal Intensive Care Unit. LOCAL PROBLEM: High frequency of body mass index (BMI) > 90th centile at discharge and 1-year postnatal age associated with elevated blood pressure and serum leptin in infancy and adolescence. METHODS: Single-institution quality improvement project in appropriately grown infants born at 230/7-286/7 weeks gestational age and discharged home. INTERVENTION: Adjustable feeding protocol based on valid serial length measurements (board or caliper). RESULTS: The average monthly percentage of weight-for-length disproportion at discharge decreased from 13% in Epoch 1 to 0% in Epoch 2 (P < 0.05). Although the average Z-score for BMI at discharge was lower in Epoch 2 versus Epoch 1 (P < 0.01), this was absent by 1 year follow-up (P = 0.91). CONCLUSIONS: Adjustable feedings plus use of accurate serial length measurements decreases weight-for-length disproportion at hospital discharge but not at 1 year.
Authors: Luc P Brion; Charles R Rosenfeld; Roy Heyne; L Steven Brown; Cheryl S Lair; Elen Petrosyan; Theresa Jacob; Maria Caraig; Patti J Burchfield Journal: J Perinatol Date: 2020-02-18 Impact factor: 2.521
Authors: Jordan D Reis; Kristine Tolentino-Plata; Roy Heyne; L Steven Brown; Charles R Rosenfeld; Maria Caraig; Patti J Burchfield; Luc P Brion Journal: J Perinatol Date: 2021-03-26 Impact factor: 3.225