Early parenteral nutrition is associated with improved growth in very low birth weight infants: a retrospective study

René Liang Shen, Christian Ritz, Yanqi Li, Per Torp Sangild, Ping Ping Jiang*

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

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.

Original languageEnglish
Article number325829
JournalArchives of Disease in Childhood: Fetal and Neonatal Edition
ISSN1359-2998
DOIs
Publication statusE-pub ahead of print - 2024

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