1. Early Hum Dev. 2010 Jun 17. [Epub ahead of print]
The influence of early postnatal nutrition on retinopathy
of prematurity in extremely low birth weight infants.
Porcelli PJ, Weaver RG Jr. Department of Pediatrics,
Wake Forest University, Winston-Salem, NC, 27157,
United States; Department of Ophthalmology, Wake
Forest University, Winston-Salem, NC, 27157, United
BACKGROUND: Retinopathy of prematurity(ROP)
is the most common serious ophthalmic disease in
preterm infants. Human milk may provide a protective
effect for ROP; however, beneficial effects of human
milk preclude randomized trials. Therefore, we
conducted a retrospective analysis comparing early
postnatal nutrition with ROP development.
OBJECTIVE: Evaluate relationship between early
postnatal nutriture and ROP surgery.
DESIGN/METHODS: Nutrition data was collected for inborn
AGA infants, BW 700-1000g. ROP surgery was the primary
outcome variable. A single pediatric ophthalmologist
supervised examinations. All infants received triweekly
IM vitamin A as chronic lung disease prophylaxis (Tyson:
NEJM, 1999). RESULTS: BW and gestational age were 867+/-85g
and 26.3+/-1.2weeks (n=77, mean+/-1SD). ROP surgery infants
(n=11) received more parenteral nutrition, 1648mL, and
less human milk, 13.8mL/kg-day, and vitamin E, 1.4mg/kg-day,
during the second postnatal week. Human milk was a negative
predictor for ROP surgery, odds ratio=0.94. Both groups met
vitamin A recommendations; however, 74% was administered
via IM injections. Neither group met vitamin E recommendations.
CONCLUSIONS: Human milk feeding, parenteral nutrition
volume and vitamin E intake were predictors for ROP surgery.
IM vitamin A injections provided the majority of vitamin A;
vitamin E administration was insufficient. Improving human
milk feeding rates and vitamin dosing options may affect
ROP surgery rates. Copyright © 2010 Elsevier Ltd. All rights
reserved. PMID: 20561759 [PubMed - as supplied by publisher]