Interneonatal intensive care unit variation in growth rates and feeding practices in healthy moderately premature infants

被引：71

作者：

Blackwell M.T. ^{[1
,9
]}

Eichenwald E.C. ^{[3
,4
]}

McAlmon K. ^{[4
,5
]}

Petit K. ^{[2
]}

Linton P.T. ^{[6
]}

McCormick M.C. ^{[4
,7
,8
]}

Richardson D.K. ^{[4
,7
,8
]}

机构：

[1] Department of Pediatrics, Lowell General Hospital, Lowell, MA

[2] Division of Neonatology, The Floating Hospital for Children at New England Medical Center, Tufts University School of Medicine, Boston, MA

[3] Newborn Medicine, Brigham and Women's Hospital, Boston, MA

[4] Harvard Newborn Medicine, Children's Hospital and Harvard Medical School, Boston, MA

[5] Department of Pediatrics, Winchester Hospital, Winchester, MA

[6] Department of Nursing, Patient Care Services, Massachusetts General Hospital, Boston, MA

[7] Department of Neonatology, Beth Israel Deacones Medical Center, Boston, MA

[8] Department of Maternal and Child Health, Harvard School of Public Health, Boston, MA

[9] Newton, MA 02462

来源：

Journal of Perinatology | 2005年 / 25卷 / 7期

关键词：

D O I：

10.1038/sj.jp.7211302

中图分类号：

学科分类号：

摘要：

Background: Variation in care and outcomes of very low birth weight infants (VLBW) in neonatal intensive care units (NICU) has been widely reported in the past decade. Less is known about care provided to healthy premature infants born between 30 and 35 weeks gestational age (GA). We have previoulsy reported inter-NICU variation in discharge (D/C) timing and achievement of maturational milestones in this population. Objective: To compare inter-NICU growth outcomes and feeding practices in healthy, moderately premature infants. Methods: Records of 450 infants, 30 to 35 weeks gestation, without medical or surgical complications, and consecutively discharged from 15 Massachussets NICUs (nine Level II and six Level III) were reviewed. Final analyses included 382 infants with hospital length of stay >6 days (d). Results: GA at birth and birth weight (BW) were 33.2 weeks (SD 1.2) and 2024 g (389). Mean Z-score decreased 0.67z (0.37) from birth to D/C. Weight loss from birth to 7 d averaged 4.0%. Mean growth velocity from 7 d to D/C was 13.3 g/k/d (5.2) with net growth velocity of 5.5 g/k/d (5.6). Mean net growth velocity ranged from 0.1 to 8.4 g/k/d (p<0.001) among study NICUs. Time of initiation, rate of advancement and caloric density of feedings also varied significantly between NICUs. Conclusion: Mean NICU growth velocity of healthy, moderately premature infants did not achieve in utero growth standards. There was significant inter-NICU variation in growth outcomes and feeding practices. Further study is needed to identify practices associated with better growth in this healthy moderately premature infant population. © 2005 Nature Publishing Group All rights reserved.

引用

页码：478 / 485

页数：7

共 23 条

[1] Morley R., Lucas A., Randomized diet in the neonatal period and growth performance until 7.5-8y of age in preterm children, Am. J. Clin. Nutr., 71, 3, pp. 822-828, (2000)
[2] Gordon N., Nutrition and cognitive function, Brain Dev., 19, 3, pp. 165-170, (1997)
[3] Cooper P.A., Rothberg A.D., Davies V.A., Horn J., Vogelman L., Three year growth and developmental follow-up of very low birth weight infants fed own mother's milk, a premature infant formula, or one of two standard formulas, J. Pediatr. Gastroenterol. Nutr., 8, 3, pp. 348-354, (1989)
[4] Georgieff M.K., Hoffman J.S., Pereira G.R., Bernbaum J., Hoffman-Williamson M., Effect of caloric deprivation on head growth and 1 year developmental status in preterm infants, J. Pediatr., 107, 4, pp. 581-587, (1985)
[5] Nutritional needs of low birth weight infants, Pediatrics, 75, pp. 976-986, (1985)
[6] Clark R.H., Thomas P., Peabody J., Extrauterine growth restriction remains a serious problem in prematurely born neonates, Pediatrics, 111, pp. 986-990, (2003)
[7] Lemons J.A., Bauer C.R., Oh W., Et al., Very low birth weight outcomes of the National Institute of Child Health and Human Development Neonatal Research Network January 1995 through December 1996. NICHD Neonatal Research Network, Pediatrics, 107, 1, (2001)
[8] Bloom B.T., Mulligan J., Arnold C., Et al., Improving growth of very low birth weight infants in the first 28 days, Pediatrics, 112, 1 PART 1, pp. 8-14, (2003)
[9] Lee S.K., McMillan D.D., Ohlsson A., Et al., Variations in practice and outcomes in the Canadian NICU network: 1996-1997, Pediatrics, 106, 5, pp. 1070-1079, (2000)
[10] Horbar J.D., Badger G.J., Lewit E.M., Rogowski J., Shiono P.H., Hospital and patient characteristics associated with variation in 28-day mortality rates for very low birth weight infants. Vermont Oxford Network, Pediatrics, 99, 2, pp. 149-156, (1997)

← 1 2 3 →