Nutritional Status In Very Low Birth Weight Infant During Stay In Hospital

Objective： To investigate the nutritional status in very low birthweightinfant(VLBWI) during their stay in Dalian Children’s hospital and evaluate high-riskfactors of extrauterine growth retardation(EUGR).Methods：Retrospectively analysis all the cases of VLBWI which were enrolled inthe NICU of DaLian Children’s Hospital from Jan.2010to Jun.2013. Bring in standardinclude:(1) birth weight<1500g;(2)enrolled age less than3days after birth.;(3)duration of hospital stays>14days;(4) No serious digestive tract abnormalities andcongenital malformations, genetic and metabolic diseases. The criteria of intrauterinegrowth retardation (IUGR) and extrauterine growth restriction(EUGR) was the bodyweight lower than the tenth percentile of the average weight at the same gestational age.T test and chi-square test were used to analysis the differences, P<0.05was significant.Results：1.Of the128VLBWL,68cases of VLBWL were enrolled in this study.27boys,41girls; The mean gestational age was (31.3±2.0)w; The mean birth weight was(1289.4±129.5)g; In the68cases of subjects, discharged gestational age was(37.4±1.9)w, discharged bodyweight was1970(1880,2080)g,36cases(52.9%) wereIUGR,61cases (89.7%) were EUGR.2．Nutritional status: All the cases were providing parenteral nutrition, amino acidbegan at1(1,1) d, the average maximum amount of amino acids was (3.0±0.7)g/kg.d;57(83.9%) cases provided intralipid in parenteral nutrition, began at3-34d, median day was6(4,10) ds, the average maximum amount of fat emulsion was (2.0±0.6) g/kg.d, the cumulative days of fat emulsion were10(5.5,17.5) ds; parenteralnutrition days persisted10~78ds, median day was27.5(21.3,36) ds; Begin feedingtime was3-336h, the median was41(22,120) h;7patients did not reach total enteralnutrition before discharged,61cases reached total enteral nutrition.Total enteral feedingage was (29.3±10.7) ds; body weight loss occurred in12patients (17.6%) duringconverting to total enteral feeding; the total calories was (95.7±13.2) kal/kg beforeconverting to total enteral feeding,the total calories was (93.9±11.8) kal/kg at thedate of total enteral feeding.3． Bodyweight changes: Only3cases had no weight loss after enrolling inhospital, the highest weight loss in65cases was (6.9±3.1)%, the lowest weight agewas (4.0±1.7) d, regained birth weight was at4-16ds, the average days was (9.5±3.1)ds.4．EUGR risk factor analysis: gestational age, birth weight, weight decrease, IUGR,illness factors were used as variables, to analysis the possible risk factors of EUGR.Gestational age, IUGR are the leading risk factors to EUGR.Conclusions：1．The incidence of EUGR in VLBWI during hospitalization was89.7%.2．Gestational age, IUGR are the leading risk factors to EUGR.3． Amino acid and Lipid emulsions should be supplied earlier and moreaggressivly; Parenteral nutrition support shouldn’t stop too early.The lowest daily caloryintake should be more than100cal/kg.Breast feeding should be advocated and forced topromote in NICU for VLBWI health.