title: Predictors of full enteral feeding achievement in very low birth weight infants.
abstract: BACKGROUND
  To elucidate the role of prenatal, neonatal and early postnatal variables in influencing the achievement of full enteral feeding (FEF) in very low birth weight (VLBW) infants and to determine whether neonatal intensive care units (NICUs) differ in this outcome.
  
  
  METHODS
  Population-based retrospective cohort study using data on 1,864 VLBW infants drawn from the "Emilia-Romagna Perinatal Network" Registry from 2004 to 2009. The outcome of interest was time to FEF achievement. Eleven prenatal, neonatal and early postnatal variables and the study NICUs were selected as potential predictors of time to FEF. Parametric survival analysis was used to model time to FEF as a function of the predictors. Marginal effects were used to obtain adjusted estimates of median time to FEF for specific subgroups of infants.
  
  
  RESULTS
  Lower gestational age, exclusive formula feeding, higher CRIB II score, maternal hypertension, cesarean delivery, SGA and PDA predicted delayed FEF. NICUs proved to be heterogeneous in terms of FEF achievement. Newborns with PDA had a 4.2 days longer predicted median time to FEF compared to those without PDA; newborns exclusively formula-fed had a 1.4 days longer time to FEF compared to those fed human milk.
  
  
  CONCLUSIONS
  The results of our study suggest that time to FEF is influenced by clinical variables and NICU-specific practices. Knowledge of the variables associated with delayed/earlier FEF achievement could help in improving specific aspects of routine clinical management of VLBW infants and to reduce practice variability.
authors.affiliation: Neonatology and Neonatal Intensive Care Unit, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Corvaglia
authors.affiliation: Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Fantini
authors.affiliation: Neonatology and Neonatal Intensive Care Unit, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Arianna
authors.initials: A
authors.lastname: Aceti
authors.affiliation: Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
authors.forename: Dino
authors.initials: D
authors.lastname: Gibertoni
authors.affiliation: Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Rucci
authors.affiliation: Servizio Presidi Ospedalieri, Direzione Generale Sanità e Politiche Sociali, Regione Emilia-Romagna, Bologna, Italy.
authors.forename: Dante
authors.initials: D
authors.lastname: Baronciani
authors.affiliation: Neonatology and Neonatal Intensive Care Unit, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Faldella
mesh_terms: D015331:Cohort Studies; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000502:physiology*; D007363:Intensive Care Units, Neonatal; D008297:Male; D013997:Time Factors