title: Nutrient intakes independently affect growth in extremely preterm infants: results from a population-based study.
abstract: OBJECTIVE
  To explore associations between energy and macronutrient intakes and early growth in extremely low gestational age (ELGA) infants.
  
  
  METHODS
  Retrospective population-based study of all ELGA infants (<27 weeks) born in Sweden during 2004-2007. Detailed data on nutrition and anthropometric measurements from birth to 70 days of postnatal age were retrieved from hospital records.
  
  
  RESULTS
  Study infants (n = 531) had a mean ± SD gestational age of 25.3 ± 1.1 weeks and a birth weight of 765 ± 170 g. Between 0 and 70 days, average daily energy and protein intakes were 120 ± 11 kcal/kg and 3.2 ± 0.4 g/kg, respectively. During this period, standard deviation scores for weight, length and head circumference decreased by 1.4, 2.3 and 0.7, respectively. Taking gestational age, baseline anthropometrics and severity of illness into account, lower energy intake correlated with lower gain in weight (r = +0.315, p < 0.001), length (r = +0.215, p < 0.001) and head circumference (r = +0.218, p < 0.001). Protein intake predicted growth in all anthropometric outcomes, and fat intake was positively associated with head circumference growth.
  
  
  CONCLUSIONS
  Extremely low gestational age infants received considerably less energy and protein than recommended and showed postnatal growth failure. Nutrient intakes were independent predictors of growth even after adjusting for severity of illness. These findings suggest that optimized energy and macronutrient intakes may prevent early growth failure in these infants.
authors.affiliation: Department of Clinical Sciences, Paediatrics, Umeå University, Umeå, Sweden.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Stoltz Sjöström
authors.forename: Inger
authors.initials: I
authors.lastname: Öhlund
authors.forename: Fredrik
authors.initials: F
authors.lastname: Ahlsson
authors.forename: Eva
authors.initials: E
authors.lastname: Engström
authors.forename: Vineta
authors.initials: V
authors.lastname: Fellman
authors.forename: Ann
authors.initials: A
authors.lastname: Hellström
authors.forename: Karin
authors.initials: K
authors.lastname: Källén
authors.forename: Mikael
authors.initials: M
authors.lastname: Norman
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Olhager
authors.forename: Fredrik
authors.initials: F
authors.lastname: Serenius
authors.forename: Magnus
authors.initials: M
authors.lastname: Domellöf
mesh_terms: D002657:Child Development; D002149:Energy Intake; D005260:Female; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena; D062071:Infant, Extremely Premature / Q000254:growth & development*; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies
keywords: Energy intake; Extremely preterm infants; Growth failure; Nutrient intake; Protein