Gestational Age-Related Associations between Early-Life Feeding Trajectories and Growth Outcomes at Term Equivalent Age in Very Preterm Infants
Establishing the different feeding trajectories based on daily enteral feeding data in preterm infants at different gestational ages (GAs), may help to identify the risks and extrauterine growth restriction (EUGR) outcomes associated with the adverse feeding pattern. In a single center, we retrospec...
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MDPI AG
2022-02-01
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| Series: | Nutrients |
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| Online Access: | https://www.mdpi.com/2072-6643/14/5/1032 |
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| author | Yung-Chieh Lin Chi-Hsiang Chu Yen-Ju Chen Ray-Bing Chen Chao-Ching Huang |
| author_facet | Yung-Chieh Lin Chi-Hsiang Chu Yen-Ju Chen Ray-Bing Chen Chao-Ching Huang |
| author_sort | Yung-Chieh Lin |
| collection | DOAJ |
| description | Establishing the different feeding trajectories based on daily enteral feeding data in preterm infants at different gestational ages (GAs), may help to identify the risks and extrauterine growth restriction (EUGR) outcomes associated with the adverse feeding pattern. In a single center, we retrospectively included 625 infants born at 23–30 weeks of gestation who survived to term-equivalent age (TEA) from 2009 to 2020. The infants were designated into three GA groups: 23–26, 27–28, and 29–30 weeks. The daily enteral feeding amounts in the first 56 postnatal days were analyzed to determine the feeding trajectories. The primary outcomes were EUGR in body weight and head circumference calculated, respectively, by the changes between birth and TEA. Clustering analysis identified two feeding trajectories, namely the improving and adverse patterns in each GA group. The adverse feeding pattern that occurred in 49%, 20%, and 17% of GA 23–26, 27–28, and 29–30 weeks, respectively, was differentiated from the improving feeding pattern as early as day 7 in infants at GA 23–26 and 27–28 weeks, in contrast to day 21 in infants at GA 29–30 weeks. The adverse feeding patterns were associated with sepsis, respiratory, and gastrointestinal morbidities at GA 23–26 weeks; sepsis, hemodynamic and gastrointestinal morbidities at GA 27–28 weeks; and preeclampsia, respiratory, and gastrointestinal morbidities at GA 29–30 weeks. Using the improving feeding group as a reference, the adverse feeding group showed significantly higher adjusted odds ratios of EUGR in body weight and head circumference in infants at GA 23–26 and 27–28 weeks. Identifying the early-life adverse feeding trajectories may help recognize the related EUGR outcomes of preterm infants in a GA-related manner. |
| first_indexed | 2024-03-09T20:27:01Z |
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| last_indexed | 2024-03-09T20:27:01Z |
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| series | Nutrients |
| spelling | doaj.art-320b8bf9656146069469c1d0836f5f122023-11-23T23:33:34ZengMDPI AGNutrients2072-66432022-02-01145103210.3390/nu14051032Gestational Age-Related Associations between Early-Life Feeding Trajectories and Growth Outcomes at Term Equivalent Age in Very Preterm InfantsYung-Chieh Lin0Chi-Hsiang Chu1Yen-Ju Chen2Ray-Bing Chen3Chao-Ching Huang4Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, TaiwanDepartment of Statistics, Tunghai University, Taichung 407224, TaiwanDepartment of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, TaiwanDepartment of Statistics, Institute of Data Science, National Cheng Kung University, Tainan 701401, TaiwanDepartment of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, TaiwanEstablishing the different feeding trajectories based on daily enteral feeding data in preterm infants at different gestational ages (GAs), may help to identify the risks and extrauterine growth restriction (EUGR) outcomes associated with the adverse feeding pattern. In a single center, we retrospectively included 625 infants born at 23–30 weeks of gestation who survived to term-equivalent age (TEA) from 2009 to 2020. The infants were designated into three GA groups: 23–26, 27–28, and 29–30 weeks. The daily enteral feeding amounts in the first 56 postnatal days were analyzed to determine the feeding trajectories. The primary outcomes were EUGR in body weight and head circumference calculated, respectively, by the changes between birth and TEA. Clustering analysis identified two feeding trajectories, namely the improving and adverse patterns in each GA group. The adverse feeding pattern that occurred in 49%, 20%, and 17% of GA 23–26, 27–28, and 29–30 weeks, respectively, was differentiated from the improving feeding pattern as early as day 7 in infants at GA 23–26 and 27–28 weeks, in contrast to day 21 in infants at GA 29–30 weeks. The adverse feeding patterns were associated with sepsis, respiratory, and gastrointestinal morbidities at GA 23–26 weeks; sepsis, hemodynamic and gastrointestinal morbidities at GA 27–28 weeks; and preeclampsia, respiratory, and gastrointestinal morbidities at GA 29–30 weeks. Using the improving feeding group as a reference, the adverse feeding group showed significantly higher adjusted odds ratios of EUGR in body weight and head circumference in infants at GA 23–26 and 27–28 weeks. Identifying the early-life adverse feeding trajectories may help recognize the related EUGR outcomes of preterm infants in a GA-related manner.https://www.mdpi.com/2072-6643/14/5/1032feeding trajectoryneonatal morbiditiesclustering analysispreterm infantsgestational agepostnatal growth |
| spellingShingle | Yung-Chieh Lin Chi-Hsiang Chu Yen-Ju Chen Ray-Bing Chen Chao-Ching Huang Gestational Age-Related Associations between Early-Life Feeding Trajectories and Growth Outcomes at Term Equivalent Age in Very Preterm Infants Nutrients feeding trajectory neonatal morbidities clustering analysis preterm infants gestational age postnatal growth |
| title | Gestational Age-Related Associations between Early-Life Feeding Trajectories and Growth Outcomes at Term Equivalent Age in Very Preterm Infants |
| title_full | Gestational Age-Related Associations between Early-Life Feeding Trajectories and Growth Outcomes at Term Equivalent Age in Very Preterm Infants |
| title_fullStr | Gestational Age-Related Associations between Early-Life Feeding Trajectories and Growth Outcomes at Term Equivalent Age in Very Preterm Infants |
| title_full_unstemmed | Gestational Age-Related Associations between Early-Life Feeding Trajectories and Growth Outcomes at Term Equivalent Age in Very Preterm Infants |
| title_short | Gestational Age-Related Associations between Early-Life Feeding Trajectories and Growth Outcomes at Term Equivalent Age in Very Preterm Infants |
| title_sort | gestational age related associations between early life feeding trajectories and growth outcomes at term equivalent age in very preterm infants |
| topic | feeding trajectory neonatal morbidities clustering analysis preterm infants gestational age postnatal growth |
| url | https://www.mdpi.com/2072-6643/14/5/1032 |
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