The influence of early postnatal nutrition on retinopathy of prematurity in extremely low birth weight infants☆
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 700–1000
g. 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
±
85
g and 26.3
±
1.2
weeks (n
=
77, mean
±
1SD). ROP surgery infants(n
=
11) received more parenteral nutrition, 1648
mL, and less human milk, 13.8
mL/kg-day, and vitamin E, 1.4
mg/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.
Keywords: Preterm infant, Enteral nutrition, Parenteral nutrition, Vitamin, Retinopathy of prematurity, Human milk
Abbreviations: ROP, retinopathy of prematurity, ELBW, extremely low birth weight (birth weight
<
1000
g, about 2
lb, 3
oz), VLBW, very low birth weight (birth weight
<
1500
g, about 3
lb, 5
oz), CRYO, cryosurgery
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☆ Presented in part at the 75th annual meeting of the Society for Pediatric Research.
PII: S0378-3782(10)00113-1
doi:10.1016/j.earlhumdev.2010.05.015
© 2010 Elsevier Ltd. All rights reserved.
