Analysis Of Nutrition And Weight Gain In Very Low Birth Weight Infants During Hospitalization

ObjectivesTo analyze the nutrition state and weight gain in very low birth weight infants (VLBWI) during hospitalization and evaluate high-risk factors of extrauterine growth retardation(EUGR).Methods180 VLBWIs were admitted in NICU of afiliated hospital of bengbu medical hospital and anhui provential hospital from Jan 2006 to Dec 2010.The criteria of enrollment were:(1)gastation age<37weeks and birth weight<1500g.(2)hospitalization time is≥2weeks.(3) at discharge, body sign is stable,without cyanosis and apnoea。The criteria of exclusion:(1) inherited metabolic disease,congenital heart diseaseand congenital intestina malformations .(2)hospitalization time is<2weeks.and at discharge, body sign is unstable , or suckle badly.The clinical data were retrospectively analyzed.alldata were analyzed using SPSS13.0 software.The risk factors which can lead to growth retardation of VLBWIs were assessed with logistic regression.P<0.05 was considered as significant.Results1. The sample included 180 VLBWI.Mean gestational age was 224.9±15.2d.Mean birth weight was 1342.4±140.8g.2. Nutrition state(1) Enteral nutrition: The time of initial enteral feeding was 2d. Feeding intolerance 49 patients(27.2%), minimal feeding 35 patients(19.4%).(2) Parenteral nutrition: 120 patients were administered parenteral nutrition. amino acid was administered in 53.9% patinets.The time to begin was 4.2±2.7d.The duration of administration was 8.7±6.2d.The total dose is17.2±7.3g.The initial dose is 0.92±0.39g/kg.Lipid emulsions was administered in 53.9% patinets.The time to begin was 4.2±2.2d.The duration of administration was 10.4±7.4d. The total dose is 31.2±19.1g. The initial dose is0.84±0.19g/kg.(3) Energy intake: Total energy intake of 120 kcal/kg.d was achieved at 13.2±5.4d.Enteral feeding of 100kcal/Kg.d was achieved at14.5±5.4d.3. Weight stateOf 118 singletons ,88.1%patients had physiological weight decline.The average extent was 6.0±4.7%.The average age reaching birth weight was 9.3±3.5d.The average growth rate after regaining birth weight was 15.1±4.0g/kg.d.Of 118 singletons,63.6% patients had growth retardation by weight at birth,while 73.7% at discharge.4. Risk factors of EUGRBy logistic regression : Gastational age,birth weiht,feeding intolerance and intrauterine growth restriction were risk factors of extrauterine growth restriction.(P<0.05). Conclusions Most VLBWIs had problems with nutration and growth during hospitalization and failed to reach growth rate as desired for normal intrauterine growth rate.It is very important to begin parenteral nutrion as early as possible and parenteral nutrion should be admitted as supplement to parenteral nutrion.