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Assessment of early nutritional intake in preterm infants with bronchopulmonary dysplasia: a cohort study

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Abstract

This cohort study evaluated the nutritional supply in 78 very preterm newborns, with 20.5% developing bronchopulmonary dysplasia (BPD). This work aimed to evaluate the nutritional intake and the calorie/protein ratio received in the first 4 weeks of life. Anthropometric measures at birth and term age, the weight at each of the first 4 weeks of life, and the feeding practices were registered. The mean gestational age and birth weight were lower in those who developed BPD. At term age, head circumference and length Z-scores were significantly lower in newborns with BPD, who started enteral feeding and reached full diet later, staying longer in parenteral nutrition. The protein rate received by all newborns was similar, whether developing BPD or not, but those who developed BPD received significantly lower fluid volume and calorie rates after the second week. The daily calorie/protein ratio (30 kcal/1-g protein) was reached by 88.7% of the newborns who did not develop BPD in the third week, with those who developed BPD receiving less than this ratio until the second week, persisting in 56.3% of them on the fourth week.

Conclusion: A calorie/protein ratio below that recommended for growth was found in preterm newborns who developed BPD, and providing nutrition for these newborns remains a challenge.

What is Known:

• The importance of preterm newborn nutrition is well known.

• Early nutritional support may avoid severe BPD.

What is New:

• Newborns who developed BPD received a calorie/protein ratio below that recommended for preterm newborns’ growth during the first 2 weeks of life, lasting until the fourth week in most of these newborns.

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Data availability

The datasets during or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

APGAR:

Vitality score at birth (Apgar)

BPD:

Bronchopulmonary dysplasia

CPAP:

Continuous positive airway pressure

ESPGHAN:

European Society for Paediatric Gastroenterology Hepatology and Nutrition

IFF/FIOCRUZ:

Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira

IMV:

Intermittent mandatory ventilation

NICU:

Neonatal intensive care unit

NIV:

Noninvasive ventilation

PDA:

Patent ductus arteriosus

RDS:

Respiratory distress syndrome

TPN:

Total parenteral nutrition

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Authors and Affiliations

  1. Neonatology, Instituto Nacional da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, FIOCRUZ, Av. Rui Barbosa, 760, Flamengo, RJ, CEP 22250-020, Rio de Janeiro, Brazil

    Brunna G Milanesi, Paola AT Lima, Letícia D Villela, Amanda S Martins, Saint Clair S Gomes-Junior, Maria E L Moreira & Maria Dalva Barbosa Baker Méio

  2. Post-graduation on Applied Clinical Research, Instituto Nacional da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil

    Saint Clair S Gomes-Junior, Maria E L Moreira & Maria Dalva Barbosa Baker Méio

  3. Rio de Janeiro, Brazil

    Maria Dalva Barbosa Baker Méio

Authors
  1. Brunna G Milanesi
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  2. Paola AT Lima
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  4. Amanda S Martins
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Contributions

All authors contributed to the study conception and design. BG Milanesi contributed with the conception of the project, data collection, analysis, interpretation of the results, and preparation of the manuscript; PAT Lima contributed with data collection, interpretation of the results, and preparation of the manuscript; LD Villela and MEL Moreira contributed with interpretation of the results and revision of the manuscript; AS Martins contributed with the conception of the project, interpretation of the results, and revision of the manuscript; SCS Gomes Junior contributed with the statistical analysis of the data, interpretation of the results, and revision of the manuscript; MDBB Méio contributed with the conception of the project, analysis, interpretation of the results, and preparation of the manuscript.

Corresponding author

Correspondence to Maria Dalva Barbosa Baker Méio.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval and consent to participate

This study was performed in line with the Declaration of Helsinki principles by all the authors and the Ethics Committee of Instituto Fernandes Figueira under opinion number CAAE: 50243615.0.0000.5269.

Informed consent

All the parents/guardians of the children included in this research signed the informed consent for their son/daughter’s participation in the study.

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All the authors have approved the submitted version and have agreed to be personally accountable for the authors’ contributions and ensure that questions related to the accuracy or integrity of any part of the work, even the ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature.

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Communicated by Gregorio Paolo Milani

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Milanesi, B.G., Lima, P.A., Villela, L.D. et al. Assessment of early nutritional intake in preterm infants with bronchopulmonary dysplasia: a cohort study. Eur J Pediatr 180, 1423–1430 (2021). https://doi.org/10.1007/s00431-020-03912-0

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  • DOI: https://doi.org/10.1007/s00431-020-03912-0

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