Document Detail


Intersite differences in weight growth velocity of extremely premature infants.
MedLine Citation:
PMID:  12456909     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To explain differences in weight growth velocity of extremely premature infants among 6 level III neonatal intensive care units (NICUs). METHODS: In 6 NICUs, we studied 564 infants, stratified by gestational age (GA), who were first admissions, survivors, <30 weeks' GA at birth, and in the NICU at least 16 days. Case mix (eg, birth weight, GA, race, illness severity, prenatal steroids), exposure to medical practices/complications (eg, respiratory support, postnatal steroids, necrotizing enterocolitis, infection), and nutritional intake (kcal/kg/d and protein in g/kg/d) were collected and used to predict weight growth velocity between day 3 and day 28 (or discharge, if transferred early) in multiple linear regression models. RESULTS: Weight growth velocities varied significantly among the 6 NICUs. Adjustment for case mix and medical factors explained little of this variability, but additional control for calorie and especially protein intake accounted for much of the intersite variability. For the average infant, adjusted growth velocity ranged from 10.4 to 14.3 g/kg/d among the sites studied. The final predictive model, including case mix and medical and nutritional factors, explained 53% of the overall variance in growth velocity. Prolonged (> or =15 days) exposure to postnatal steroids and greater severity of illness both decreased growth velocity. The model predicted that adding 1 g/kg/d protein to the mean intake for our sample would increase growth by 4.1 g/kg/d. CONCLUSIONS: Variation in nutrition explained much of the difference in growth among the NICUs studied. Mean intake of calories and protein failed to meet recommended levels, and the average growth in only 1 NICU approximated intrauterine growth standards. Increasing nutritional intake into the recommended ranges, in particular of protein, may increase growth of extremely premature infants up to or above intrauterine rates.
Authors:
Irene E Olsen; Douglas K Richardson; Christopher H Schmid; Lynne M Ausman; Johanna T Dwyer
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Pediatrics     Volume:  110     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2002-11-28     Completed Date:  2002-12-11     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1125-32     Citation Subset:  AIM; IM    
Affiliation:
Departments of Nutrition, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. olseni@email.chop.edu
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MeSH Terms
Descriptor/Qualifier:
Body Weight / physiology
Cohort Studies
Diagnosis-Related Groups
Enteral Nutrition / statistics & numerical data
Enterocolitis, Necrotizing / physiopathology,  therapy
Humans
Infant, Newborn
Infant, Premature / growth & development*
Infant, Premature, Diseases / physiopathology,  therapy
Infection / physiopathology,  therapy
Intensive Care Units, Neonatal / statistics & numerical data*
Length of Stay / statistics & numerical data
Linear Models
New England
Nutritional Status / physiology
Nutritional Support / methods,  statistics & numerical data
Parenteral Nutrition / statistics & numerical data
Retrospective Studies
Steroids / administration & dosage
Grant Support
ID/Acronym/Agency:
R01 HS07015/HS/AHRQ HHS
Chemical
Reg. No./Substance:
0/Steroids

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