title: Alimentazione del neonato pretermine IUGR: studio multicentrico ADEPT (Abnormal Doppler Enteral Prescription Trial). (Feeding the IUGR premature newborn infant: the multicenter ADEPT study).
abstract: OBJECTIVE
  Pregnancies complicated by abnormal antenatal Doppler blood flow often result in the preterm delivery of a growth restricted baby. These babies have a high risk of milk intolerance and necrotising enterocolitis (1), and introduction of milk feeds is frequently delayed. Our aim was to determine the effect of early or late introduction on success of achieving full milk feeds and on adverse outcomes including NEC.
  
  
  METHODS
  Eligible babies with birthweight below 10th centile and gestation below 34+6 weeks, born after abnormal antenatal Dopplers, were randomised between 20 and 48 hours to either early (24-48 hours) or late (120-144 hours) introduction of milk feeds. Babies with major congenital anomaly, in-utero transfusion, multi-organ failure or need for inotropes were excluded. Feed volumes and rate of increase were standardised, and were the same for both groups. Daily feed logs were kept.
  
  
  RESULTS
  404 babies were randomised from 56 units in U.K. and Ireland (202 in each group). There were no important differences between groups at randomisation.
  
  
  CONCLUSIONS
  growth restricted preterm infants born after absent or reversed end-diastolic flow in the umbilical artery who are fed from the second day after birth achieve full feeds faster than those commencing feeds on day six. No difference was been seen in the incidence of NEC, in preliminary analysis. Final data analysis is currently being completed and will be presented at the conference.
authors.forename: A
authors.initials: A
authors.lastname: Leaf
mesh_terms: D000818:Animals; D002417:Cattle; D002536:Cerebral Arteries / Q000000981:diagnostic imaging* / Q000503:physiopathology; D015930:Diet Records; D004750:Enteral Nutrition / Q000379:methods*; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D019102:Infant, Very Low Birth Weight; D007494:Ireland; D017078:Laser-Doppler Flowmetry; D008892:Milk / Q000009:adverse effects*; D008895:Milk, Human; D013997:Time Factors; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006113:United Kingdom