Nutritional Care and Head Growth in Preterm Infants

Study Overview
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Brief Summary
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As extremely low birth weight infants are high-risk patients, the study aimed to compare neonatal care, nutritional strategy and postnatal growth of these infants in two European neonatal units. A retrospective study included extremely low birth weight infants born in Lyon, France or in Stockholm, Sweden. Data on morbidity, treatments, care practices, macro-nutrient intakes and postnatal growth were collected to determine risk factors of extra uterine growth restriction at discharge. By comparing postnatal growth in ELBW infants hospitalized in two European neonatal intensive care units with different nutritional and extra nutritional care,our objective was to evaluate the role of nutrition in this population of preterm infants.

Detailed Description
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In a retrospective study, all ELBW infants (birth weight under 1000 g) with a gestational age between 23 and 28 weeks were included if they were admitted during the first 24 hours of life and stayed for at least seven weeks in two European units (Lyon, france, and Stockholm, Sweden). Parenteral and enteral nutrition policies were detailed and protein and energy intakes were collected.Growth assessment Postnatal growth was precisely evaluated and compared in the two groups of infants. Body weight, crown-heel length and head circumference were measured in both units at birth and until discharge. We calculated z-scores and changes in z-scores between birth and 36 weeks post-conceptional age (delta z-score) for body weight, HC, and crown-to-heel length using Olsen's references. Intra-uterine growth restriction was defined as a birth weight below or equal to minus two standard deviations. Extra-uterine growth restriction was defined as a z-score loss above or equal one standard deviation between birth and 36 weeks PCA. I

Official Title
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Nutritional Care Influences Head Growth at Discharge in Extremely Low Birth Weight Infants.

Conditions
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Prematurity; Extreme, Growth Retardation

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: birth weight under 1000 grams gestational age (GA) between 23 and 28 weeks born in 2012 admitted during the first 24 hours of life stayed in one of the two studied units for at least 7 weeks before transfer to the referring hospital, discharge to home or death. Exclusion Criteria: Neonates with congenital anomalies

Ages Eligible for Study
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Minimum Age: 1 Minute
Maximum Age: 6 Months

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group A<br>Infants born in Lyon (France) | |
| Group B<br>Infants born in Stockholm (Sweden) | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Weight gain during hospitalization | difference in weight between birth and discharge | between birth and 40 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Crown-heel length gain during hospitalization | difference in recumbent length between birth and discharge | between birth and 40 weeks | 
| Head circumference gain during hospitalization | difference in head circumference between birth and discharge | between birth and 40 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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growth, small for gestational age, prematurity, breastfeeding, fortification, parenteral nutrition, nutrition