Nutritional assessment in preterm infants with special reference to body composition
In recent years, improvements in care have significantly improved survival in preterm and, particularily, the very low birth weight infant (VLBW). While immediate survival can be directly related to pulmonary maturity, several studies stress the importance of timely and adequate nutrition in these high-risk infants on a short- and long-term [1]. Yet, nutritional support remains a very controversial issue in these high-risk infants. Early provision of adequate intakes may be limited by clinical instability and immaturity. At the same time, nutritional requirements and methods of nutritional assessment are not well defined. The aim of this paper is to outline some of the methods used during n…
Alimentazione del lattante
The Italian longitudinal cohort of newborn twins: A research opportunity
Fabbisogni nutrizionali
Il neonato sano
Enteral feeding policies for extremely low birth weight infants. A survey in 74 Italian neonatal intensive cAre units
Background: Enterai feeding for infants with birth weight1000 g (ELBWI) is still a controversial issue. The aim of the present survey was to ascertain the attitudes of Italian neonatal intensive care units (NICUs) regarding this point. Method: A questionnaire, with multiple choice answers, regarding the timing of enteral feeding, its progression, the different techniques utilised, the eventual use of fortifiers and the interrupting criteria, was mailed to 92 Italian NICUs. Results: 74 NICUs all over the country participated in the study.1153 ELBWI were hospitalised in 1996 in these Units. Enterai feeding for babies between 501 g and 750 g is started on the 1st day of life in 23.3% of the NI…
Association of maternal hypertension and chorioamnionitis with preterm outcomes
OBJECTIVES: We compared the relative effect of hypertensive disorders of pregnancy and chorioamnionitis on adverse neonatal outcomes in very preterm neonates, and studied whether gestational age (GA) modulates these effects. METHODS: A cohort of neonates 23 to 30 weeks' GA, born in 2008 to 2011 in 82 hospitals adhering to the Italian Neonatal Network, was analyzed. Infants born from mothers who had hypertensive disorders (N = 2096) were compared with those born after chorioamnionitis (N = 1510). Statistical analysis employed logistic models, adjusting for GA, hospital, and potential confounders. RESULTS: Overall mortality was higher after hypertension than after chorioamnionitis (odds rati…
Weight Gain Composition in Preterm Infants with Dual Energy X-Ray Absorptiometry
Whole body composition was investigated using dual energy x-ray absorptiometry in 54 healthy preterm infants, birth weight < 1750 g, who were fed fortified human milk (n = 20) and preterm formula (n = 34) when full enteral feeding was attained and then again 3 wk later at around the time of discharge. Weight gain composition was calculated from the difference between the earlier and later measurement. The minimal detectable changes in whole body composition over time according to the variance of the population (within groups of 20 infants) and the minimal detectable changes according to the dietary intervention (between two groups of 20 infants) were determined at 5% significance and 80% po…
Bone mineral metabolism in the micropremie
Environmental factors, nutritional supplies, hormonal status, diseases, and treatments appear to affect postnatal skeletal growth and mineralization in VLBW infants. Compared with their term counterparts, ELBW infants are at risk of postnatal growth deficiency and osteopenia at the time of hospital discharge. From recent data, DXA is becoming one of the reference techniques to evaluate mineral status, whole-body composition, and effects of dietary manipulations on weight gain composition and mineral accretion in preterm infants. Weight gain and length increases need to be evaluated carefully during the first weeks of life, in the intensive care unit and out of it, in the step down unit. Nut…