Efeito da nutrição parenteral precoce em recém-nascidos pré-termos de muito baixo peso ao nascer

Abstract

Introduction:Premature birth is considered a nutritional emergency, as an interruption in the supply of nutrients occurs in the last quarter, leading to a cumulative deficiency of protein and energy, with negative repercussions on growth and development. Thus, the nutrition of the preterm infant constitutes a major challenge. The aim of this study was to evaluate the impact of early parenteral nutrition in preterm infants with very low birth weight. Methods: A retrospective cohort study was performed and two groups of preterm infants were compared, before and after the change in the protocol of parenteral nutrition. The Early Group included infants born in the 12 months following the change in the protocol that had onset of parenteral nutrition immediately after birth with intake of 1.5g/kg/day of protein. The Late Group included infants born in the 12 months preceding the change in protocol whose parenteral nutrition was started after 24 hours of life with an initial offering of 0.5-1g/kg/day of protein. Results: We studied 99 infants with 50 in Early Group and 49 in Late Group. There was no difference between the two groups regarding gestacional age, birth weight, age of minimum weight, age of recovery of birth weight and length of stay. Statistically significant difference was observed regarding the time of initiation of parenteral nutrition with a median of 2 hours in Early Group and 27 hours in Late Group. Both groups showed a worsening in z scores for weight and length during hospitalization, but not for head circumference, with no statistically significant difference between them. Conclusion: In this study the early initiation of parenteral nutrition was insufficient to improve the growth of very low birth weight preterm infants and prevent the restriction of extra-uterine growth.