TY - JOUR
T1 - Early parenteral nutrition is associated with improved growth in very low birth weight infants
T2 - a retrospective study
AU - Shen, René Liang
AU - Ritz, Christian
AU - Li, Yanqi
AU - Sangild, Per Torp
AU - Jiang, Ping-Ping
N1 - © Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2024/8/16
Y1 - 2024/8/16
N2 - OBJECTIVE: To assess the association between early initiation of parenteral nutrition (PN) and body growth in preterm infants with very low birth weight (VLBW).DESIGN: Causal inference analysis with confounders preselected by causal diagram based on the NeoNutriNet cohort containing data of infants born between 2011 and 2014 from 13 hospitals from 5 continents.PATIENTS: Neonates with birth weight ≤1500 g.INTERVENTIONS: PN initiated within the first day of life (early PN) versus within day 2-5 (delayed PN).MAIN OUTCOME MEASURES: The primary outcome was body weight z-scores at postmenstrual age (PMA) 36 weeks or early discharge or death, whichever comes first (WT z-score END). Secondary outcomes included WT z-scores at week 1 and 4 of life (WT z-scores CA1 and CA4), corresponding growth velocities (GVs), mortality and incidence of necrotising enterocolitis (NEC), and duration and episodes of antibiotic treatment.RESULTS: In total, 2151 infants were included in this study and 2008 infants were in the primary outcome analysis. Significant associations of early PN were found with WT z-score END (adjusted mean difference, 0.14 (95% CI 0.05 to 0.23)), CA4 (β, 0.09 (0.04 to 0.14)) and CA1 (0.04 (0.01 to 0.08)), and GV PMA 36 weeks (1.02 (0.46 to 1.58)) and CA4 (1.03 (0.56 to 1.49), all p<0.001), but not with GV CA1 (p>0.05). No significant associations with mortality, incidence of NEC or antibiotic use was found (all p>0.05).CONCLUSIONS: For VLBW infants, PN initiated within the first day of life is associated with improved in-hospital growth.
AB - OBJECTIVE: To assess the association between early initiation of parenteral nutrition (PN) and body growth in preterm infants with very low birth weight (VLBW).DESIGN: Causal inference analysis with confounders preselected by causal diagram based on the NeoNutriNet cohort containing data of infants born between 2011 and 2014 from 13 hospitals from 5 continents.PATIENTS: Neonates with birth weight ≤1500 g.INTERVENTIONS: PN initiated within the first day of life (early PN) versus within day 2-5 (delayed PN).MAIN OUTCOME MEASURES: The primary outcome was body weight z-scores at postmenstrual age (PMA) 36 weeks or early discharge or death, whichever comes first (WT z-score END). Secondary outcomes included WT z-scores at week 1 and 4 of life (WT z-scores CA1 and CA4), corresponding growth velocities (GVs), mortality and incidence of necrotising enterocolitis (NEC), and duration and episodes of antibiotic treatment.RESULTS: In total, 2151 infants were included in this study and 2008 infants were in the primary outcome analysis. Significant associations of early PN were found with WT z-score END (adjusted mean difference, 0.14 (95% CI 0.05 to 0.23)), CA4 (β, 0.09 (0.04 to 0.14)) and CA1 (0.04 (0.01 to 0.08)), and GV PMA 36 weeks (1.02 (0.46 to 1.58)) and CA4 (1.03 (0.56 to 1.49), all p<0.001), but not with GV CA1 (p>0.05). No significant associations with mortality, incidence of NEC or antibiotic use was found (all p>0.05).CONCLUSIONS: For VLBW infants, PN initiated within the first day of life is associated with improved in-hospital growth.
KW - Enterocolitis, Necrotizing/epidemiology
KW - Female
KW - Gestational Age
KW - Humans
KW - Infant, Newborn
KW - Infant, Premature/growth & development
KW - Infant, Very Low Birth Weight/growth & development
KW - Male
KW - Parenteral Nutrition/methods
KW - Retrospective Studies
UR - http://www.scopus.com/inward/record.url?scp=85183293540&partnerID=8YFLogxK
U2 - 10.1136/archdischild-2023-325829
DO - 10.1136/archdischild-2023-325829
M3 - Journal article
C2 - 38212106
SN - 1359-2998
VL - 109
SP - 495
EP - 499
JO - Archives of Disease in Childhood: Fetal and Neonatal Edition
JF - Archives of Disease in Childhood: Fetal and Neonatal Edition
IS - 5
ER -