scholarly journals Aggressive nutrition in extremely low birth weight infants: impact on parenteral nutrition associated cholestasis and growth

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e2483 ◽  
Author(s):  
Andreas Repa ◽  
Ruth Lochmann ◽  
Lukas Unterasinger ◽  
Michael Weber ◽  
Angelika Berger ◽  
...  
Keyword(s):  
Body Weight ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Parenteral Nutrition ◽  
Head Circumference ◽  
Postnatal Growth ◽  
The Body ◽  
Extremely Low Birth Weight ◽  
Secondary Outcome ◽  
Z Score

BackgroundParenteral nutrition associated cholestasis (PNAC) is a frequently observed pathology in extremely low birth weight (ELBW) infants. Its pathogenesis is determined by the composition and duration of parenteral nutrition (PN) as well as the tolerance of enteral feeds (EF). “Aggressive” nutrition is increasingly used in ELBW infants to improve postnatal growth. Little is known about the effect of “aggressive” nutrition on the incidence of PNAC. We analyzed the influence of implementing an “aggressive” nutritional regimen on the incidence of PNAC and growth in a cohort of ELBW infants.MethodsELBW infants were nourished using a “conservative” (2005–6;n= 77) or “aggressive” (2007–9;n= 85) nutritional regimen that differed in the composition of PN after birth as well as the composition and timing of advancement of EFs. We analyzed the incidence of PNAC (conjugated bilirubin > 1.5 mg/dl (25 µmol/l)) corrected for confounders of cholestasis (i.e., NEC and/or gastrointestinal surgery, sepsis, birth weight, Z-score of birth weight, time on PN and male sex), growth until discharge (as the most important secondary outcome) and neonatal morbidities.ResultsThe incidence of PNAC was significantly lower during the period of “aggressive” vs. “conservative “nutrition (27% vs. 46%,P< 0.05; adjusted OR 0.275 [0.116–0.651],P< 0.01). Body weight (+411g), head circumference (+1 cm) and length (+1 cm) at discharge were significantly higher. Extra-uterine growth failure (defined as a Z-score difference from birth to discharge lower than −1) was significantly reduced for body weight (85% vs. 35%), head circumference (77% vs. 45%) and length (85% vs. 65%) (P< 0.05). The body mass index (BMI) at discharge was significantly higher (11.1 vs. 12.4) using “aggressive” nutrition and growth became more proportionate with significantly less infants being discharged below the 10th BMI percentile (44% vs. 9%), while the percentage of infants discharged over the 90th BMI percentile (3% vs. 5%) did not significantly increase.Discussion“Aggressive” nutrition of ELBW infants was associated with a significant decrease of PNAC and marked improvement of postnatal growth.

scholarly journals Effects of total parenteral nutrition on postnatal growth in very low birth weight and extremely low birth weight newborns

2020 ◽  
Vol 8 (2) ◽  
pp. 714
Author(s):  
Divya Ahuja ◽  
Pritosh Srivastava ◽  
Anshuman Srivastava
Keyword(s):  
Amino Acids ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Very Low Birth Weight ◽  
Postnatal Growth ◽  
Extremely Low Birth Weight ◽  
High Dose ◽  
Preterm Newborns

Background: Prematurity is the most important cause of mortality in Under-5 children responsible for one million deaths/ year. Premature babies are not able to store enough nutrients for their optimal survival; it is essential to provide them total parenteral nutrition. Intravenous lipid infusion in neonates is linked with high risk of sepsis and thrombocytopenia. PN with amino acids and glucose can be imparted to achieve nutritional goal. This trial was intended to assess the effects of various components of amino acid PN on postnatal growth in VLBW and ELBW newborns.Methods: A prospective observational study was conducted from January 2018 - May 2019 in NICU of TMMC and RC which included preterm newborns with birth weight of less than 1500gms who received aminoven infusion. Anthropometric measurements, incidence of hypo/hypercalcaemia, hypo/hyperglycaemia, direct hyperbilirubinemia, incidence of sepsis were evaluated.Results: Out of 22 patients, 12 neonates received high dose aminoven therapy whereas 10 neonates received low dose aminoven therapy. It was seen that rapid rate of increment of amino acids had adequate weight on discharge, 72.72% have adequate growth among the rapid group compared to 36.36% among slower group. No significant changes in calcium metabolism or glucose metabolism were seen in both the groups.Conclusions: In resource limited settings, parenteral nutrition with intravenous amino acids have a better effect on the weight of preterm newborns at discharge when high doses of amino acids infusion started early with rapid increment in the dose.

Is intravenous fish oil associated with the neurodevelopment of extremely low birth weight preterm infants on parenteral nutrition?

2021 ◽  
Author(s):  
Chiara Biagetti ◽  
Alessio Correani ◽  
Rita D’Ascenzo ◽  
Enrica Ferretti ◽  
Cecilia Proietti ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Parenteral Nutrition ◽  
Fish Oil ◽  
Preterm Infants ◽  
Extremely Low Birth Weight

Post-natal thyroid function in low birth weight infants; a longitudinal assessment of free thyroxine and thyroid hormone binding globulin

1985 ◽  
Vol 110 (1) ◽  
pp. 56-60 ◽  
Author(s):  
Takeki Hirano ◽  
Jaideep Singh ◽  
Gopal Srinivasan ◽  
Rosita Pildes
Keyword(s):  
Body Weight ◽  
Birth Weight ◽  
Thyroid Hormone ◽  
Low Birth Weight ◽  
Free Thyroxine ◽  
Extremely Low Birth Weight ◽  
Longitudinal Assessment ◽  
Hormone Binding ◽  
Low Birth Weight Infants ◽  
Term Infants

Abstract. Because the concentrations of serum free thyroxine (FT4) and thyroid hormone binding globulin (TBG) have not been fully evaluated in preterm infants at the immediate post-natal period, we studied the longitudinal changes of serum FT4 and TBG, along with thyroxine (T4) and thyroid stimulating hormone (TSH), at birth (cord blood), 2 days, 1 week and 2 weeks of age in 7 infants with birth body weight ≦ 1000 g, 7 infants with body weight 1001 to 1350 g, 11 infants with body weight 1351 to 2499 g, and 11 full-term infants. Free T4 concentrations were measured by Corning Medical radio-immunoassay (RIA) kit. The infants with extremely low birth weight (ELBW) (body weight ≦ 1000 g) showed precipitous declines of total T4 and, to a lesser extent, of FT4 concentrations at 1 and 2 weeks of age. These post-natal T4 and FT4 decreases in ELBW neonates have not previously been reported. The clinical significance of this finding remains, speculative, but it may be due to metabolic or nutritional problems related to extreme prematurity itself. This study suggests that measurement of FT4 is a useful adjunct to the assessment of ELBW infants with wery low T4 values, if done between 1 to 2 weeks af age, and could be used as a primary hypothyroid screening tool instead of T4 measurements, provided that an FT4 assay is developed that uses the elute of blood spotted on filter paper.

scholarly journals Effects of ligature-induced periodontitis in pregnant Wistar rats

2003 ◽  
Vol 17 (1) ◽  
pp. 51-55 ◽  
Author(s):  
Mariane Ponzio de Azevedo Galvão ◽  
Cassiano Kuchenbecker Rösing ◽  
Maria Beatriz Cardoso Ferreira
Keyword(s):  
Body Weight ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Periodontal Disease ◽  
Wistar Rats ◽  
The Body ◽  
Control Group ◽  
Female Adult ◽  
Pregnant Rats ◽  
Male Adult

The aim of this study was to evaluate the influence of ligature-induced periodontal disease in pregnant rats on their newborn's health parameters. Twenty-four female adult Wistar rats were divided into two groups: the control group (G1) and the group that was submitted to dental ligatures around second upper molars (G2). After the four week period of development of periodontitis, the female animals were mated with male adult Wistar rats. There were no differences in the body weight of females between the two groups during mating and pregnancy. No differences were observed among the groups in relation to the viable newborn index. However, there were differences in newborn birth weight, explained by the diverse size of the litters. In this study, ligature-induced periodontal disease did not promote changes during pregnancy that resulted in low birth weight in newborn Wistar rats.

Exposure to placental insufficiency alters postnatal growth trajectory in extremely low birth weight infants

2019 ◽  
Vol 11 (4) ◽  
pp. 384-391 ◽  
Author(s):  
Fu-Sheng Chou ◽  
Hung-Wen Yeh ◽  
Chu-Yen Chen ◽  
Gene T. Lee ◽  
Marc R. Parrish ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Fixed Effects ◽  
Demographic Data ◽  
Total Duration ◽  
Information Criterion ◽  
Postnatal Growth ◽  
Placental Insufficiency ◽  
Extremely Low Birth Weight ◽  
Quadratic Term

AbstractGrowth in the immediate postnatal period for extremely low birth weight (ELBW, birth weight < 1000 g) infants is an important topic in neonatal medicine. The goal is to ensure adequate postnatal growth and to minimize complications resulting from suboptimal growth. Past efforts have focused on postnatal nutrition as well as on minimizing comorbidities. It has not been systematically assessed whether antenatal factors play a role in postnatal growth. In this report, we conducted a retrospective study on 91 maternal–neonatal pairs. We prospectively collected maternal and neonatal demographic data, neonatal nutrition in the first 7 days of life and after enteral nutrition is fully established, comorbidity data, as well as weight data from birth to 50 weeks corrected gestational age. We developed a linear mixed-effects model to examine the role of placental insufficiency, as defined by fetal Doppler studies, in postnatal weight z-score trajectory over time in the ELBW population. We relied on Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) for model selection. Interestingly, the selected model included a quadratic term of time and a placental insufficiency-by-time interaction term. In a covariate analysis, AIC and BIC both favored a model that included calories intake in the first 7 days of life and the total duration of antibiotics as fixed-effects, but not their interaction terms with time. Overall, we demonstrated for the first time that placental insufficiency, an antenatal factor, is a major determinant of postnatal weight trajectory in the ELBW population. Prospective studies are warranted to confirm our findings.

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