Effect Of Different Nutritional Support Strategy On The Growth And Development Of Preterm Infants

Objective: To explore the effect of aggressive nutritional support in early life onnutritional status and growth development of preterm infants during hospitalization.Method: Two retrospective cohorts of preterm infants were compared;99infants of groupA (born between January1,2007and September30,2009) and101infants of group B(September30,2010and December31,2012) with gestational age above28weeks and less37weeks and birth weight less2500g, transferred to NICU within12hours after birth,hospitalized for＞or=14days,who were free of major congenital anomalies and stable todischarge were recruited. The comparison of enteral and parenteral nutrition, growth rate,EUGR incidence during hospitalization between these both groups were made. Result:Compared to group A, group B was given greater volume of amino acid infusion on the3rd and7th day of life. And consumed more enteral nutrition energy and total energyintake on the3rd and7th day of life. Enteral nutrition energy and total energy intakes onthe14th day of life were similar between the two groups. Comparing with group A，patients in group B started enteral feeding time earlier, recovered the birth weightearlier.The duration of parenteral nutrition, reached sufficient amount of feeding andhospital stay time were shorter. And the rate of weight loss was lower in group B,thedifferences were statistically significance, P <0.05. Compared to group A,<32weeks ofgroup B had faster average weight, head circumference and length growth rate, lowerincidence of EUGR. Compared to group A,≥32weeks of group B had faster averageweight and head circumference growth rate, lower incidence of weight and headcircumference EUGR. The length growth rate and incidence of length EUGR were similarin both groups. After stratification according to weight, both very low birth weight infantsand infants with birth weight between1500g and2000g in group B grew more rapidly. The infants with birth weight between2000g and2500g in group B, had faster averageweight and head circumference rate, lower incidence of weight EUGR, but its length rateand incidence of head circumference and length EUGR were similar in both groups.During hospitalization the incidence of hypoglycemia, hyperglycemia, hyperbilirubinemiaand cholestasis was no significant difference in both groups, but the incidence of feedingintolerance, NEC, sepsis in group B was lower. Conclusion: Early proactive nutritionalsupport strategy can improve nutritional status of premature infants, promote the growthvelocity of premature infants, reduce the incidence of EUGR, and did not increase theincidence of preterm children related complications during hospitalization.