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.
N1 - Publisher Copyright:
© 2017 The Authors. Journal of Parenteral and Enteral Nutrition published by Wiley Periodicals, Inc. on behalf of American Society for Parenteral and Enteral Nutrition.
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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U2 - 10.1177/0148607117722927
DO - 10.1177/0148607117722927
M3 - Article
C2 - 28800397
AN - SCOPUS:85045937223
SN - 0148-6071
VL - 42
SP - 805
EP - 812
JO - Journal of Parenteral and Enteral Nutrition
JF - Journal of Parenteral and Enteral Nutrition
IS - 4
ER -