Nutritional intake and growth until two years of age in moderate and late preterms

Background and aim

Moderate and late preterm infants (MLPTI) (gestational age 32 0/7–36 6/7 weeks), are at risk for suboptimal growth. This study evaluated adherence to nutritional recommendations until 6 months corrected age (CA), growth until 2 years CA, and associations between nutritional intake and growth until 2 years CA.

Methods

We prospectively collected nutritional intakes from 100 MLPTI during the first week of life and at 6 weeks, 3 months, and 6 months CA. Anthropometry was assessed at birth, discharge, term age, and at 6 weeks, 3 months, 6 months, 1 year, and 2 years CA.

Results

On day 7, <40% reached nutritional recommendations. Thereafter, >80% reached protein recommendations until 6 months of life, but <60% reached energy recommendations. Weight z-scores increased from −0.44 at term-age to 0.59 at 3 months CA, but declined to −0.53 at 2 years CA on the TNO curves. No significant associations were found between nutritional intake and growth until 2 years CA.

Conclusion

No associations were demonstrated between nutritional intakes and growth until 2 years CA, despite not reaching recommended intakes. Despite high efforts to optimize growth, MLPTI find their own growth curve in the first 2 years of life.

Impact

This research is pioneering in identifying how nutrition influences growth in moderate and late preterm infants (MLPTI) up to 2 years corrected age (CA).

MLPTI often do not meet the recommended protein and energy intake in their first week of life, suggesting that current guidelines might be too high.

No association was demonstrated between nutritional intake and growth of MLPTI in the first 2 years of life.

Initially, MLPTI show an increase in weight z-scores from term age up to 3 months CA but experience a decline in weight z-scores at 2 years CA, according to TNO growth charts.