After NICU discharge: Feeding and growth of low-income urban preterm infants through the first year.
J Neonatal Perinatal Med 2023;
16:151-164. [PMID:
36872797 DOI:
10.3233/npm-221156]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
BACKGROUND
Little is known about preterm infant feeding and growth in the outpatient setting, and there are no standardized post-hospital discharge feeding guidelines. This study aims to describe post-neonatal intensive care unit (NICU) discharge growth trajectories of very preterm (<32 weeks gestational age (GA)) and moderately preterm (32-34 0/7 weeks GA) infants managed by community providers and to determine the association between post-discharge feeding type and growth Z-scores and z-score changes through 12 months corrected age (CA).
METHODS
This retrospective cohort study included very preterm infants (n = 104) and moderately preterm infants (n = 109) born 2010-2014 and followed in community clinics for low-income, urban families. Infant home feeding and anthropometry were abstracted from medical records. Repeated measures analysis of variance calculated adjusted growth z-scores and z-score differences between 4 and 12 months CA. Linear regression models estimated associations between 4 months CA feeding type and 12 months CA anthropometry.
RESULTS
Moderately preterm infants on nutrient-enriched vs. standard term feeds at 4 months CA had significantly lower length z-scores at NICU discharge that persisted to 12 months CA (-0.04 (0.13) vs. 0.37 (0.21), respectively, P = .03), with comparable length z-score increase for both groups between 4 and 12 months CA. Very preterm infants' 4 months CA feeding type predicted 12 month CA body mass index z-scores (β=-0.66 (-1.28, -0.04)).
CONCLUSION
Community providers may manage preterm infant post-NICU discharge feeding in the context of growth. Further research is needed to explore modifiable drivers of infant feeding and socio-environmental factors that influence preterm infant growth trajectories.
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