Unique Patterns of Body Composition and Anthropometric Measurements During Maturation in Neonatal Intensive Care Unit Neonates: Opportunities for Modifying Nutritional Therapy and Influencing Clinical Outcomes

摘要

Background: Body composition is an important predictor of long-term outcomes in neonates and may be altered by several factors. Innovative methods like air displacement plethysmography (ADP) can safely and reliably measure body composition, potentially assisting in individualization of nutrition therapy. Objectives: 1) To characterize patterns of body composition change in convalescing neonates in the neonatal intensive care unit (NICU) and examine factors leading to variation. 2) To evaluate if the time interval between 2 measurements via ADP can detect significant changes. Methods: NICU infants underwent anthropometry and body composition measurements by ADP at 37.5 +/- 0.7 weeks (Time 1) and 41.0 +/- 0.7 weeks (Time 2) postmenstrual age. Nutrition data were recorded. Data were analyzed using paired t-tests and linear regression models, presented as mean +/- SE, median (IQR), or %. Results: Twenty-two neonates (54% males, 32.2 +/- 0.9 weeks gestation) were evaluated with a median interval of 3.6 (2.9-4.0) weeks between studies. Mean weight and % body fat increased significantly. There was no significant difference between mean weight and mean % body fat compared with normal references. Abdominal girth increased and mid-arm circumference decreased (p 0.01). Preterm group had higher mean % body fat (10.1) than term infants (6.5), p = 0.03. Conclusion: Longitudinal assessment of body composition can effectively assess nutrition status of fragile NICU infants. Although, an interval of 2.9-4.0 weeks between consecutivemeasurements detected significant changes in body composition, more frequent measurements are needed to determine nutrition factors responsible for body composition changes.