The characteristics of nutritional intake and bone metabolism in preterm infants with very low birth weight and small gestational age / 中国新生儿科杂志

ABSTRACT

Objective:To study the differences in nutritional intake and bone metabolism between small gestational age infant (SGA) and appropriate gestational age infant (AGA) in very low birth weight (VLBW) preterm infants.Methods:From January 2015 to January 2020, infants admitted to the neonatal intensive care unit of our hospital immediately after birth and survived more than 4 weeks were retrospectively studied. The infants with GA<32 weeks, BW<1 500 g and small for gestational age were assigned into SGA group. Each SGA group infants were paired with an AGA infants The perinatal history was reviewed. Serum total calcium, blood phosphorus, blood magnesium, alkaline phosphatase and other nutritional intake indicators in the blood biochemistry were examined at 1 w, 2 w and 4 w after birth. SPSS 22.0 statistical software was used to analyze the relationship between nutritional intake and bone metabolism indexes.Results:A total of 80 cases were included in SGA group and AGA group, respectively. No significant difference existed in the incidence of hypophosphatemia within 2w after birth between the two groups ( P>0.05). SGA group had significantly lower incidence of hypophosphatemia at 4w than AGA group [36.3% (29/80 ) vs. 56.3% (45/80)]( P<0.05). SGA group showed significantly higher proportion of ALP>500 U/L cases than AGA group at 2 w and 4 w [16.3% (13/80) vs. 1.3% (1/80), 21.3% (17/80) vs. 2.5% (2/80)]( P<0.05). The two groups had similar serum magnesium level ( P>0.05). SGA group had higher incidence of delayed milk feeding [67.5% (54/80) vs. 26.2% (21/80)], longer parenteral nutrition duration [(49.4±14.4)d vs. (40.5±18.2)d] and slower increase of calorie intake and enteral nutrition than AGA group ( P<0.05). Conclusions:Among VLBW preterm infants, SGA infants have worse nutritional intake than AGA and are more vulnerable to abnormal bone metabolism.