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Impact of introducing a standardized nutrition protocol on very premature infants’ growth and morbidity

BACKGROUND: Inappropriate nutritional intake in premature infants may be responsible for postnatal growth restriction (PGR) and adverse long-term outcomes. OBJECTIVE: We evaluated the impact of an updated nutrition protocol on very premature infants’ longitudinal growth and morbidity, and secondly t...

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Autores principales: Wittwer, Apolline, Hascoët, Jean-Michel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7241817/
https://www.ncbi.nlm.nih.gov/pubmed/32437423
http://dx.doi.org/10.1371/journal.pone.0232659
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author Wittwer, Apolline
Hascoët, Jean-Michel
author_facet Wittwer, Apolline
Hascoët, Jean-Michel
author_sort Wittwer, Apolline
collection PubMed
description BACKGROUND: Inappropriate nutritional intake in premature infants may be responsible for postnatal growth restriction (PGR) and adverse long-term outcomes. OBJECTIVE: We evaluated the impact of an updated nutrition protocol on very premature infants’ longitudinal growth and morbidity, and secondly the compliance to this new protocol. DESIGN: All infants born between 26–32 weeks gestation (GA) were studied retrospectively during two 6-month periods before (group 1) and after (group 2) the introduction of an optimized nutrition protocol, in a longitudinal comparative analysis. RESULTS: 158 infants were included; 72 before and 86 after the introduction of the protocol (Group 1: (mean±SD) birthweight (BW) 1154±276 g, GA 29.0±1.4 weeks; Group 2: BW 1215±332 g, GA 28.9±1.7 weeks). We observed growth improvement in Group 2 more pronounced in males (weight z-score) at D42 (−1.688±0.758 vs. −1.370±0.762, p = 0.045), D49 (−1.696±0.776 vs. −1.370±0.718, p = 0.051), D56 (−1.748±0.855 vs. −1.392±0.737, p = 0.072), D63 (−1.885±0.832 vs. −1.336±0.779 p = 0.016), and D70 (−2.001±0.747 vs. −1.228±0.765 p = 0.004). There was no difference in females or in morbidities between the groups. We observed low compliance to the protocol in both groups: similar energy intake but higher lipid intake in Group 1 and higher protein intake in Group 2. CONCLUSION: The quality of nutritional care with a strictly-defined protocol may significantly improve weight gain for very preterm infants. As compliance remained low, an educational reinforcement is needed to prevent PGR. CLINICAL TRIAL REGISTRATION: This retrospective study was registered by ClinicalTrials.gov under number NCT03217045, and by the CNIL (Commission Nationale de l’Informatique et des Libertés) under study number R2015-1 for the Maternity of the CHRU of Nancy.
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spelling pubmed-72418172020-06-03 Impact of introducing a standardized nutrition protocol on very premature infants’ growth and morbidity Wittwer, Apolline Hascoët, Jean-Michel PLoS One Research Article BACKGROUND: Inappropriate nutritional intake in premature infants may be responsible for postnatal growth restriction (PGR) and adverse long-term outcomes. OBJECTIVE: We evaluated the impact of an updated nutrition protocol on very premature infants’ longitudinal growth and morbidity, and secondly the compliance to this new protocol. DESIGN: All infants born between 26–32 weeks gestation (GA) were studied retrospectively during two 6-month periods before (group 1) and after (group 2) the introduction of an optimized nutrition protocol, in a longitudinal comparative analysis. RESULTS: 158 infants were included; 72 before and 86 after the introduction of the protocol (Group 1: (mean±SD) birthweight (BW) 1154±276 g, GA 29.0±1.4 weeks; Group 2: BW 1215±332 g, GA 28.9±1.7 weeks). We observed growth improvement in Group 2 more pronounced in males (weight z-score) at D42 (−1.688±0.758 vs. −1.370±0.762, p = 0.045), D49 (−1.696±0.776 vs. −1.370±0.718, p = 0.051), D56 (−1.748±0.855 vs. −1.392±0.737, p = 0.072), D63 (−1.885±0.832 vs. −1.336±0.779 p = 0.016), and D70 (−2.001±0.747 vs. −1.228±0.765 p = 0.004). There was no difference in females or in morbidities between the groups. We observed low compliance to the protocol in both groups: similar energy intake but higher lipid intake in Group 1 and higher protein intake in Group 2. CONCLUSION: The quality of nutritional care with a strictly-defined protocol may significantly improve weight gain for very preterm infants. As compliance remained low, an educational reinforcement is needed to prevent PGR. CLINICAL TRIAL REGISTRATION: This retrospective study was registered by ClinicalTrials.gov under number NCT03217045, and by the CNIL (Commission Nationale de l’Informatique et des Libertés) under study number R2015-1 for the Maternity of the CHRU of Nancy. Public Library of Science 2020-05-21 /pmc/articles/PMC7241817/ /pubmed/32437423 http://dx.doi.org/10.1371/journal.pone.0232659 Text en © 2020 Wittwer, Hascoët http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Wittwer, Apolline
Hascoët, Jean-Michel
Impact of introducing a standardized nutrition protocol on very premature infants’ growth and morbidity
title Impact of introducing a standardized nutrition protocol on very premature infants’ growth and morbidity
title_full Impact of introducing a standardized nutrition protocol on very premature infants’ growth and morbidity
title_fullStr Impact of introducing a standardized nutrition protocol on very premature infants’ growth and morbidity
title_full_unstemmed Impact of introducing a standardized nutrition protocol on very premature infants’ growth and morbidity
title_short Impact of introducing a standardized nutrition protocol on very premature infants’ growth and morbidity
title_sort impact of introducing a standardized nutrition protocol on very premature infants’ growth and morbidity
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7241817/
https://www.ncbi.nlm.nih.gov/pubmed/32437423
http://dx.doi.org/10.1371/journal.pone.0232659
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