IMPACT OF A FEEDING PROCEDURE FOR EXTREMELY LOW AND VERY LOW BIRTH WEIGHT INFANTS ON THE RATE AND DEGREE OF HYPERGLYCEMIA


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Objective. To evaluate the impact of a forced feeding procedure on the rate and degree of hyperglycemia in extremely low and very low birth weight (ELBW and VIBW) infants. Subjects and methods. A total of 120 neonates, including 47EIBWinfants and 73 VLBWinfants, who had been treated in an intensive care unit in January 2012 to January 2014, were examined. Blood glucose levels were determined in all the babies. The two-fold increased blood glucose level (>8.0 mmol/l) at a 4-hour interval was considered to be hyperglycemia. The infants were divided into the following groups according to gestational age: 1) 25-27weeks (n=22); 2) 28-29 weeks (n=43), 3) 30-31 weeks (n=40), and 4) 32-33 weeks (n=15). Each group was divided into subgroups in relation to a parenteral feeding procedure: A) forcedfeeding; B) traditional feeding. Results. The investigation established that the difference in the rate of hyperglycemia was statistically insignificant in relation to the feeding procedure. This trend was noted in all the groups. Comparative analysis of the two parenteral feeding procedures also re vealed no increase in the mean blood glucose levels in the forced feeding subgroups in the first week of life. Comparison of the rate of intragastric bleeding (IGB) in the examined groups showed a statistically significant increase in the rate of grade 1-2 IGB in Subgroup В of Group 1 versus Subgroup A. Examination of the two parenteral feeding procedures revealed no statistical difference in the incidence of retinopathy of prematurity. Analysis of the possible complications of parenteral nutrition in Group 1 patients demonstrated a rise in the incidence of neonatal cholestasis in Subgroup В versus Subgroup A. There was no significant difference in the incidence of neonatal cholestasis or IGB in the groups of infants at more than 27 weeks’ gestation (p > 0.05). Conclusion. The forcedfeeding procedure in ELBW and VLBW infants does not result in a significant increase in the rate and degree of hyperglycemia. The lack of an increase in the frequency of complications of hyperglycemia, such as IGB, retinopathy, neonatal cholestasis, additionally suggests that the forced feeding procedure is safe.

Full Text

Restricted Access

About the authors

Elena N. Baibarina

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia; Department of medical care for children and obstetric services, Ministry of Health of Russia

Email: baibarina@mail.ru
MD, chief researcher, professor of department of pathology of newborn and premature babies; Director Moscow 117997, Ac. Oparina str. 4, Russia

Olga Yu. Markova

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: terolganeo@mail.ru
Postgraduate Moscow 117997, Ac. Oparina str. 4, Russia

Oleg V. Ionov

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: dr.ionov@hotmail.com
PhD, head of the intensive care unit newborns Moscow 117997, Ac. Oparina str. 4, Russia

References

  1. Morgan С., McGowan Р., Herwitker S., Hart А.Е. Turner М.А. Postnatal head growth in preterm infants: a randomized controlled parenteral nutrition study. Pediatrics. 2014; 133(1): ЄІ20-8. doi: 10.1542/ peds.2013-2207.
  2. Heimann K, Peschgens T, Kwiecien R., Stanzel S., Hoemchen H., Men U. Are recurrent hyperglycemic episodes and median blood glucose level a prognostic factor for increased morbidity and mortality in premature infants № 1500 g? J. Perinat. Med. 2007; 35(3): 245-8.
  3. Hays S.P., Smith E. 0., Sunehag A.L. Hyperglycemia is a risk factor for early death and morbidity in extremely low birth-weight infants. Pediatrics. 2006; 118(5): 1811-8.
  4. Ertl I, Gyarmati J., Gadl V, Szabd I. Relationship between hyperglycemia and retinopathy of prematurity in very low birth weight infants. Biol. Neonate. 2006; 89(1): 56-9.
  5. Blanco C.L., Baillargeon J.G., Morrison R.L., Gong A.К Hyperglycemia in extremely low birth weight infants in a predominantly Hispanic population and related morbidities. J. Perinatol. 2006; 26(12): 737-41.
  6. Ng S.M., May J.E., Emmerson A.J. Continuous insulin infusion in hyperglycae- mic extremely-low-birth-weight neonates. Biol. Neonate. 2005; 87(4): 269-72.
  7. Pati N.K., Maheshwari R., Chellani H, Salhan R.N. Transient neonatal hyperglycemia. Indian Pediatr. 2001; 38(8): 898-901.
  8. Cowett A.A., Farrag H.M., Gelardi N.L., Cowett R.M. Hyperglycemia in the micropremie: evaluation of the metabolic disequilibrium during the neonatal period. Prenat. Neonatal Med.1997; 2: 360-5.
  9. Louik C., Mitchell A.A., Epstein M.F., Shapiro S. Risk factors for neonatal hyperglycemia associated with 10% dextrose infusion. Am. J. Dis. Child. 1985; 193(8): 783-6.
  10. DiGiacomo J.E., Hay W.W. Jr. Effect of hypoinsulinemia and hyperglycemia on fetal glucose utilization. Am. J. Physiol. 1990; 259(4, Pt 1): 506-12.
  11. Pildes R.S. Neonatal hyperglycemia. J. Pediatr. 1986; 109(5): 905-7.
  12. Иванов Д.О. Клинико-лабораторные варианты течения сепсиса новорожденных: автореф.дисс..д-ра мед. наук. СПб.; 2002.
  13. JanotaJ., StranakZ., Stateca B., Dohnalova A., SipekA., SimakJ. Characterization of multiple organ dysfunction syndrome in very low birth weight infants: a new equential scoring system. Shock. 2001; 15(5): 348-52.
  14. van derLugt N.M., Smits-Wintjens V.E., van Zwieten P.H., WaltherF.J. Short and long term outcome of neonatal hyperglycemia in very preterm infants: a retrospective follow-up study. BMC Pediatr. 2010; 10: 52-6.
  15. Roos R., Genzel-Boroviczeny 0., Proquitte H. Checkliste Neonatologie: Das NeoABC. Stuttgart, New York: Georg Thieme Verlag; 2010.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2016 Bionika Media