GROWTH IN PRETERM INFANTS RECEIVING NUTRIENT INTAKES APPROXIMATING FETAL INTAKES

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。在全国范围内，针对极早产儿的营养策略导致新生儿在出院时无法恢复的产后生长障碍。营养不良，特别是在关键发育期蛋白质摄入不足，会对长期的神经发育和健康结果产生不利影响。优化营养支持对于避免这些不良后果至关重要。唯一已发表的关于在早产儿出院时为早产儿提供全面营养的建议是美国儿科学会（AAP）建议模拟与早产儿相同胎龄的正常胎儿的生长速度。AAP没有关于如何实现这一目标的指南，文献中也没有数据支持或反驳这一建议。我们认为，确定这是否是一项有效的建议至关重要。本研究旨在确定：a）早产新生儿出生后立即开始并维持至孕后36周的营养素输送率，以及B）与相同胎龄胎儿输送量相同的营养素输送率，是否能达到AAP建议的子宫外生长应接近相同胎龄胎儿的水平。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Nationally, nutritional strategies for very preterm infants are resulting in postnatal growth failure from which the neonate does not recover by hospital discharge. Undernutrition, particularly insufficient protein intake during critical development periods adversely affects long-term neurodevelopmental and health outcomes. Optimizing nutritional support is critical to avoid these adverse outcomes. The only published recommendation for providing comprehensive nutrition to the preterm neonate through the time of discharge is the American Academy of Pediatrics (AAP) recommendation to mimic the growth rate of the normal fetus of the same gestational age as the preterm infant. There are no guidelines by the AAP as to how this should be achieved, and no data in the literature to support or refute this recommendation. We believe that it is critical to determine if this is a valid recommendation. This study aims to determine if nutrient delivery rates that are: a) started immediately after birth in preterm neonates and maintained through 36 weeks postconceptional age, and b) administered in quantities that duplicate what is delivered to the fetus of the same gestational age, will achieve the AAP recommendation that extrauterine growth should approximate that of the fetus at the same gestational age.