title: Safety of home parenteral nutrition during pregnancy.
abstract: Few studies have examined the effect of total parenteral nutrition which is lipid-based given throughout pregnancy to patients unable to obtain adequate nutrition by the oral route. In this study we examined the use of lipid-based home parenteral nutrition (HPN) in 7 pregnant women, commenced either before or during pregnancy, and their intra-pregnant course as well as a 2-year follow-up of their offspring is described.
  
  
  
  HPN was formulated on an individual basis and protein administered in a dose of 0.8-1.1 g/kg during the three trimesters. Lipid emulsions included long chain triglycerides or olive-oil based formulae and all patients received trace elements. Data were collected during the course of pregnancy and at birth while infants were followed for a period of between 6 months and 2 years using medical records and questionnaires.
  
  
  
  In total, we studied 9 pregnancies (in 7 women). HPN was administered for a median of 9 months (range 3-9 months). The mean energy provided during the 1st, 2nd and 3rd trimester was 9297 ± 2797 kcal/week, 9148 ± 2629 kcal/week and 8564 ± 4059 kcal/week resp. The mean increase in weight during the pregnancy was 9 ± 5 Kg. The only complications noted during the pregnancy consisted of 3 episodes of catheter-related infections which were successfully treated by antibiotics. The infants were born after a mean of 38.00 ± 1.55 weeks of gestation, with a mean first minute Apgar score of 8.7 ± 1.8 which increased to 9.8 ± 0.4 after 10 min. The mean infant birth weight was 2.45 ± 0.37 kg. No complications were noted at birth apart from one infant who suffered from torticollis which resolved spontaneously. During follow up, a decrease in hemoglobin related to low iron levels was noted in 1 infant, 2 infants were noted to be allergic to pollen and one underwent a scrotal hernia reduction. No developmental problems have been observed, neither physiological nor psychomotor, over the 2-year follow-up period.
  
  
  
  The authors suggest, based on, the current study, that lipid-based HPN for pregnant women is a safe method for meeting the nutritional demands of both mother and fetus, and may be administered throughout the pregnancy.
authors.affiliation: Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Affiliated to the Sackler School of Medicine, Tel Aviv University, Israel; Nursing Department, Steyer School of Health Professions, Sackler School of Medicine, Tel Aviv University, Israel.
authors.forename: Miriam
authors.initials: M
authors.lastname: Theilla
authors.affiliation: Department of General Surgery and Clinical Nutrition, Medical University of Warsaw, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Ławiński
authors.affiliation: Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Affiliated to the Sackler School of Medicine, Tel Aviv University, Israel.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Cohen
authors.affiliation: Department of Maternal Fetal Medicine Unit, Helen Shneider Hospital for Women, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Affiliated to the Sackler School of Medicine, Tel Aviv University, Israel.
authors.forename: Eran
authors.initials: E
authors.lastname: Hadar
authors.affiliation: Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Affiliated to the Sackler School of Medicine, Tel Aviv University, Israel.
authors.forename: Ilya
authors.initials: I
authors.lastname: Kagan
authors.affiliation: Department of General Surgery and Clinical Nutrition, Medical University of Warsaw, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Perkewick
authors.affiliation: Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Affiliated to the Sackler School of Medicine, Tel Aviv University, Israel. Electronic address: psinger@clalit.org.il.
authors.forename: Pierre
authors.initials: P
authors.lastname: Singer
mesh_terms: D000328:Adult; D001724:Birth Weight; D015992:Body Mass Index; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007557:Israel; D009752:Nutritional Status; D016331:Parenteral Nutrition, Home; D011247:Pregnancy; D039401:Prenatal Nutritional Physiological Phenomena; D011795:Surveys and Questionnaires; D014131:Trace Elements / Q000008:administration & dosage / Q000032:analysis; D016896:Treatment Outcome
chemical_list: D005217:Fat Emulsions, Intravenous; D014131:Trace Elements
keywords: Complications; Home parenteral nutrition; IV lipid emulsions; Newborn; Pregnancy