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Optimising enteral nutrition in growth restricted extremely preterm neonates- a difficult proposition.
MedLine Citation:
PMID:  25302862     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract Optimising enteral nutrition of extremely preterm neonates (EP: Gestation <28 weeks) with intrauterine growth restriction (IUGR) has always been difficult considering their higher risk of necrotising enterocolitis (NEC), and frequency of feed intolerance. Aim: To evaluate the nutritional outcomes in EP neonates with IUGR. Methods: Data on demographic characteristics, feeding details (e.g. type of milk, postnatal age at start), and outcomes to discharge or death were collected from the medical notes for all EP neonates, who survived first 72 hours of life, between January 2009 and December 2010. A standardised feeding protocol was followed during the study period. Results: 38/220 (17.3%) EP neonates admitted during the study period had IUGR. The mean (IQR) age at start of minimal enteral nutrition [7 (5-10) vs. 5 (4-8) days, p=0.005), and nutritional (1 ml/2hourly) feeds [12 (8-15) vs. 9 (7-13) days, p=0.034] was significantly delayed in IUGR compared to non-IUGR neonates. IUGR neonates reached full enteral feeds (150ml/kg/day) at a significantly late median (IQR) postnatal age [32 (21-40) vs. 24 (17-31) days, p=0.009), taking longer time to achieve this milestone [20(15-34) vs. 16 (12-24) days, p=0.008). The incidence of postnatal growth restriction was significantly higher in IUGR vs non-IUGR (73 % vs. 45%, p=0.003) neonates. The incidence of ≥Stage II NEC was low [18/220 (8.1%)] to make valid statistical comparisons. Conclusion: Optimising enteral nutrition in growth restricted extremely preterm neonates is difficult using the current strategies for enteral nutrition.
Authors:
P Shah; E Nathan; D Doherty; S Patole
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-10-10
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  -     ISSN:  1476-4954     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2014 Oct 
Date Detail:
Created Date:  2014-10-10     Completed Date:  -     Revised Date:  2014-10-11    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-13     Citation Subset:  -    
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