Analysis Of Energy, Protein Intake And Weight Gain In Extremely Low Birth Weight And Very Low Birth Weight Infants During Hospitalization

ObjectiveDiscussion of parenteral nutrition after birth and early enteral nutrition interventionspreterm extremely low birth weight infants and very low birth weight infants as well as thesupply of energy and protein intake into the relationship between weight gain levels.MethodA retrospective analysis from January2009to December2012in the third AffiliatedHospital of Guangzhou Medical College hospital neonatal premature ELBWI/VLBWIinformation. Respectively, according to birth weight, gestational age and birth weightgrowth rate during hospitalization were divided into groups and VLBWI ELBWI group,<28w group and≥28w group,<15g/(kg d) group and≥15g/(kg d) group,comparison between the various groups of preterm ELBWI/VLBWI weight, analyzes therelationship between energy supply and protein intake and weight gain levels.Results①Preterm ELBWI met the inclusion criteria/VLBWI total265cases,39cases inwhich ELBWI group, VLBWI group of226cases. ELBWI group, the average duvsn ofhospitalization, use of intravenous nutrition time, full oral feeding times longer thanVLBWI group [(76±27) days vs (52±24) days, P=0.00;(68±28) days vs (46±18)days, P=0.00;(48±31) days vs (32±18) days, P=0.00]; ELBWI group weight growthrate [g/(kg d)] higher than VLBWI group [(17±7) vs (12±5), P=0.00]; two largestproportion of weight loss, increased birth weight, body weight began to increase in time,the time to start enteral nutrition, adequate feeding time, open milk time, dischargeweight comparison, the difference was not statistically significant (P>0.05). ELBWI group born three days after the energy supply is higher than VLBWI group [(43±19) kcal/(kg d) vs (37±9) kcal/(kg d), P=0.00]; born after the first two to4weeks, theenergy supply during hospitalization and three days after birth, the first1-4weeks,protein intake during hospitalization,the difference was not statistically significant(P>0.05). Born three days after ELBWI group energy supply and average daily cumulativemissing missing were lower than VLBWI group [(201±56) kcal/(kg d) vs (220±27)kcal/(kg d), P=0.01;(67±19) kcal/(kg d) vs (73±9) kcal/(kg d), P=0.00];energy supply accumulated1to4weeks, both groups during hospitalization after birthlack of volume and average daily volume is missing, the difference was not statisticallysignificant (P>0.05);3days after ELBWI group of students, the first1-4weeks, a totallack of protein intake during hospitalization missing volume and average daily volumegreater than VLBWI group [(10±2) g/kg vs (8±1) g/kg, P=0.00;(17±5) g/kg vs(12±5) g/kg, P=0.00;(24±12) g/kg vs (14±13) g/kg, P=0.00;(31±20) g/kg vs(17±20) g/kg, P=0.00;(40±26) g/kg vs (22±26) g/kg, P=0.00;(128±77) g/kg vs(57±49) g/kg, P=0.00;(3.2±0.8) g/(kg d) vs (2.7±0.5) g/(kg d), P=0.00;(2.4±0.8) g/(kg d) vs (1.7±0.7) g/(kg d), P=0.00;(1.7±0.9) g/(kg d) vs (1.0±0.9) g/(kg d), P=0.00;(1.5±0.9) g/(kg d) vs (0.8±1.0) g/(kg d), P=0.00;(1.4±0.9) g/(kg d) vs (0.8±0.9) g/(kg d), P=0.00;(1.7±0.7) g/(kg d) vs(1.1±0.8) g/(kg d), P=0.00). Gestational age, the first week after birth, the averagedaily energy supply and discharge weight was positively correlated (respectively β=0.25,P=0.00and β=0.15, P=0.02).②Preterm ELBWI met the inclusion criteria/VLBWI of265cases, includinggestational age <28w group of25cases, gestational age≥28w group of240cases.<28wgroup, the average length of stay, time of use of intravenous nutrition, adequate feedingtime, full oral feeding times longer than≥28w group [(88±44) days vs (52±20)days, P=0.00;(71±28) days vs (47±19) days, P=0.00;(77±23) days longer than (49±17) days, P=0.00;(69±20) days vs (32±19) days, P=0.00]; two largest proportionof weight loss, weight gain rate, increased birth weight, body weight began to increase intime, the time to start enteral nutrition, open milk time, discharge weight, the differencewas not statistically significant (P>0.05). Three days after two students, the first four weeks after birth, energy supply and protein intake three days, the difference was notstatistically significant (P>0.05).<28w group born after1to3weeks, the average dailyenergy supply during hospitalization were lower than≥28w group,[(50±2) kcal/(kgd) vs (57±1) kcal/(kg d), P=0.04;(67±4) kcal/(kg d) vs (77±1) kcal/(kg d), P=0.02;(74±4) kcal/(kg d) vs (86±2) kcal/(kg d), P=0.02;(73±24) kcal/(kg d) vs (87±33) kcal/(kg d), P=0.01];<28w group of students after1-4weeks,the average daily protein intake during hospitalization were lower than≥28w group [(1.4±0.1) g/(kg d) vs (1.8±0.0) g/(kg d), P=0.01;(2.0±0.1) g/(kg d) vs(2.5±0.1) g/(kg d), P=0.00;(2.2±0.1) g/(kg d) vs (2.7±0.1) g/(kg d), P=0.01;(2.3±0.1) g/(kg d) vs (2.7±0.1) g/(kg d), P=0.03;(2.1±0.5) g/(kg d) vs(2.4±0.8) g/(kg d), P=0.05]. Born three days after the two groups, the first four weeksof accumulated energy supply and the lack of volume average daily volume comparison ismissing, the difference was not statistically significant (P>0.05);<cumulative energysupply1to3weeks,28w group during hospitalization after birth missing missing andaverage daily volume greater than≥28w group [(417±16) kcal/(kg d) vs (373±7)kcal/(kg d), P=0.04;(604±53) kcal/(kg d) vs (462±19) kcal/(kg d), P=0.02;(748±93) kcal/(kg d) vs (487±35) kcal/(kg d), P=0.02;(3456±3051) kcal/(kg d) vs (1119±1783) kcal/(kg d), P=0.00;(60±11) kcal/(kg d) vs (53±15) kcal/(kgd), P=0.04;(43±19) kcal/(kg d) vs (33±21) kcal/(kg d), P=0.02;(36±22) kcal/(kg d) vs (23±25) kcal/(kg d), P=0.02;(37±24) kcal/(kg d) vs (23±33) kcal/(kg d), P=0.01];<3days after birth28w group,1to4weeks, the cumulative dailyprotein intake during hospitalization were higher than lack of lack of volume and average≥28w group [(9.4±0.3) g/kg vs (8.4±0.1) g/kg, P=0.00;(16.7±1.0) g/kg vs (12.4±0.3) g/kg, P=0.00;(24.8±2.0) g/kg vs (14.3±0.8) g/kg, P=0.00;(33.1±3.2) g/kgvs (17.5±1.4) g/kg, P=0.00;(40.6±4.4) g/kg vs (23.1±1.8) g/kg, P=0.00;(146.7±84.6) g/kg vs (58.9±49.7) g/kg, P=0.00;(3.1±0.6) g/(kg d) vs (2.8±0.5) g/(kg d), P=0.00;(2.4±0.7) g/(kg d) vs (1.8±0.7) g/(kg d), P=0.00;(1.8±0.7) g/(kg d) vs (1.0±0.9) g/(kg d), P=0.00;(1.6±0.7) g/(kg d) vs (0.8±1.0) g/(kg d), P=0.00;(1.4±0.8) g/(kg d) vs (0.8±1.0) g/(kg d), P=0.00;(1.6±0.6) g/(kg d) vs (1.1±0.8) g/(kg d), P=0.00). ③Preterm ELBWI met the inclusion criteria/VLBWI of265cases, of which the rateof weight gain during hospitalization <15g/(kg d) group of184cases, weight gainduring hospitalization rate≥15g/(kg d) group of81cases.<15g/(kg d) group,the average length of stay, time of use of intravenous nutrition, adequate feeding timeswere shorter in≥15g/(kg d) group [(52±26) days vs (62±25) days, P=0.01;(47±21) days vs (55±20) days, P=0.01;(48±20) days longer than (60±19) days, P=0.01];<15g/(kg d) group weight growth rate [g/(kg d)] and discharge were lowerweight≥15g/(kg d) group [(10±5) vs (18±3), P=0.00;(2005±381) g vs (2223±474) g, P=0.00]; two largest proportion of weight loss, increased birth weight, bodyweight began to increase in time, the time to start enteral nutrition, oral feeding timecompletely open milk time, EUGR number and proportion of patients, the difference wasnot statistically significant (P>0.05). Three days after two students, the first1-4weeks,energy supply and protein intake during hospitalization, the difference was notstatistically significant (P>0.05). Three days after two students, the first1-4weeks, thecumulative lack of energy supply during hospitalization and average daily volume ismissing, the difference was not statistically significant (P>0.05);<15g/(kg d) group ofstudents3days after the three days, the first1to2weeks, protein intake duringhospitalization and the cumulative amount of missing students, the first1to2weeksmissing a day on average were higher than≥15g/(kg d) group [(9±2) g/kg vs (8±1) g/kg, P=0.01;(14±6) g/kg vs of (12±5) g/kg, P=0.01;(18±13) g/kg vs(14±13) g/kg, P=0.03;(80±67) g/kg vs (62±55) g/kg, P=0.04;(2.9±0.7) g/(kg d)vs (2.8±0.5) g/(kg d), P=0.01;(2.0±0.8) g/(kg d) vs (1.8±0.7) g/(kg d), P=0.01;(1.3±0.9) g/(kg d) vs (1.0±0.9) g/(kg d), P=0.03);3to4weeks after twostudents cumulative protein intake volume and raw missing after3to4average week,every day during hospitalization missing volume comparison, the difference was notstatistically significant (P>0.05).3days after <15g/(kg d) Group Health,1to4weeks, the rate of weight gain during hospitalization [g/(kg d)] were lower than those≥15g/(kg d) group [to (-7±15) than (2±29), P=0.01;(-6±10) than (0±16),P=0.01;(2±6) vs (6±9), P=0.01;(6±4) vs (9±6), P=0.01;(9±4) vs of (12±5),P=0.01;(10±5) vs of (18±3), P=0.01].Birth weight and weight growth rate was negatively correlated (β=-0.63, P=0.00), was born three days daily protein intake andweight average growth rate was positively correlated (β=0.36, P=0.01).≥15g/(kg d) group of81cases,15cases of non EUGR group at discharge, EUGR group of66cases. After three days of non-EUGR group born after1to2weeks supply of energy andraw protein intake three days, the difference was not statistically significant (P>0.05);3to4weeks, non-EUGR group during hospitalization after birth energy supply and the firstborn after3to4weeks, during hospitalization were higher than EUGR protein intakegroup (P<0.05). Three days after the birth of non-EUGR group,1to2weeks aftermissing a daily supply of energy and raw three days the amount of daily protein intakecomparing the average mean missing amount, the difference was not statisticallysignificant (P>0.05); non EUGR group after birth after3to4weeks, lack of energysupply during hospitalization average daily volume and raw3to4weeks, missing theaverage protein intake per day during hospitalization were higher than EUGR group(P<0.05). Non-EUGR group, the first week after birth, the average daily protein intakeand discharge rate of weight gain was positively correlated (β=0.30, P=0.01).ConclusionPreterm ELBWI/VLBWI, especially ELBWI, GA <28w and the rate of weight gainduring hospitalization <15g/(kg d) of preterm infants during hospitalization and allstages of the energy supply are inadequate protein intake, growth retardation duringhospitalization phenomenon is more prominent. Early postnatal adequate energy supplyand protein intake in favor of weight gain.