versão On-line ISSN 1683-9803
GENES, L e GRUPO COLABORATIVO NEOCOSUR et al. In-Hospital Weight Gain in Very Low Birth Weight Newborns at the Centro Materno-Infantil of Asuncion, Paraguay: Comparison with the NEOCOSUR Database. Pediatr. (Asunción) [online]. 2010, vol.37, n.3, pp.169-174. ISSN 1683-9803.
Introduction: Assessing the growth and nutritional status of newborns (NB) is very important because of how strongly both factors are associated with overall health and development. Growth is associated with nutritional practices; with differences in calorie and protein intake varying according to when enteral and parenteral feeding of the VLBWI are begun. Objectives: To determine in-hospital weight gain and feeding practices for VLBWI in the Neonatal Unit of the Pediatrics Department of the Centro Materno-Infantil (CMI), of the School of Medical Sciences, National University of Asunción (UNA). Methodology: A retrospective, observational, and analytical study. Patients included were NB treated in the CMI Neonatal Intensive Care Unit (NICU) with birth weights between 500 and 1500 grams between 1 January 2007 and 31 December 2009. Their development, weight, and food intake were recorded in follow up from birth until discharge to home. VLBW newborns in the NEOCOSUR database for the same period of time served as the control group. Results: Of the 140 VLBW newborns in that time period, 93 met inclusion criteria, and their rate of survival to discharge was 66.4%. Average birth weight was 1187 ± 201 grams, while on day 7 weight was 1091 ± 200 grams: an average loss of 95.4 ± 5.6 grams, corresponding to 8% of birth weight, and a daily rate of loss of 13.6 grams per day. At 28 days of age, average weight was 1470 ± 271 grams, with weight gain from day 7 to day 28 days of 293 ± 79.4 grams, a gain of 26.5%, corresponding to an estimated gain of 10.5 grams per day. At discharge, the average weight was 2140 ± 356 grams: a variation of weight relative to birthweight of 930 ± 97 grams (85.3%), corresponding to a gain of 14.5 grams per day. Among the 69 (74%) of VLBW newborn who received total parenteral nutrition (TPN), total days of hospitalization averaged 16 ± 9.4, while amino acid supplementation was begun at 2.7 ± 3.6 days and lipids at 3.9 ± 3.4 days. Newborns in the NEOCOSUR database showed total days of TPN as 14 ± 11.7 days, with amino acids begun at 1.6 ± 1.8 days and lipids at 2 ± 1.8 days. Of the total sample analyzed, 2,346 VLBW newborns (89%) received TPN. Enteral feeding was started at the CMI at 4.1 ± 3.6 days and in NEOCOSUR at 3.2 ± 3 days. A volume of 100 ml/kg/day was reached at 14 ± 8 days in the CMI and in NEOCOSUR at 13.1 ± 8.4 days of life. Conclusion: By comparing in-hospital growth of VLBW newborns at the CMI with those in same category in the NEOCOSUR database, a significant difference is observed in the final weight gain of 15 grams per day in the CMI compared to 20 grams per day in the NEOCOSUR group.
Palavras-chave : VLBW newborns; nutritional status; enteral and parenteral feeding; in-hospital weight; nutritional practices.