Article Text
Abstract
Background and aims Nutrition for VLBW infants varies widely among countries. To better understand differences in nutritional practices internationally, we compare data from fourteen hospitals from eight countries (Guangzhou, Shenzhen, Foshan, Amsterdam, Auckland, Copenhagen, Chennai, Chicago, Perth, Newcastle).
Methods Infants with birth weights <1500 g are included and data include time, type, and amount of (par)enteral nutrition, anti-/pro-biotics, anthropometrics and clinical complications from birth to 37 w corrected gestational age, or discharge.
Results Data collection is ongoing, here preliminary data are reported for two selected hospitals (2011–2012, n = 96+107=203) with similar demographic data (e.g. birth weight, median 1335 g; gestational age, median 30.1 w; gender, 59% boys). In hospital A, the growth velocity and proportion of infants reaching 120 mL/kg/d enteral feeding at 5 weeks was higher (median 14.5 vs. 9.1 g/kg/d and 84 vs. 69%, P < 0.05), and the decrease in weight Z-score was lower vs. B (median -0.55 vs. -0.94, P < 0.05). Neither of the units reached the protein intake recommended by ESPGHAN (3.5 g/kg/d, JPGN, 50, 89–95, 2010) within the first month although the average daily deficit was less in hospital A vs. B (median -0.8 vs. -1.2 g/kg/d, P < 0.05). NEC incidence was lower in hospital A vs. B (1 vs. 9%, P < 0.05). There was no difference in the time on antibiotics (~50% of hospitalisation days).
Conclusion Large differences in nutrition and growth outcomes were evident between the two units. The NeoNutriNet cohort will show how differences in nutrition may relate to feeding guidelines, clinical traditions, and use of anti-/pro-biotics around the world.