Nutrition practice, compliance to guidelines and postnatal growth in moderately premature babies: the NUTRIQUAL French survey
Identifieur interne : 000498 ( Ncbi/Merge ); précédent : 000497; suivant : 000499Nutrition 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
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Saint Pierre, BP 350 97448 Saint Pierre Cedex, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Centre d’Etudes Périnatales de l’Océan Indien, CHU La Réunion - Saint Pierre, BP 350 97448 Saint Pierre Cedex</wicri:regionArea><placeName><region type="region" nuts="2">La Réunion</region><settlement type="city">Saint Pierre</settlement></placeName></affiliation><affiliation><nlm:aff id="Aff2">Néonatologie, Réanimation Néonatale et Pédiatrique, CHU La Réunion - Saint Pierre, Saint Pierre Cedex, BP 350 97448 France</nlm:aff><wicri:noCountry code="subfield">BP 350 97448 France</wicri:noCountry></affiliation></author><author><name sortKey="Viaud, Marianne" sort="Viaud, Marianne" uniqKey="Viaud M" first="Marianne" last="Viaud">Marianne Viaud</name><affiliation><nlm:aff id="Aff2">Néonatologie, Réanimation Néonatale et Pédiatrique, CHU La Réunion - Saint Pierre, Saint Pierre Cedex, BP 350 97448 France</nlm:aff><wicri:noCountry code="subfield">BP 350 97448 France</wicri:noCountry></affiliation></author><author><name sortKey="Lapillonne, Alexandre" sort="Lapillonne, Alexandre" uniqKey="Lapillonne A" first="Alexandre" last="Lapillonne">Alexandre Lapillonne</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Department of Neonatology, APHP Necker Enfants Malades Hospital, Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of Neonatology, APHP Necker Enfants Malades Hospital, Paris</wicri:regionArea><placeName><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff4">Paris Descartes University, Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris Descartes University, Paris</wicri:regionArea><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Robillard, Pierre Yves" sort="Robillard, Pierre Yves" uniqKey="Robillard P" first="Pierre-Yves" last="Robillard">Pierre-Yves Robillard</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Centre d’Etudes Périnatales de l’Océan Indien, CHU La Réunion - Saint Pierre, BP 350 97448 Saint Pierre Cedex, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Centre d’Etudes Périnatales de l’Océan Indien, CHU La Réunion - Saint Pierre, BP 350 97448 Saint Pierre Cedex</wicri:regionArea><placeName><region type="region" nuts="2">La Réunion</region><settlement type="city">Saint Pierre</settlement></placeName></affiliation><affiliation><nlm:aff id="Aff2">Néonatologie, Réanimation Néonatale et Pédiatrique, CHU La Réunion - Saint Pierre, Saint Pierre Cedex, BP 350 97448 France</nlm:aff><wicri:noCountry code="subfield">BP 350 97448 France</wicri:noCountry></affiliation></author><author><name sortKey="Gouyon, Jean Bernard" sort="Gouyon, Jean Bernard" uniqKey="Gouyon J" first="Jean-Bernard" last="Gouyon">Jean-Bernard Gouyon</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Centre d’Etudes Périnatales de l’Océan Indien, CHU La Réunion - Saint Pierre, BP 350 97448 Saint Pierre Cedex, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Centre d’Etudes Périnatales de l’Océan Indien, CHU La Réunion - Saint Pierre, BP 350 97448 Saint Pierre Cedex</wicri:regionArea><placeName><region type="region" nuts="2">La Réunion</region><settlement type="city">Saint Pierre</settlement></placeName></affiliation><affiliation><nlm:aff id="Aff2">Néonatologie, Réanimation Néonatale et Pédiatrique, CHU La Réunion - Saint Pierre, Saint Pierre Cedex, BP 350 97448 France</nlm:aff><wicri:noCountry code="subfield">BP 350 97448 France</wicri:noCountry></affiliation></author><author><name sortKey="Bonsante, Francesco" sort="Bonsante, Francesco" uniqKey="Bonsante F" first="Francesco" last="Bonsante">Francesco Bonsante</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Centre d’Etudes Périnatales de l’Océan Indien, CHU La Réunion - Saint Pierre, BP 350 97448 Saint Pierre Cedex, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Centre d’Etudes Périnatales de l’Océan Indien, CHU La Réunion - Saint Pierre, BP 350 97448 Saint Pierre Cedex</wicri:regionArea><placeName><region type="region" nuts="2">La Réunion</region><settlement type="city">Saint Pierre</settlement></placeName></affiliation><affiliation><nlm:aff id="Aff2">Néonatologie, Réanimation Néonatale et Pédiatrique, CHU La Réunion - Saint Pierre, Saint Pierre Cedex, BP 350 97448 France</nlm:aff><wicri:noCountry code="subfield">BP 350 97448 France</wicri:noCountry></affiliation></author></analytic><series><title level="j">BMC Pediatrics</title><idno type="eISSN">1471-2431</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><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><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Clark, Rh" uniqKey="Clark R">RH Clark</name></author><author><name sortKey="Thomas, P" uniqKey="Thomas P">P Thomas</name></author><author><name sortKey="Peabody, J" uniqKey="Peabody J">J Peabody</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Embleton, Ne" uniqKey="Embleton N">NE Embleton</name></author><author><name sortKey="Pang, N" uniqKey="Pang N">N Pang</name></author><author><name sortKey="Cooke, Rj" uniqKey="Cooke R">RJ Cooke</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Olsen, Ie" uniqKey="Olsen I">IE Olsen</name></author><author><name sortKey="Richardson, Dk" uniqKey="Richardson D">DK Richardson</name></author><author><name sortKey="Schmid, Ch" uniqKey="Schmid C">CH 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<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Pediatr</journal-id><journal-id journal-id-type="iso-abbrev">BMC Pediatr</journal-id><journal-title-group><journal-title>BMC Pediatrics</journal-title></journal-title-group><issn pub-type="epub">1471-2431</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26337814</article-id><article-id pub-id-type="pmc">4559914</article-id><article-id pub-id-type="publisher-id">426</article-id><article-id pub-id-type="doi">10.1186/s12887-015-0426-4</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>Nutrition practice, compliance to guidelines and postnatal growth in moderately premature babies: the NUTRIQUAL French survey</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Iacobelli</surname><given-names>Silvia</given-names></name><address><phone>+262 262 35 95 78</phone><email>silvia.iacobelli@chu-reunion.fr</email></address><xref ref-type="aff" rid="Aff1"></xref><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Viaud</surname><given-names>Marianne</given-names></name><address><email>marianne.viaud@chu-reunion.fr</email></address><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Lapillonne</surname><given-names>Alexandre</given-names></name><address><email>alexandre.lapillonne@nck.aphp.fr</email></address><xref ref-type="aff" rid="Aff3"></xref><xref ref-type="aff" rid="Aff4"></xref></contrib><contrib contrib-type="author"><name><surname>Robillard</surname><given-names>Pierre-Yves</given-names></name><address><email>pierre-yves.robillard@chu-reunion.fr</email></address><xref ref-type="aff" rid="Aff1"></xref><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Gouyon</surname><given-names>Jean-Bernard</given-names></name><address><email>jean-bernard.gouyon@chu-reunion.fr</email></address><xref ref-type="aff" rid="Aff1"></xref><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Bonsante</surname><given-names>Francesco</given-names></name><address><email>francesco.bonsante@chu-reunion.fr</email></address><xref ref-type="aff" rid="Aff1"></xref><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author"><collab>for the NUTRIQUAL group</collab></contrib><aff id="Aff1"><label></label>Centre d’Etudes Périnatales de l’Océan Indien, CHU La Réunion - Saint Pierre, BP 350 97448 Saint Pierre Cedex, France</aff><aff id="Aff2"><label></label>Néonatologie, Réanimation Néonatale et Pédiatrique, CHU La Réunion - Saint Pierre, Saint Pierre Cedex, BP 350 97448 France</aff><aff id="Aff3"><label></label>Department of Neonatology, APHP Necker Enfants Malades Hospital, Paris, France</aff><aff id="Aff4"><label></label>Paris Descartes University, Paris, France</aff></contrib-group><pub-date pub-type="epub"><day>3</day><month>9</month><year>2015</year></pub-date><pub-date pub-type="pmc-release"><day>3</day><month>9</month><year>2015</year></pub-date><pub-date pub-type="collection"><year>2015</year></pub-date><volume>15</volume><elocation-id>110</elocation-id><history><date date-type="received"><day>7</day><month>4</month><year>2015</year></date><date date-type="accepted"><day>20</day><month>8</month><year>2015</year></date></history><permissions><copyright-statement>© Iacobelli et al. 2015</copyright-statement><license license-type="OpenAccess"><license-p><bold>Open Access</bold>This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>) applies to the data made available in this article, unless otherwise stated.</license-p></license></permissions><abstract id="Abs1"><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></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>Newborn</kwd><kwd>Survey</kwd><kwd>Feeding</kwd><kwd>Calories</kwd><kwd>Standards</kwd><kwd>Growth retard</kwd><kwd>Parenteral and enteral intake</kwd></kwd-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Author(s) 2015</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc><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>Pour manipuler ce document sous Unix (Dilib)
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