Association Between the 7-Day Moving Average for Nutrition and Growth in Very Low Birth Weight Infants

Gustave H. Falciglia*, Karna Murthy, Jane Holl, Hannah L. Palac, Yuliya Oumarbaeva, Pratyusha Yadavalli, Donna Woods, Daniel T. Robinson

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Very low birth weight (VLBW) infants remain at risk for postnatal growth restriction. Clinicians may have difficulty identifying growth patterns resulting from nutrition interventions, impeding prompt management changes intended to increase growth velocity. This study aimed to quantify the association between growth and nutrition intake through 7-day moving averages (SDMAs). Methods: The first 6 weeks of daily nutrition intake and growth measurements were collected from VLBW infants admitted to a level 4 neonatal intensive care unit (2011–2014). The association between SDMA for energy and macronutrients and subsequent 7-day growth velocities for weight, length, and head circumference were determined using mixed effects linear regression. Analyses were adjusted for fluid intake, infant characteristics, and comorbid conditions. Results: Detailed enteral and parenteral caloric provisions were ascertained for 115 infants (n = 4643 patient-days). Each 10-kcal/kg/d increase over 7 days was independently associated with increased weight (1.7 g/kg/d), length (0.4 mm/wk), and head circumference (0.9 mm/wk; P <.001, for weight and head circumference; P =.041 for length). Each 1 g/kg/d macronutrient increase was also associated with increased weight (protein, P =.027; fat and carbohydrates, P <.001), increased length (fat, P =.032), and increased head circumference (fat and carbohydrates, P <.001). Conclusions: The SDMA identifies clinically meaningful associations among total energy, macronutrient dosing, and growth in VLBW infants. Whether SDMA is a clinically useful tool for providing clinicians with prompt feedback to improve growth warrants further attention.

Original languageEnglish (US)
Pages (from-to)805-812
Number of pages8
JournalJournal of Parenteral and Enteral Nutrition
Volume42
Issue number4
DOIs
StatePublished - May 1 2018

Fingerprint

Very Low Birth Weight Infant
Growth
Head
Weights and Measures
Fats
Carbohydrates
Neonatal Intensive Care Units
Small Intestine
Linear Models

Keywords

  • growth
  • life cycle
  • mixed effects linear regression
  • moving averages
  • neonates
  • nutrition
  • very low birth weight infants

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

@article{96bef566fd5a4b4db689b9a1c2c45e1f,
title = "Association Between the 7-Day Moving Average for Nutrition and Growth in Very Low Birth Weight Infants",
abstract = "Background: Very low birth weight (VLBW) infants remain at risk for postnatal growth restriction. Clinicians may have difficulty identifying growth patterns resulting from nutrition interventions, impeding prompt management changes intended to increase growth velocity. This study aimed to quantify the association between growth and nutrition intake through 7-day moving averages (SDMAs). Methods: The first 6 weeks of daily nutrition intake and growth measurements were collected from VLBW infants admitted to a level 4 neonatal intensive care unit (2011–2014). The association between SDMA for energy and macronutrients and subsequent 7-day growth velocities for weight, length, and head circumference were determined using mixed effects linear regression. Analyses were adjusted for fluid intake, infant characteristics, and comorbid conditions. Results: Detailed enteral and parenteral caloric provisions were ascertained for 115 infants (n = 4643 patient-days). Each 10-kcal/kg/d increase over 7 days was independently associated with increased weight (1.7 g/kg/d), length (0.4 mm/wk), and head circumference (0.9 mm/wk; P <.001, for weight and head circumference; P =.041 for length). Each 1 g/kg/d macronutrient increase was also associated with increased weight (protein, P =.027; fat and carbohydrates, P <.001), increased length (fat, P =.032), and increased head circumference (fat and carbohydrates, P <.001). Conclusions: The SDMA identifies clinically meaningful associations among total energy, macronutrient dosing, and growth in VLBW infants. Whether SDMA is a clinically useful tool for providing clinicians with prompt feedback to improve growth warrants further attention.",
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author = "Falciglia, {Gustave H.} and Karna Murthy and Jane Holl and Palac, {Hannah L.} and Yuliya Oumarbaeva and Pratyusha Yadavalli and Donna Woods and Robinson, {Daniel T.}",
year = "2018",
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Association Between the 7-Day Moving Average for Nutrition and Growth in Very Low Birth Weight Infants. / Falciglia, Gustave H.; Murthy, Karna; Holl, Jane; Palac, Hannah L.; Oumarbaeva, Yuliya; Yadavalli, Pratyusha; Woods, Donna; Robinson, Daniel T.

In: Journal of Parenteral and Enteral Nutrition, Vol. 42, No. 4, 01.05.2018, p. 805-812.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Association Between the 7-Day Moving Average for Nutrition and Growth in Very Low Birth Weight Infants

AU - Falciglia, Gustave H.

AU - Murthy, Karna

AU - Holl, Jane

AU - Palac, Hannah L.

AU - Oumarbaeva, Yuliya

AU - Yadavalli, Pratyusha

AU - Woods, Donna

AU - Robinson, Daniel T.

PY - 2018/5/1

Y1 - 2018/5/1

N2 - Background: Very low birth weight (VLBW) infants remain at risk for postnatal growth restriction. Clinicians may have difficulty identifying growth patterns resulting from nutrition interventions, impeding prompt management changes intended to increase growth velocity. This study aimed to quantify the association between growth and nutrition intake through 7-day moving averages (SDMAs). Methods: The first 6 weeks of daily nutrition intake and growth measurements were collected from VLBW infants admitted to a level 4 neonatal intensive care unit (2011–2014). The association between SDMA for energy and macronutrients and subsequent 7-day growth velocities for weight, length, and head circumference were determined using mixed effects linear regression. Analyses were adjusted for fluid intake, infant characteristics, and comorbid conditions. Results: Detailed enteral and parenteral caloric provisions were ascertained for 115 infants (n = 4643 patient-days). Each 10-kcal/kg/d increase over 7 days was independently associated with increased weight (1.7 g/kg/d), length (0.4 mm/wk), and head circumference (0.9 mm/wk; P <.001, for weight and head circumference; P =.041 for length). Each 1 g/kg/d macronutrient increase was also associated with increased weight (protein, P =.027; fat and carbohydrates, P <.001), increased length (fat, P =.032), and increased head circumference (fat and carbohydrates, P <.001). Conclusions: The SDMA identifies clinically meaningful associations among total energy, macronutrient dosing, and growth in VLBW infants. Whether SDMA is a clinically useful tool for providing clinicians with prompt feedback to improve growth warrants further attention.

AB - Background: Very low birth weight (VLBW) infants remain at risk for postnatal growth restriction. Clinicians may have difficulty identifying growth patterns resulting from nutrition interventions, impeding prompt management changes intended to increase growth velocity. This study aimed to quantify the association between growth and nutrition intake through 7-day moving averages (SDMAs). Methods: The first 6 weeks of daily nutrition intake and growth measurements were collected from VLBW infants admitted to a level 4 neonatal intensive care unit (2011–2014). The association between SDMA for energy and macronutrients and subsequent 7-day growth velocities for weight, length, and head circumference were determined using mixed effects linear regression. Analyses were adjusted for fluid intake, infant characteristics, and comorbid conditions. Results: Detailed enteral and parenteral caloric provisions were ascertained for 115 infants (n = 4643 patient-days). Each 10-kcal/kg/d increase over 7 days was independently associated with increased weight (1.7 g/kg/d), length (0.4 mm/wk), and head circumference (0.9 mm/wk; P <.001, for weight and head circumference; P =.041 for length). Each 1 g/kg/d macronutrient increase was also associated with increased weight (protein, P =.027; fat and carbohydrates, P <.001), increased length (fat, P =.032), and increased head circumference (fat and carbohydrates, P <.001). Conclusions: The SDMA identifies clinically meaningful associations among total energy, macronutrient dosing, and growth in VLBW infants. Whether SDMA is a clinically useful tool for providing clinicians with prompt feedback to improve growth warrants further attention.

KW - growth

KW - life cycle

KW - mixed effects linear regression

KW - moving averages

KW - neonates

KW - nutrition

KW - very low birth weight infants

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