The influence of early postnatal nutrition on retinopathy of prematurity in extremely low birth weight infants☆
Received 12 October 2009; received in revised form 7 May 2010; accepted 11 May 2010.
Abstract
Background
Retinopathy of prematurity(ROP) is the most common serious ophthalmic disease in preterm infants. Human milk may provide a protective effect for ROP; however, beneficial effects of human milk preclude randomized trials. Therefore, we conducted a retrospective analysis comparing early postnatal nutrition with ROP development.
Objective
Evaluate relationship between early postnatal nutriture and ROP surgery.
Design/methods
Nutrition data was collected for inborn AGA infants, BW 700–1000g. ROP surgery was the primary outcome variable. A single pediatric ophthalmologist supervised examinations. All infants received triweekly IM vitamin A as chronic lung disease prophylaxis (Tyson: NEJM, 1999).
Results
BW and gestational age were 867±85g and 26.3±1.2weeks (n=77, mean±1SD). ROP surgery infants(n=11) received more parenteral nutrition, 1648mL, and less human milk, 13.8mL/kg-day, and vitamin E, 1.4mg/kg-day, during the second postnatal week. Human milk was a negative predictor for ROP surgery, odds ratio=0.94. Both groups met vitamin A recommendations; however, 74% was administered via IM injections. Neither group met vitamin E recommendations.
Conclusions
Human milk feeding, parenteral nutrition volume and vitamin E intake were predictors for ROP surgery. IM vitamin A injections provided the majority of vitamin A; vitamin E administration was insufficient. Improving human milk feeding rates and vitamin dosing options may affect ROP surgery rates.
ABSTRACT