title: Changes in Parenteral Nutrition During the First Week of Life Influence Early but Not Late Postnatal Growth in Very Low-Birth-Weight Infants.
abstract: OBJECTIVE
  Postnatal growth restriction remains a serious problem in very low-birth-weight infants. Enhanced parenteral supply of nutrients as soon as possible after birth is one of the strategies addressed to avoid extrauterine growth restriction. We aimed to analyze changes in growth patterns and in clinical outcomes in our unit after a change in our parenteral nutrition (PN) protocol.
  
  
  METHODS
  We collected data from 2 time periods, comprising the 2 years before (period I) and the 2 years after (period II) the change of protocol. We included 142 very low-birth-weight infants ≤32 weeks of gestation with a birth weight ≤1500 g. Data regarding nutrition intakes (parenteral and enteral) in the first week of life, growth during admission, and clinical outcomes were retrieved from clinical charts.
  
  
  RESULTS
  Babies in period II received a higher nutrition supply during the first week of life, but no further differences were found after this period. Weight at 14 days of life was significantly higher in period II but not at day 28 of life or discharge.
  
  
  CONCLUSIONS
  In our population, an enhanced PN regimen for very low-birth-weight infants led to a better growth at 14 days of life. However, this positive effect had disappeared at day 28 of life. Strategies to improve nutrient supply once the preterm baby is stable and on full enteral feeds should be implemented and analyzed.
authors.affiliation: Hospital Sant Joan de Déu, Neonatology Department, Barcelona, Spain BCN-Natal, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain mizquierdo@hsjdbcn.org.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Izquierdo
authors.affiliation: Hospital Sant Joan de Déu, Neonatology Department, Barcelona, Spain BCN-Natal, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Antonio Federico
authors.initials: AF
authors.lastname: Martínez-Monseny
authors.affiliation: Hospital Universitari Arnau de Vilanova, Pediatric Department, Lleida, Spain.
authors.forename: Neus
authors.initials: N
authors.lastname: Pociello
authors.affiliation: Hospital Nuestra Señora de la Candelaria, Neonatology Department, Santa Cruz de Tenerife, Spain.
authors.forename: Paloma
authors.initials: P
authors.lastname: Gonzalez
authors.affiliation: Hospital Sant Joan de Déu, Neonatology Department, Barcelona, Spain BCN-Natal, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Ruth
authors.initials: R
authors.lastname: Del Rio
authors.affiliation: Hospital Sant Joan de Déu, Neonatology Department, Barcelona, Spain BCN-Natal, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Martin
authors.initials: M
authors.lastname: Iriondo
authors.affiliation: Hospital Sant Joan de Déu, Neonatology Department, Barcelona, Spain BCN-Natal, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Iglesias-Platas
mesh_terms: D001835:Body Weight / Q000187:drug effects*; D016022:Case-Control Studies; D002657:Child Development / Q000187:drug effects*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000254:growth & development*; D008297:Male; D009752:Nutritional Status; D010288:Parenteral Nutrition / Q000379:methods* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: clinical protocols; enteral nutrition; outcomes assessment; parenteral nutrition; postnatal growth restriction; very low-birth-weight infant