Brunna G Milanesi1, Paola At Lima1, Letícia D Villela1, Amanda S Martins1, Saint Clair S Gomes-Junior1,2, Maria E L Moreira1,2, Maria Dalva Barbosa Baker Méio3,4,5. 1. Neonatology, Instituto Nacional da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, FIOCRUZ, Av. Rui Barbosa, 760, Flamengo, RJ, CEP 22250-020, Rio de Janeiro, Brazil. 2. Post-graduation on Applied Clinical Research, Instituto Nacional da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil. 3. Neonatology, Instituto Nacional da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, FIOCRUZ, Av. Rui Barbosa, 760, Flamengo, RJ, CEP 22250-020, Rio de Janeiro, Brazil. mdbakermeio@gmail.com. 4. Post-graduation on Applied Clinical Research, Instituto Nacional da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil. mdbakermeio@gmail.com. 5. , Rio de Janeiro, Brazil. mdbakermeio@gmail.com.
Abstract
This cohort study evaluated the nutritional supply in 78 very preterm newborns, with 20.5% developing bronchopulmonary dysplasia (BPD). This work aimed to evaluate the nutritional intake and the calorie/protein ratio received in the first 4 weeks of life. Anthropometric measures at birth and term age, the weight at each of the first 4 weeks of life, and the feeding practices were registered. The mean gestational age and birth weight were lower in those who developed BPD. At term age, head circumference and length Z-scores were significantly lower in newborns with BPD, who started enteral feeding and reached full diet later, staying longer in parenteral nutrition. The protein rate received by all newborns was similar, whether developing BPD or not, but those who developed BPD received significantly lower fluid volume and calorie rates after the second week. The daily calorie/protein ratio (30 kcal/1-g protein) was reached by 88.7% of the newborns who did not develop BPD in the third week, with those who developed BPD receiving less than this ratio until the second week, persisting in 56.3% of them on the fourth week. Conclusion: A calorie/protein ratio below that recommended for growth was found in preterm newborns who developed BPD, and providing nutrition for these newborns remains a challenge. What is Known: • The importance of preterm newborn nutrition is well known. • Early nutritional support may avoid severe BPD. What is New: • Newborns who developed BPD received a calorie/protein ratio below that recommended for preterm newborns' growth during the first 2 weeks of life, lasting until the fourth week in most of these newborns.
This cohort study evaluated the nutritional supply in 78 very preterm newborns, with 20.5% developing bronchopulmonary dysplasia (BPD). This work aimed to evaluate the nutritional intake and the calorie/protein ratio received in the first 4 weeks of life. Anthropometric measures at birth and term age, the weight at each of the first 4 weeks of life, and the feeding practices were registered. The mean gestational age and birth weight were lower in those who developed BPD. At term age, head circumference and length Z-scores were significantly lower in newborns with BPD, who started enteral feeding and reached full diet later, staying longer in parenteral nutrition. The protein rate received by all newborns was similar, whether developing BPD or not, but those who developed BPD received significantly lower fluid volume and calorie rates after the second week. The daily calorie/protein ratio (30 kcal/1-g protein) was reached by 88.7% of the newborns who did not develop BPD in the third week, with those who developed BPD receiving less than this ratio until the second week, persisting in 56.3% of them on the fourth week. Conclusion: A calorie/protein ratio below that recommended for growth was found in preterm newborns who developed BPD, and providing nutrition for these newborns remains a challenge. What is Known: • The importance of preterm newborn nutrition is well known. • Early nutritional support may avoid severe BPD. What is New: • Newborns who developed BPD received a calorie/protein ratio below that recommended for preterm newborns' growth during the first 2 weeks of life, lasting until the fourth week in most of these newborns.
Authors: Paola Azara Tabicas Lima; Maria Dalva Barbosa Baker Méio; Maria Elisabeth Lopes Moreira; Andrea Dunshee de Abranches; Brunna Grazziotti Milanesi; Saint Clair S Gomes Junior Journal: Eur J Pediatr Date: 2022-06-04 Impact factor: 3.860
Authors: Gregory C Valentine; Krystle M Perez; Thomas R Wood; Dennis E Mayock; Bryan A Comstock; Mihai Puia-Dumitrescu; Patrick J Heagerty; Sandra E Juul Journal: J Perinatol Date: 2022-03-25 Impact factor: 3.225