Nutrition Support And Weight Growth Velocity Of Premature Infants In Hospital

Objective:This study aimed to evaluate the association between weight growth velocity and nutrition intake of premature infants in neonatal intensive care unit(NICU)in our hospital,and to evaluate the effect of nutrition support on extrauterine growth restriction(EUGR)in premature infants.And we would like to improve the clinical practice of the nutrition support.Methods: A prospective study was performed in Xinhua Hospital from February 2017 to June 2019,and a total of 501 premature infants were enrolled.Nutrition support was according to CSPEN guidelines for nutrition support in neonates.Growth velocity(GV),parenteral nutrition(PN)and enteral nutrition(EN)intake were analyzed.There were two sections in this study.1、Infants were divided into four groups according to birth weights(BW):(1)BW≥2500g(n=59),(2)2000g≤BW<2500g(n=175),(3)1500g≤BW<2000g(n=155)and(4)BW<1500g(n=112).Nutrition intake and growth velocity(GV)were analyzed in these four groups.We divided the infants into five groups according to PN energy ratio of total energy(90~120 kcal/kg/d,the standard was 105 kcal/kg/d).Group A((80%<PN ratio≤100%),Group B(60%<PN ratio≤80%),Group C(40%<PN ratio≤60%),Group D(20%<PN ratio≤40%),Group E(0<PN ratio≤20%).Nutrition intake and GV were analyzed in these five groups 2、Infants were divided into EUGR group and non-EUGR group.Baseline characteristics,nutritional support,weight growth velocity,complications and risk factors of EUGR were analyzed.Results: 1.Evaluation of Nutrition intake and GV of premature infants with different birth weights and different PN ratio.VLBWI had the highest average of total energy intake 104.5±10.9kcal/kg/d(P<0.001),and the highest average of GV 10.8±2.2g/kg/d(P<0.001).In group C(40%<PN ratio≤60%),EN energy intake was at an average of 28.0(19.4-36.7)kcal/kg/d,total energy intake was at an average of 81.8(72.6-90.8)kcal/kg/d,GV was at an average of 1.0±12.4g/kg/d.In group E(0<PN ratio≤20%),EN energy intake was at an average of 96.4(81.6-103.2)kcal/kg/d,totally energy intake was at an average of 114.3(99.2-123.5)kcal/kg/d and GV was at an average of 9.9(2.1-16.9)g/kg/d.2.Premature infants of EUGR group and non-EUGR group.The incidence of EUGR in premature infants was 46.3%.The average of energy intake in week 1,2,5,6,7,8,9,10 after birth in EUGR group were lower than non-EUGR group(P<0.05),and the average of GV in week 3,7,8,9,10 after birth in EUGR group were lower than non-EUGR group(P<0.05).EUGR group had significantly higher incidence of Necrotizing enterocolitis(NEC)and bronchopulmonary dysplasia(BPD)than non-EUGR group(P<0.05).The logistic regression analysis showed that BW,duration of PN and total energy intake were negatively correlated with EUGR,days to start EN,BPD and NEC were positively correlated with EUGR.Conclusion: Infants with birth weight below 1500 g had the highest energy intake and their growth velocity was also the highest.The decrease of PN was much faster than EN advance in group C(40%<PN ratio≤60%)and whose growth velocity was lowest.Therefore we should pay more attention to keep more total energy intake during reduction of PN in premature infants.The incidence of EUGR in premature infants was still high.Inadequate nutrition intake was one of the cause of EUGR.NEC and BPD increased in EUGR group.The risk factors of EUGR included the low birth weight,short-term PN,delay to start EN,insufficient total energy intake,BPD and NEC.