GROWTH IN PRETERM INFANTS RECEIVING NUTRIENT INTAKES APPROXIMATING FETAL INTAKES

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。在全国范围内，针对早产儿的营养策略正在导致出生后发育障碍，新生儿无法通过出院恢复。营养不良，特别是关键发育期蛋白质摄入不足，对神经发育和健康的长期结果产生不利影响。优化营养支持对于避免这些不良后果至关重要。美国儿科学会(AAP)建议模仿与早产儿相同胎龄的正常胎儿的生长速度，这是唯一发表的关于在出院时为早产儿提供全面营养的建议。AAP没有关于如何实现这一点的指导方针，也没有文献中的数据来支持或驳斥这一建议。我们认为，确定这是否是一项有效的建议至关重要。这项研究旨在确定：a)早产儿出生后立即开始并维持到受孕后36周的营养递送率，以及b)给予相同胎龄的胎儿的数量是否会达到美国儿科学会的建议，即宫外生长应该与相同胎龄的胎儿大致相同。

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.