Nutrition practice, compliance to guidelines and postnatal growth in moderately premature babies: the NUTRIQUAL French survey
Identifieur interne : 000160 ( France/Analysis ); précédent : 000159; suivant : 000161Nutrition practice, compliance to guidelines and postnatal growth in moderately premature babies: the NUTRIQUAL French survey
Auteurs : Silvia Iacobelli [France] ; Marianne Viaud ; Alexandre Lapillonne [France] ; Pierre-Yves Robillard [France] ; Jean-Bernard Gouyon [France] ; Francesco Bonsante [France]Source :
- BMC Pediatrics [ 1471-2431 ] ; 2015.
Abstract
The nutritional care provided to moderately premature babies is poorly studied. For a large cohort of such babies, we aimed to describe: nutrition practice intentions, comparison of the intended with the actual practice, compliance of actual practice to current nutrition guidelines, and postnatal growth.
A questionnaire was sent out to 29 neonatal intensive care units in France, in order to address practice intentions. In the same units, retrospective patient’s data were collected to assess actual practice, compliance to nutrition guidelines and infant postnatal growth. The cumulative nutritional deficit during the two first weeks of life was calculated and variables associated with ΔZ-score for weight at 36 weeks postconceptional age/discharge (ΔZ-scorew 36PCA/DC) were analysed by multivariate linear regression.
276 infants born 30 to 33 weeks of gestation were studied. Among them, 76 % received parenteral nutrition on central venous line after birth. On day of life 1 (DOL1), 93 % of infants had parenteral amino acids (AA), at an intake ≥ 1.5 g/kg in 27 % of cases. Lipids were started at ≤ DOL2 in 47 % of infants. There was a divergence between the intended and the actual practice for both AA and lipids intake. The AA and energy cumulative deficit (DOL1 to DOL14) were respectively 10.9 ± 8.3 g/kg and 483 ± 181 kcal/kg. Weight Z-score (mean ± SD) significantly decreased from birth (−0.17 ± 0.88) to 36 weeks PCA/DC (−1.00 ± 0.82) (p < 0.0001), and the extra-uterine growth retardation (EUGR) rate at 36 weeks PCA/DC was 24.2 %. Independent variables associated with ΔZ-scorew 36PCA/DC were AA cumulative intake and DOL of full enteral feeding.
Nutrition intake was not in compliance with recommendations, and the rate of EUGR was considerable in this cohort. Efforts are needed to improve adherence to nutrition guidelines and growth outcome of moderately preterm infants.
Url:
DOI: 10.1186/s12887-015-0426-4
PubMed: 26337814
PubMed Central: 4559914
Affiliations:
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PMC:4559914Le document en format XML
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<author><name sortKey="Robillard, Pierre Yves" sort="Robillard, Pierre Yves" uniqKey="Robillard P" first="Pierre-Yves" last="Robillard">Pierre-Yves Robillard</name>
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<author><name sortKey="Gouyon, Jean Bernard" sort="Gouyon, Jean Bernard" uniqKey="Gouyon J" first="Jean-Bernard" last="Gouyon">Jean-Bernard Gouyon</name>
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<author><name sortKey="Bonsante, Francesco" sort="Bonsante, Francesco" uniqKey="Bonsante F" first="Francesco" last="Bonsante">Francesco Bonsante</name>
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<series><title level="j">BMC Pediatrics</title>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>The nutritional care provided to moderately premature babies is poorly studied. For a large cohort of such babies, we aimed to describe: nutrition practice intentions, comparison of the intended with the actual practice, compliance of actual practice to current nutrition guidelines, and postnatal growth.</p>
</sec>
<sec><title>Methods</title>
<p>A questionnaire was sent out to 29 neonatal intensive care units in France, in order to address practice intentions. In the same units, retrospective patient’s data were collected to assess actual practice, compliance to nutrition guidelines and infant postnatal growth. The cumulative nutritional deficit during the two first weeks of life was calculated and variables associated with ΔZ-score for weight at 36 weeks postconceptional age/discharge (ΔZ-score<sub>w</sub>
36PCA/DC) were analysed by multivariate linear regression.</p>
</sec>
<sec><title>Results</title>
<p>276 infants born 30 to 33 weeks of gestation were studied. Among them, 76 % received parenteral nutrition on central venous line after birth. On day of life 1 (DOL1), 93 % of infants had parenteral amino acids (AA), at an intake ≥ 1.5 g/kg in 27 % of cases. Lipids were started at ≤ DOL2 in 47 % of infants. There was a divergence between the intended and the actual practice for both AA and lipids intake. The AA and energy cumulative deficit (DOL1 to DOL14) were respectively 10.9 ± 8.3 g/kg and 483 ± 181 kcal/kg. Weight Z-score (mean ± SD) significantly decreased from birth (−0.17 ± 0.88) to 36 weeks PCA/DC (−1.00 ± 0.82) (p < 0.0001), and the extra-uterine growth retardation (EUGR) rate at 36 weeks PCA/DC was 24.2 %. Independent variables associated with ΔZ-score<sub>w</sub>
36PCA/DC were AA cumulative intake and DOL of full enteral feeding.</p>
</sec>
<sec><title>Conclusions</title>
<p>Nutrition intake was not in compliance with recommendations, and the rate of EUGR was considerable in this cohort. Efforts are needed to improve adherence to nutrition guidelines and growth outcome of moderately preterm infants.</p>
</sec>
</div>
</front>
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</author>
<author><name sortKey="Bauer, Cr" uniqKey="Bauer C">CR Bauer</name>
</author>
<author><name sortKey="Korones, Sb" uniqKey="Korones S">SB Korones</name>
</author>
<author><name sortKey="Stoll, Bj" uniqKey="Stoll B">BJ Stoll</name>
</author>
<author><name sortKey="Stevenson, Dk" uniqKey="Stevenson D">DK Stevenson</name>
</author>
<author><name sortKey="Papile, La" uniqKey="Papile L">LA Papile</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Fischer, Cj" uniqKey="Fischer C">CJ Fischer</name>
</author>
<author><name sortKey="Maucort Boulch, D" uniqKey="Maucort Boulch D">D Maucort-Boulch</name>
</author>
<author><name sortKey="Essomo Megnier Mbo, Cm" uniqKey="Essomo Megnier Mbo C">CM Essomo Megnier-Mbo</name>
</author>
<author><name sortKey="Remontet, L" uniqKey="Remontet L">L Remontet</name>
</author>
<author><name sortKey="Claris, O" uniqKey="Claris O">O Claris</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Hair, Ab" uniqKey="Hair A">AB Hair</name>
</author>
<author><name sortKey="Blanco, Cl" uniqKey="Blanco C">CL Blanco</name>
</author>
<author><name sortKey="Moreira, Ag" uniqKey="Moreira A">AG Moreira</name>
</author>
<author><name sortKey="Hawthorne, Km" uniqKey="Hawthorne K">KM Hawthorne</name>
</author>
<author><name sortKey="Lee, Ml" uniqKey="Lee M">ML Lee</name>
</author>
<author><name sortKey="Rechtman, Dj" uniqKey="Rechtman D">DJ Rechtman</name>
</author>
<author><name sortKey="Abrams, Sa" uniqKey="Abrams S">SA Abrams</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Zecca, E" uniqKey="Zecca E">E Zecca</name>
</author>
<author><name sortKey="Costa, S" uniqKey="Costa S">S Costa</name>
</author>
<author><name sortKey="Barone, G" uniqKey="Barone G">G Barone</name>
</author>
<author><name sortKey="Giordano, L" uniqKey="Giordano L">L Giordano</name>
</author>
<author><name sortKey="Zecca, C" uniqKey="Zecca C">C Zecca</name>
</author>
<author><name sortKey="Maggio, L" uniqKey="Maggio L">L Maggio</name>
</author>
</analytic>
</biblStruct>
</listBibl>
</div1>
</back>
</TEI>
<affiliations><list><country><li>France</li>
</country>
<region><li>La Réunion</li>
</region>
<settlement><li>Paris</li>
<li>Saint Pierre</li>
</settlement>
</list>
<tree><noCountry><name sortKey="Viaud, Marianne" sort="Viaud, Marianne" uniqKey="Viaud M" first="Marianne" last="Viaud">Marianne Viaud</name>
</noCountry>
<country name="France"><region name="La Réunion"><name sortKey="Iacobelli, Silvia" sort="Iacobelli, Silvia" uniqKey="Iacobelli S" first="Silvia" last="Iacobelli">Silvia Iacobelli</name>
</region>
<name sortKey="Bonsante, Francesco" sort="Bonsante, Francesco" uniqKey="Bonsante F" first="Francesco" last="Bonsante">Francesco Bonsante</name>
<name sortKey="Gouyon, Jean Bernard" sort="Gouyon, Jean Bernard" uniqKey="Gouyon J" first="Jean-Bernard" last="Gouyon">Jean-Bernard Gouyon</name>
<name sortKey="Lapillonne, Alexandre" sort="Lapillonne, Alexandre" uniqKey="Lapillonne A" first="Alexandre" last="Lapillonne">Alexandre Lapillonne</name>
<name sortKey="Lapillonne, Alexandre" sort="Lapillonne, Alexandre" uniqKey="Lapillonne A" first="Alexandre" last="Lapillonne">Alexandre Lapillonne</name>
<name sortKey="Robillard, Pierre Yves" sort="Robillard, Pierre Yves" uniqKey="Robillard P" first="Pierre-Yves" last="Robillard">Pierre-Yves Robillard</name>
</country>
</tree>
</affiliations>
</record>
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