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
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01.01.2018 |
Degtyareva A.
Talvirskaya V.
Amirkhanova D.
Narogan M.
Ionov O.
Kukhartseva M.
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Akusherstvo i Ginekologiya (Russian Federation) |
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© Bionika Media Ltd. 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.
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