Adjustable feedings plus accurate serial length measurements decrease discharge weight-length disproportion in very preterm infants: quality improvement project.


Journal

Journal of perinatology : official journal of the California Perinatal Association
ISSN: 1476-5543
Titre abrégé: J Perinatol
Pays: United States
ID NLM: 8501884

Informations de publication

Date de publication:
Aug 2019
Historique:
received: 16 02 2019
accepted: 26 05 2019
revised: 05 05 2019
pubmed: 3 7 2019
medline: 30 5 2020
entrez: 3 7 2019
Statut: ppublish

Résumé

Preterm very-low-birth-weight (≤1500 g) infants exhibit disproportionate weight-for-length growth in the Neonatal Intensive Care Unit. High frequency of body mass index (BMI) > 90th centile at discharge and 1-year postnatal age associated with elevated blood pressure and serum leptin in infancy and adolescence. Single-institution quality improvement project in appropriately grown infants born at 23 Adjustable feeding protocol based on valid serial length measurements (board or caliper). The average monthly percentage of weight-for-length disproportion at discharge decreased from 13% in Epoch 1 to 0% in Epoch 2 (P < 0.05). Although the average Z-score for BMI at discharge was lower in Epoch 2 versus Epoch 1 (P < 0.01), this was absent by 1 year follow-up (P = 0.91). Adjustable feedings plus use of accurate serial length measurements decreases weight-for-length disproportion at hospital discharge but not at 1 year.

Sections du résumé

BACKGROUND BACKGROUND
Preterm very-low-birth-weight (≤1500 g) infants exhibit disproportionate weight-for-length growth in the Neonatal Intensive Care Unit.
LOCAL PROBLEM OBJECTIVE
High frequency of body mass index (BMI) > 90th centile at discharge and 1-year postnatal age associated with elevated blood pressure and serum leptin in infancy and adolescence.
METHODS METHODS
Single-institution quality improvement project in appropriately grown infants born at 23
INTERVENTION METHODS
Adjustable feeding protocol based on valid serial length measurements (board or caliper).
RESULTS RESULTS
The average monthly percentage of weight-for-length disproportion at discharge decreased from 13% in Epoch 1 to 0% in Epoch 2 (P < 0.05). Although the average Z-score for BMI at discharge was lower in Epoch 2 versus Epoch 1 (P < 0.01), this was absent by 1 year follow-up (P = 0.91).
CONCLUSIONS CONCLUSIONS
Adjustable feedings plus use of accurate serial length measurements decreases weight-for-length disproportion at hospital discharge but not at 1 year.

Identifiants

pubmed: 31263201
doi: 10.1038/s41372-019-0424-8
pii: 10.1038/s41372-019-0424-8
doi:

Substances chimiques

Leptin 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1131-1139

Commentaires et corrections

Type : ErratumIn

Auteurs

Luc P Brion (LP)

Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA. luc.brion@utsouthwestern.edu.

Charles R Rosenfeld (CR)

Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.

Roy Heyne (R)

Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.

Steven L Brown (SL)

Parkland Hospital and Health System, Dallas, TX, USA.

Cheryl S Lair (CS)

Parkland Hospital and Health System, Dallas, TX, USA.

Patti J Burchfield (PJ)

Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.

Maria Caraig (M)

Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.

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Classifications MeSH