Relation Between Energy, Nutrients Intakes And Weight Gain Among Preterm Neonate

Objective To analyze enteral nutrition and parenteral nutrition intakes level of preterm infants during neonate period, access growth and development status of preterm infants in early time, and to explore the relation between energy and nutrients intake and weight gain of them, so as to provide the reference of nutrition intervention for them on account of evidence based, to improve the living quality of them.Methods 214 preterm infants were chosen by cohort study and prospective dynamic observation from the department of neonate at Anhui province children's hospital, who were born during Oct 2007 and Oct 2008. We divided all objects into GA<32w group (72) and GA≥32w group (142) by gestational age (GA), SGA (small for gestational age) group (50) (whose birth weight under 10th percentile of the same gestational age) and AGA (appropriate for gestational age) group (164) (whose birth weight during 10thand 90th percentile of the same gestational age). Recorded daily milk, glucose, amino acids and fat emulsion which preterm infants intake, calculated daily total energy, protein, fat and carbohydrate they intake. To compare feeding characteristic, the difference of total energy and protein intake of each group, describe profile of energy and protein by day. To measure weight everyday and compare weight gain status of each group including age of lowest weight loss,age of recovery birth weight, extent of weight loss and velocity of weight gain, describe curve of weight gain during neonate period. To analyze the relation between energy, protein and weight gain, and influence factors with velocity of weight gain. We used method of LMS to establish standard percentile curve of energy and protein intakes, numerical data was analyzed by independent-samples t test, and categorical data was analyzed by chi-square test. The relation between energy, protein and weight gain was researched with Pearson's correlation analysis and linear regression analysis. The factors of growth restriction was analyzed by Logistic regression.Results At feeding, the study shows that there are 142(66.4%) preterm infants by total enteral nutrition, and 72(33.6%) by parenteral nutrition, at achieving age of full dose feeding, GA<32w group is longer than GA≥32w group, the difference is significant (P<0.05), while there is no statistic difference between SGA group and AGA group. There are 40(55.6%) preterm infants given parenteral nutrition in GA<32w group which is higher than 32 (44.4%) infants in GA≥32w group and the difference is significant (P<0.01), while there is no statistic difference between SGA group and AGA group. The energy and nutrients intakes have not achieved the level of RDIs during first week after birth, there is no statistic difference between GA<32w and GA≥32w groups in total energy intake during two weeks, while GA<32w group are lower than GA≥32w group in fat,protein and carbohydrate, the difference is significant (P<0.05). Total energy and nutrients intake are no statistic difference between SGA group and AGA group during two weeks. In addition, total energy and protein intake of parenteral nutrition group are lower than enteral nutrition group (P<0.05 or P<0.01). At weight gain status, age of lowest weight loss,age of recovery birth weight and extent of weight loss in GA<32w group are higher than GA≥32w group, the incidence of growth retardation at discharge is no statistic difference between two groups. The incidence of growth retardation at discharge in SGA group is lower than AGA group (P <0.01), and no significant difference in others, the velocity of weight gain does not achieve ideal status during neonate period, and the incidence of growth retardation at discharge is 123(57.5%). The Pearson coefficient study shows there are positive correlation between weight gain and total energy, protein intake. the study shows that preterm infants who have lower birth weight and longer age of achieving full dose feeding emerge growth retardation easily. Conclusion Preterm infants inevitably accumulate a widespread energy and nutrients deficit in the early time of life and velocity of weight gain does not come close to approximating rates of uteri growth, extrauterine growth restriction remains highly at discharge. Preterm infants of small GA have higher feeding difficulties, deficient in energy and nutrients intakes, and slow in velocity of weight gain. In addition, lower birth weight and longer age of achieving full dose feeding are risk factors of growth retardation. Accordingly, when providing active treatment, we should give reasonable feeding mode and establish safe and appropriate nutrition intake standard for them in early life, so as to promote growth and development healthily for them.