Early Nutrition and Weight Gain in Preterm Infants with Bronchopulmonary Dysplasia
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Date
2004-06
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The Ohio State University
Abstract
Purpose of the Study: Preterm infants born at or before 28 weeks gestation are at high-risk for the development of respiratory distress due to their underdeveloped lungs. One of the complications that arises as a result of the management strategies used for respiratory distress is bronchopulmonary dysplasia (BPD). BPD is a chronic lung disease of prematurity that requires supplemental oxygen until at least 36 weeks post-conceptional age. The numbers of preterm infants developing BPD is on the increase due to the improved survival rates of these infants. Providing adequate nutrition and promoting the growth of preterm infants is a significant challenge. Little evidence exists related to the nutritional intake of preterm infants with BPD. The purpose of this study was to compare actual nutritional intake and weight gain in preterm infants with BPD with the recommendations for nutrition and growth in preterm infants during the first 28 days of life.
Research Method: The sample was comprised of 30 preterm infants who developed BPD. All the infants were on the ventilator during the first 72 hours of life for respiratory distress. Data related to nutritional intake and weight gain for the first 28 days of life were abstracted from the infant’s medical record. Daily nutritional intake and weights were analyzed using the nutritional software NEONOVA. This software is specifically designed to analyze the nutrition and growth of newborn infants in the neonatal intensive care unit.
Findings: The average birthweight was 946 grams. The infants received significantly less kcal/kg/day than the recommended 120 kcal/kg/day. During the first week of life, the infants were receiving 68.35 kcal/kg/day. By 28 days of life, the infants were receiving 98.63 kcal/kg/day. The infants did not achieve 120 kcal/kg/day until day of life 27. The result of receiving less than the recommended caloric intake is that the infants had accumulated an energy deficit of 598.23 kcal/kg by the end of 28 days of life. Further, these infants accumulated a protein deficit of 7.56 grams/kg. The goal for preterm infants is to gain weight at a minimum rate of 15 grams/kg/day. The rate of weight gain for the infants in this study was 11.55 grams/kg/day.
Implications: Preterm infants with BPD are undernourished during the first 28 days of life and, thus gain weight at a slower rate. The slow introduction and advancement of nutrition contributes to this clinical problem. Undernutrition very well may be contributing to the development of BPD. BPD develops because of damage to the immature lungs. Subsequent healing and continued growth and development of the lungs are most likely altered due to the preterm infant being undernourished. If the infant is not gaining weight at an appropriate rate, it could be hypothesized that the lungs also are not growing. The results from this study provide the basis for closely examining current nutritional practices in the neonatal intensive care unit.
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Keywords
Preterm infants, Bronchopulmonary dysplasia, Nutrition, Weight gain