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Low energy intake and severe retinopathy of prematurity
Growth restriction at birth and poor postnatal weight gain have been linked with increased risk of developing severe retinopathy of prematurity (ROP). This study suggests that low energy intake during the first 4 weeks is more important than poor postnatal growth. In a remarkably detailed study, Elisabeth Sjöström and colleagues examined the records of all preterm infants born in Sweden before 27 weeks of gestation over a 3 year period. They extracted detailed nutrition and growth data, including actual intakes of all enteral and parenteral fluid from 14 442 patient days during the first 28 days of life of 498 of 504 eligible infants who survived to complete ROP evaluation. There were 172 (34.5%) infants who developed severe ROP (stages 3–5). The association of severe ROP with energy intake was strong. In multivariable analyses, total energy intake during the first 4 weeks was a significant predictor of ROP, with a change in energy intake of 10kCal/kg/day associated with a 24% change in the odds ratio for developing severe ROP. The mean energy intake of infants with severe ROP was 97kcal/kg day and for those with no ROP was 108kcal/kg/day. Analyses suggested that average intakes of more than 110kcal/kg/day would be required to minimise the risk associated with low energy intake. A leading …
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