title: Is nutritional support needed in late preterm infants?
abstract: BACKGROUND
  Late preterm birth accounts for 70 % of all preterm births. While the impact of feeding problems in very preterm infants has been widely investigated, data on late preterm infants' feeding issues are scarce. The aim of the present study was to investigate the need of nutritional support during hospital stay in a cohort of late preterm infants and to identify the factors that most contribute to its occurrence.
  
  
  METHODS
  We analyzed the medical records of late preterm infants, born 2011-2013, admitted to a single institution. Neonatal data, the need for nutritional support, defined as the need for parenteral nutrition or intravenous fluids or tube feeding, and the feeding status at discharge were retrieved. The occurrence of respiratory distress syndrome, congenital malformations/chromosomal diseases, cardiac diseases, sepsis, hypoglycemia, poor feeding and the need for surgical intervention were also collected.
  
  
  RESULTS
  A total of 1768 late preterm infants were included. Among the 592 infants requiring a nutritional support, 228 developed a respiratory distress syndrome, two developed a sepsis, one presented with a cardiac disease, 24 underwent a surgical intervention, eight had a chromosomal disease/congenital malformation, 80 had hypoglycemia. In addition, 100 infants required nutritional support due to poor feeding and 149 were born small for gestational age. Birth weight ≤2000 g (adjusted OR = 12.2, 95 % CI 7.5-19.9, p < 0.0001), gestational age of 34 weeks (adjusted OR = 4.08, 95 % CI 2.8-5.9, p < 0.0001), being small for gestational age (adjusted OR = 2.17, 95 % CI 2.8-5.9, p=0.001), having a respiratory distress syndrome (adjusted OR = 79.6, 95 % CI 47.2-134.3, p < 0.0001) and the need of surgical intervention (adjusted OR = 49.4, 95 % CI 13.9-174.5, p < 0.0001) were associated with a higher risk of need of nutritional support during hospital stay.
  
  
  CONCLUSIONS
  Late preterm infants are at relatively high risk of requiring nutritional support during hospital stay, especially if they have a birth weight ≤2000 g, a gestational age of 34 weeks, are born small for gestational age, develop a respiratory distress syndrome and require a surgical intervention. The present findings add to the knowledge of late preterm infants' feeding issues and may contribute to tailoring nutritional approaches for these infants.
authors.affiliation: Department of Clinical Science and Community Health, Neonatal Intensive Care Unit, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via Commenda 12, 20122, Milano, Italy. maria.gianni@unimi.it.
authors.forename: Maria Lorella
authors.initials: ML
authors.lastname: Giannì
authors.affiliation: Department of Clinical Science and Community Health, Neonatal Intensive Care Unit, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via Commenda 12, 20122, Milano, Italy. paola.roggero@unimi.it.
authors.forename: Paola
authors.initials: P
authors.lastname: Roggero
authors.affiliation: Department of Clinical Science and Community Health, Neonatal Intensive Care Unit, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via Commenda 12, 20122, Milano, Italy. pasqua.piemontese@mangiagalli.it.
authors.forename: Pasqua
authors.initials: P
authors.lastname: Piemontese
authors.affiliation: Department of Clinical Science and Community Health, Neonatal Intensive Care Unit, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via Commenda 12, 20122, Milano, Italy. nadia.liotto@unimi.it.
authors.forename: Nadia
authors.initials: N
authors.lastname: Liotto
authors.affiliation: Department of Clinical Science and Community Health, Neonatal Intensive Care Unit, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via Commenda 12, 20122, Milano, Italy. anna.orsi@mangiagalli.it.
authors.forename: Anna
authors.initials: A
authors.lastname: Orsi
authors.affiliation: Department of Clinical Science and Community Health, Neonatal Intensive Care Unit, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via Commenda 12, 20122, Milano, Italy. orsola.amato@mangiagalli.it.
authors.forename: Orsola
authors.initials: O
authors.lastname: Amato
authors.affiliation: Department of Clinical Science and Community Health, Neonatal Intensive Care Unit, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via Commenda 12, 20122, Milano, Italy. francesca.taroni@unimi.it.
authors.forename: Francesca
authors.initials: F
authors.lastname: Taroni
authors.affiliation: Department of Clinical Science and Community Health, Neonatal Intensive Care Unit, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via Commenda 12, 20122, Milano, Italy. lally.morly@hotmail.it.
authors.forename: Laura
authors.initials: L
authors.lastname: Morlacchi
authors.affiliation: Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Epidemiology Unit, Via San Barnaba 8, 20122, Milan, Italy. dario.consonni@unimi.it.
authors.forename: Dario
authors.initials: D
authors.lastname: Consonni
authors.affiliation: Department of Clinical Science and Community Health, Neonatal Intensive Care Unit, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via Commenda 12, 20122, Milano, Italy. fabio.mosca@unimi.it.
authors.forename: Fabio
authors.initials: F
authors.lastname: Mosca
mesh_terms: D001724:Birth Weight; D004750:Enteral Nutrition; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000601:surgery; D007236:Infant, Small for Gestational Age; D008297:Male; D010288:Parenteral Nutrition; D012127:Respiratory Distress Syndrome, Newborn / Q000150:complications; D012307:Risk Factors