Peculiarities of development of deep-preterm infants by 12 months of adjusted age, depending on the rate of escalating enteral nutrition in the early neonatal period
Background. Results of numerous studies have shown the advantages of fast increase in the volume of enteral nutrition (>25 ml/kg/day) in very premature infants in the early neonatal period with regard to the slow one (<25 ml/kg/day). Such tactics has demonstrated potential for decrease in postnatal growth retardation in the majority of infants with very low birth weight. Long-term outcomes of physical and psychomotor development are studied poorly. Objective. To assess the influence of enteral nutrition (EN) pace in the early neonatal period on physical and psychomotor development of extremely premature infants during first 12 corrected months. Materials and methods. The study dealt with extremely premature infants that were born at the age of up to 31 weeks of gestation and had body of up to 1,500 grams. The rate of EN increase was more than 25 ml/kg/day in group 1, in group two – less than 25 ml/kg/day. Physical development was assessed in different age periods according to centile curves, also routine neurological examination with assessment of psychomotor development (PMD) according to Griffiths R. mental development scale (1954) was carried out. Results. EN of more than 25 ml/kg/day in the early neonatal period contributes to higher indications of body mass, body length and head circumference, as well as fast pace of body mass gain from the moment of birth and after discharge, during first 12 corrected months of life. All this positively correlates with the results of PMD assessment. According to the results of the study, the number of studied infants that caught up with passport age in development already by 12±0.5 months of corrected age (CA) was definitely higher in the group, where scheme of EN with fast rate of increase was used in the early neonatal period. Conclusion. Scheme of EN with fast rate of increase in volume (>25 ml/kg/day) in the early neonatal period in very premature children that were born with body mass of up to 1,500 grams contributes to higher indicators of body mass, body length and head circumference, as well as fast pace of body mass gain from the moment of birth and after discharge, during first 12 corrected months of life. By 12 months of CA the percentage of infants, whose PMD corresponded to passport age, was definitely higher than in the group with fast increase in EN in the early neonatal period than in the group with slow increase (р=0.005). Thus the influence of increase rate of EN on PMD during first 12 months of CA is determined.Degtyareva AV, Talvirskaya VM, Amirkhanova D.Yu., Naragan M.V., Ionov O.V., Kukhartseva M.V.
Keywords
premature infants
very low birth weight
enteral nutrition
psychomotor development
References
1. van Goudoever J.B. Nutrition for preterm infants: 75 years of history. Ann. Nutr. Metab. 2018; 72(Suppl.3): 25-31.
2. Kumar RK., Singhal A., Vaidya U., Banerjee S., Anwar F., Rao S. Optimizing nutrition in preterm low birth weight infants — consensus summary. Front. Nutr. 2017; 4: 20.
3. Sirch M., Poryo M., Butte M., Lindner U., Gortner L., Zemlin M. et al. Parenterale Ernährung bei Frühgeborenen mit einem Geburtsgewicht <1500 g: eine systematische Zentrumsanalyse und Vergleich mit publizierten Leitlinien. Springer-Verlag; 2017.
4. Agostoni C., Buonocore G., Carnielli V.P., De Curtis M., Darmaun D., Decsi T. et al. Enteral nutrient supply for preterm infants: commentary from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. J. Pediatr. Gastroenterol. Nutr. 2010; 50(1): 85-9.
5. Klingenberg C., Embleton N.D., Jacobs S.E., O’Connell L.A., Kuschel C.A. Enteral feeding practices in very preterm infants: an international survey. Arch. Dis. Child. Fetal Neonatal Ed. 2011; 97(1): F56-61.
6. Henderson G., Craig S., Brocklehurst P., McGuire W. Enteral feeding regimens and necrotising enterocolitis in preterm infants: a multicentre case-control study. Arch. Dis. Child. Fetal Neonatal Ed. 2009; 94(2): F120-3.
7. Morgan J., Young L., McGuire W. Slow advancement of enteral feed volumes to prevent necrotising enterocolitis in very low birth weight infants. Cochrane Database Syst. Rev. 2014; (12): CD001241.
8. Morgan J., Young L., McGuire W. Slow advancement of enteral feed volumes to prevent necrotising enterocolitis in very low birth weight infants. Cochrane Database Syst. Rev. 2015; (10): CD001241.
9. Morgan J., Young L., McGuire W. Slow advancement of enteral feed volumes to prevent necrotising enterocolitis in very low birth weight infants. Cochrane Database Syst. Rev. 2013; (3): CD001241.
10. Belfort M.B., Rifas-Shiman S.L., Sullivan T., Collins C.T., McPhee A.J., Ryan P. et al. Infant growth before and after term: effects on neurodevelopment in preterm infants. Pediatrics. 2011; 128(4): e899-906.
11. Ионов О.В., Балашова Е.Н., Ленюшкина А.Л., Киртбая А.Р., Кухарцева М.В., Зубков В.В. Сравнение двух стартовых схем — быстрого и медленного увеличения объема энтерального питания у новорожденных с очень низкой массой тела в условиях отделения реанимации и интенсивной терапии. Неонатология: новости, мнения, обучение. 2015; 4: 73-81. [Ionov O.V., Balashova E.N., Lenyushkina A.L., Kirtbaya A.R., Kukhartseva M.V., Zubkov V.V. Comparison of the two starting schemes - rapid and slow increase in enteral feeding in very low birth weight infants in intensive care units. Neonatology: news, opinions, training. 2015; 4: 73-81. (in Russian)]
12. Initiating and progressing enteral feeds. London: Imperial College Healthcare NHS Trust Division of Neonatology; 2012.
13. Belfort M.B., Martin C.R., Smith V.C., Gillman M.W., McCormick M.C. Infant weight gain and school-age blood pressure and cognition in former preterm infants. Pediatrics. 2010; 125(6): e1419-26.
14. Griffits R. The Abilities of babies. A study in mental measurement. London, UK: University of London Press; 1976:5-44.
15. Kim M.J. Enteral nutrition for optimal growth in preterm infants. Korean J. Pediatr. 2016; 59(12): 466-70.
16. Ong K.K., Kennedy K., Castaneda Gutierrez E., Forsyth S., Godfrey K., Koletzko B. et al. Postnatal growth in preterm infants and later health outcomes: a systematic review. Acta Paediatr. 2015;104(10): 974-86.
17. Huang C., Martorell R., Ren A., Li Z. Cognition and behavioural development in early childhood: the role of birth weight and postnatal growth. Int. J. Epidemiol. 2013; 42(1): 160-71.
Received 20.02.2018
Accepted 02.03.2018
About the Authors
Degtyareva, Anna V., MD, Professor of the Department of Neonatology, Pediatric Faculty, I.M. Sechenov First Moscow State Medical University; head of the Departmentof neonatology and pediatrics for clinical work, National Medical Research Center of Obstetrics, Gynecology, and Perinatology named after Academician V.I. Kulakov,
Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: a_degtyareva@oparina4.ru
Talvirskaya, Vasilisa M., post-graduate student of the Department of Neonatology, Pediatric Faculty, I.M. Sechenov First Moscow State Medical University.
119991, Russia, Moscow, Trubetskaya str. 8, bld. 2. E-mail: dr.vasilisa@gmail.com
Amirkhanova, Janetta Yu., neurologist of the scientific-consultative pediatric department of the Department of Neonatology and Pediatrics, National Medical Research Center of Obstetrics, Gynecology, and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: d_amirhanova@oparina4.ru
Narogan, Marina V., MD, professor of the neonatology department of the pediatric faculty, I.M. Sechenov First Moscow State Medical University; Leading researcher of the department of pathology of newborn and premature children of the department of neonatology and pediatrics, National Medical Research Center of Obstetrics, Gynecology, and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: m_narogan@oparina4.ru
Ionov, Oleg V., Candidate of Medical Science, Associate Professor of the Department of Neonatology, Pediatric Faculty, I.M. Sechenov First Moscow State Medical University; head of the Department of resuscitation and intensive care of the Department of Neonatology and Pediatrics, National Medical Research Center of Obstetrics, Gynecology, and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: o_ionov@oparina4.ru
Kukhartseva, Marina V., neonatologist of the Department of Pathology of Neonatal and Premature Children of the Department of Neonatology and Pediatrics,
National Medical Research Center of Obstetrics, Gynecology, and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia; post-graduate student
of the neonatology department of the pediatric faculty, I.M. Sechenov First Moscow State Medical University.
119991, Russia, Moscow, Trubetskaya str. 8, bld. 2. E-mail: kolibry90@list.ru, m_kukhartseva@oparina4.ru
For citations: Degtyareva AV, Talvirskaya VM, Amirkhanova D.Yu., Naragan M.V., Ionov O.V., Kukhartseva M.V. Peculiarities of development of deep-preterm infants by 12 months of adjusted age, depending on the rate of escalating enteral nutrition in the early neonatal period. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (8): 152-9. (in Russian)
https://dx.doi.org/10.18565/aig.2018.8.152-159
Similar Articles
