Medical Student Cooper Medical School of Rowan University Dorothy, New Jersey, United States
Background: “Late preterm”(LPT) neonates are generally defined as infants born between 34 0/7 and 36 6/7 weeks gestation and constitute approximately 70% of all preterm births. Determining the nutritional needs of this population poses a challenge to clinicians. While much effort has been put into evaluating the nutritional needs of early preterm or low birthweight infants, there is a shortage of research on the nutritional needs of LPT infants. Many LPT neonates are cared for outside of the neonatal intensive care unit (NICU), yet may be at risk for medical morbidities due to their shortened development in utero. Objective: To examine how adherence to current nutrition guidelines and how the use of fortification of feeds affects the growth of LPT neonates in the first year of life. Design/Methods: A retrospective chart review was conducted at a Tertiary level academic hospital in the Northeast of neonates born between 34 0/7 and 36 6/7 weeks gestation from 1/2013-12/2022. The neonates were identified from electronic medical records, EPIC. Head circumference, weight, and length at birth (documented as measurements, percent, and z-scores), at discharge, at 2 months, at 6 months, and at 12 months post birth were collected and evaluated. Data regarding the neonate’s feeding regimen, caloric fortification, and type of nutrition were assessed. Data was analyzed using independent t-tests and Mann-Whitney U tests to assess statistical significance. Results: A total of 591 patients were evaluated. Of these patients, 50.6% were male, the mean gestational age was 34.86 (± 0.83), and the mean birth weight was 2286 grams (±484). Babies with lower birth weight (BW) were more likely to receive fortification (BW p=0.05, BW percentile p=0.01). Patients who followed fortification guidelines had lower birth weight, discharge weight, and weight percentile (p < 0.001), as well as lower Z-scores for BW, length, and head circumference (HC) at birth and at discharge (p < 0.001). At 6 and 12 months, length, and weight of those who were fortified was similar to those who were not, and the HC Z-score at 1 year had a higher median (-0.03 vs 0.34).
Conclusion(s): The results show that adherence to nutritional guidelines recommending fortified feeding impacts growth within the first year of life of late premature neonates. Even those infants who had lower weight, length, and head circumference at birth were able to catch up by 6 months when adhering to fortification guidelines.
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