STUDYING THE WAYS OF VITAMINS AND MINERALS SUPPLEMENTATION IN PRETERM INFANTS
Summary Introduction. About 15 million babies are born prematurely annually in the world, 10–11% of all newborns. Their birth rates vary from 5 to 18% in different countries depending on income level and quality of care. Breast milk is the best food for babies, including premature babies, but in som...
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| Format: | Article |
| Language: | English |
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Bukovynian State Medical University
2019-12-01
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| Series: | Неонатологія, хірургія та перинатальна медицина |
| Subjects: | |
| Online Access: | http://neonatology.bsmu.edu.ua/article/view/188432 |
| Summary: | Summary Introduction. About 15 million babies are born prematurely annually in the world, 10–11% of all newborns. Their birth rates vary from 5 to 18% in different countries depending on income level and quality of care. Breast milk is the best food for babies, including premature babies, but in some cases it may not fully offset the high demand for some vitamins and minerals. The issue of correction of zinc deficiency, which is clinically associated with a decrease in growth rate, development of dermatitis, impaired immunity, poor wound healing and diarrhea, remains open. The aim. To substantiate the feasibility of correcting the deficiency of minerals and vitamins in preterm infants in the first year of life and to evaluate the impact, safety and efficacy of the drug containing the complex of vitamins and minerals on their growth and psychomotor development, compared with children who received standard nutrition supplementation. Materials and methods. The study was conducted in 2012–2019. The study cohort included 150 children (boys / girls 74/76), which were divided into three groups: group I - body weight at birth 2499–1500 g (n = 67); Group II - body weight at birth 1499-1000 g (n = 45); Group III - body weight at birth up to 1000 g (n = 38). The study evaluated the health of children, including anthropometric parameters, psychomotor development, and the level of macro- and microelements in whole blood: calcium, magnesium, zinc, and copper by atomic absorption spectrometry; manganese - by atomic emission spectrometry. The next stage was a prospective cohort study of the effectiveness and safety of the use of a complex of vitamins and minerals in preterm infants in the first year of life. Criteria for inclusion in the cohort study: birth weight 1500-2499 (low body weight -LBW), presence of growth retardation at the age of six months. Children (n - 38) who corresponded the above criteria were randomly assigned to two subgroups. Subgroup 1 (basic) - 20 children who received standard dietary supplementation and consumed a complex of vitamins and minerals for one month. Subgroup 2 (control) - 18 children receiving standard nutrition supplementation. Results of the study and their discussion. Analysis of the average age of introduction of solid food showed that this indicator was in the subgroup 1 - 6,15 ± 0,65 months, in the subgroup 2 - 6,17 ± 0,69 months (p> 0,05). The average age of prescription for children of subgroup 1 of the complex of vitamins and minerals was 5.95 ± 0.86 months. When examining the children of both subgroups at the age of 12 months, we found a significant positive dynamics of all indicators among the children of the basic subgroup. So growth retardation in subgroup 1 was determined only in 5% (95% CI 0,89-23,61) versus 27,78% (95% CI 12,5-50,87) in subgroup 2. Weight deficit to length (exhaustion) was not detected in subgroup 1 children, but persisted in 11.11% (95% CI 3.10-32.80) of subgroup 2 children. A delayed PMD of more than 1 month at the age of 12 months was observed almost twice as rare among children of subgroup 1 - 35% (95% CI 18,12-56,71) against 66,67% (95% CI 43,75-83,72) among children of subgroup 2. Frequent acute respiratory diseases (more than 5 times a year) were observed in 10% (95% CI 2,79-30,10) of subgroup 1 and 33,33% (95% CI 16,28-56,25) of subgroup 2. Skin rash cues (dermatitis) of different genesis were recorded with significantly lower frequency among children of subgroup 1: 15% (95% CI 5,24-36,04) versus 61,11% (95% CI 38,62- 79,69). In the next step, we evaluated the effectiveness of the proposed treatment regimen by calculating the relative and absolute risk reduction (RRR, ARR) for the detection of growth retardation (GR) in preterm infants born with low body weight (LBW) at 12 months of age. Yes, RRR = 82%, which means that the use of the proposed treatment regimen can reduce the risk of detecting SFR at the age of 12 months by 82%. ARR = 22.78%. The number of people in need of treatment (NNT number needed to be treated) is 4%. That is, in order to prevent at least one case of GR at the age of 12 months among premature infants with LBW at birth, a recommended treatment regimen for at least 4 children with MMT should be prescribed. Conclusions. 1. The study showed that preterm infants who were supplemented with rational nutrition with a complex of vitamins and minerals had significantly better physical and psychomotor development rates at the age of 12 months, compared to children who received standard nutrition adjustments. 2. Evaluation of therapeutic efficacy has shown that the use of a complex of vitamins and minerals will reduce the risk of detection of growth retardation among children with LBW at birth by 82%. 3. The administration of a complex of vitamins and minerals demonstrates high efficiency and complete safety and may be recommended for the administration of 6-8 months of age to premature infants in the first year of life. |
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| ISSN: | 2226-1230 2413-4260 |