Pediatr Surg Int

. 2020 Nov 28;1-8. doi: 10.1007/s00383-020-04785-y. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/33247318/

Weight gain velocity and adequate amount of nutrition for infants with congenital diaphragmatic hernia

Keita Terui ¹, Yuko Tazuke ², Kouji Nagata ³, Miharu Ito ⁴, Hiroomi Okuyama ², Masahiro Hayakawa ⁴, Tomoaki Taguchi ³, Yasunori Sato ⁵, Noriaki Usui ⁶Affiliations expand

• PMID: 33247318
• PMCID: PMC7695587
• DOI: 10.1007/s00383-020-04785-y

Free PMC article

Abstract

Purpose: Growth retardation is a severe morbidity in infants with congenital diaphragmatic hernia (CDH). This study aimed to determine when catch-up growth starts in infants with CDH and to determine the adequate amount of nutrition required during catch-up growth.

Methods: This was a multicenter retrospective cohort study involving neonates with isolated CDH (born 2006-2010; n = 98). Weight gain velocity (WGV) was calculated using body weight Z-scores. The minimum required weight gain was defined as WGV ≥ 0. Patients were dichotomized into severe and non-severe cases according to diaphragmatic defects.

Results: Average monthly WGV changed from < 0 to ≥ 0 at 2 months of age. Total caloric intake at 2 months of age was lower when the WGV between 1 and 3 months was < 0 in both severe cases [122 (95% confidence interval (CI) 116-128) vs. 97 (95% CI 84-110) kcal/kg/day, p = 0.02] and non-severe cases [115 (95% CI 110-120) vs. 99 (95% CI 87-111) kcal/kg/day, p < 0.001)].

Conclusion: Catch-up growth started at approximately 2 months of age. During this period, total caloric intake of > 122 kcal/kg/day was needed to avoid decreases in the body weight Z-score in severe cases.

Keywords: Body weight; Enteral nutrition; Neonatal intensive care; Parenteral nutrition; neonatal care.