Early feeding tolerance in small for gestational age infants with normal versus abnormal antenatal Doppler characteristics

M. F. Ahamed, Pe'er Dar, M. Vega, Mimi Kim, Qi Gao, Thomas G. Havranek

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

OBJECTIVES: To determine differences in feeding tolerance amongst preterm small for gestational age (SGA) infants with normal versus abnormal umbilical artery Doppler flow defined as absent or reversed end diastolic flow (AREDF). METHODS: This was a retrospective cohort study of infants<35 weeks gestational age (GA) and birth weight (BW) <10th percentile. Day of initiation of feeds, days to full feeds and CRIB II scores were the primary outcomes. Clinical characteristics were compared between the groups of SGA infants with normal and AREDF. Multivariable regression models were fit to the data to adjust for potential confounders of the association of AREDF and feeding intolerance. RESULTS: 120 infants with normal and 64 infants with AREDF were included. The infants with AREDF were smaller (971g vs. 1183g, p=0.0002), less mature (29.9 wks vs. 31.2 wks, p=0.0009), had higher CRIB II score (7.2 vs. 5.2, p=0.0033), started feeding later (4.1 days vs. 3.3 days, p=0.020) and advanced slower to full feeds (17.7 days vs. 13.7 days, p=0.0017). Necrotizing enterocolitis was similar between the groups (p=0.18). After adjusting for confounders, Doppler flow was no longer a significant predictor of the initiation (p=0.37) and advancement of feeds (p=0.44). CONCLUSIONS: Infants with AREDF are sicker at birth and have more feeding difficulties; after adjusting for BW and GA, Doppler flow was no longer a significant predictor of feeding intolerance.

Original languageEnglish (US)
Pages (from-to)43-48
Number of pages6
JournalJournal of Neonatal-Perinatal Medicine
Volume10
Issue number1
DOIs
StatePublished - 2017

Fingerprint

Small for Gestational Age Infant
Birth Weight
Gestational Age
Necrotizing Enterocolitis
Umbilical Arteries
Cohort Studies
Retrospective Studies
Parturition

Keywords

  • Feeding tolerance
  • Growth restriction
  • IUGR

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

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title = "Early feeding tolerance in small for gestational age infants with normal versus abnormal antenatal Doppler characteristics",
abstract = "OBJECTIVES: To determine differences in feeding tolerance amongst preterm small for gestational age (SGA) infants with normal versus abnormal umbilical artery Doppler flow defined as absent or reversed end diastolic flow (AREDF). METHODS: This was a retrospective cohort study of infants<35 weeks gestational age (GA) and birth weight (BW) <10th percentile. Day of initiation of feeds, days to full feeds and CRIB II scores were the primary outcomes. Clinical characteristics were compared between the groups of SGA infants with normal and AREDF. Multivariable regression models were fit to the data to adjust for potential confounders of the association of AREDF and feeding intolerance. RESULTS: 120 infants with normal and 64 infants with AREDF were included. The infants with AREDF were smaller (971g vs. 1183g, p=0.0002), less mature (29.9 wks vs. 31.2 wks, p=0.0009), had higher CRIB II score (7.2 vs. 5.2, p=0.0033), started feeding later (4.1 days vs. 3.3 days, p=0.020) and advanced slower to full feeds (17.7 days vs. 13.7 days, p=0.0017). Necrotizing enterocolitis was similar between the groups (p=0.18). After adjusting for confounders, Doppler flow was no longer a significant predictor of the initiation (p=0.37) and advancement of feeds (p=0.44). CONCLUSIONS: Infants with AREDF are sicker at birth and have more feeding difficulties; after adjusting for BW and GA, Doppler flow was no longer a significant predictor of feeding intolerance.",
keywords = "Feeding tolerance, Growth restriction, IUGR",
author = "Ahamed, {M. F.} and Pe'er Dar and M. Vega and Mimi Kim and Qi Gao and Havranek, {Thomas G.}",
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TY - JOUR

T1 - Early feeding tolerance in small for gestational age infants with normal versus abnormal antenatal Doppler characteristics

AU - Ahamed, M. F.

AU - Dar, Pe'er

AU - Vega, M.

AU - Kim, Mimi

AU - Gao, Qi

AU - Havranek, Thomas G.

PY - 2017

Y1 - 2017

N2 - OBJECTIVES: To determine differences in feeding tolerance amongst preterm small for gestational age (SGA) infants with normal versus abnormal umbilical artery Doppler flow defined as absent or reversed end diastolic flow (AREDF). METHODS: This was a retrospective cohort study of infants<35 weeks gestational age (GA) and birth weight (BW) <10th percentile. Day of initiation of feeds, days to full feeds and CRIB II scores were the primary outcomes. Clinical characteristics were compared between the groups of SGA infants with normal and AREDF. Multivariable regression models were fit to the data to adjust for potential confounders of the association of AREDF and feeding intolerance. RESULTS: 120 infants with normal and 64 infants with AREDF were included. The infants with AREDF were smaller (971g vs. 1183g, p=0.0002), less mature (29.9 wks vs. 31.2 wks, p=0.0009), had higher CRIB II score (7.2 vs. 5.2, p=0.0033), started feeding later (4.1 days vs. 3.3 days, p=0.020) and advanced slower to full feeds (17.7 days vs. 13.7 days, p=0.0017). Necrotizing enterocolitis was similar between the groups (p=0.18). After adjusting for confounders, Doppler flow was no longer a significant predictor of the initiation (p=0.37) and advancement of feeds (p=0.44). CONCLUSIONS: Infants with AREDF are sicker at birth and have more feeding difficulties; after adjusting for BW and GA, Doppler flow was no longer a significant predictor of feeding intolerance.

AB - OBJECTIVES: To determine differences in feeding tolerance amongst preterm small for gestational age (SGA) infants with normal versus abnormal umbilical artery Doppler flow defined as absent or reversed end diastolic flow (AREDF). METHODS: This was a retrospective cohort study of infants<35 weeks gestational age (GA) and birth weight (BW) <10th percentile. Day of initiation of feeds, days to full feeds and CRIB II scores were the primary outcomes. Clinical characteristics were compared between the groups of SGA infants with normal and AREDF. Multivariable regression models were fit to the data to adjust for potential confounders of the association of AREDF and feeding intolerance. RESULTS: 120 infants with normal and 64 infants with AREDF were included. The infants with AREDF were smaller (971g vs. 1183g, p=0.0002), less mature (29.9 wks vs. 31.2 wks, p=0.0009), had higher CRIB II score (7.2 vs. 5.2, p=0.0033), started feeding later (4.1 days vs. 3.3 days, p=0.020) and advanced slower to full feeds (17.7 days vs. 13.7 days, p=0.0017). Necrotizing enterocolitis was similar between the groups (p=0.18). After adjusting for confounders, Doppler flow was no longer a significant predictor of the initiation (p=0.37) and advancement of feeds (p=0.44). CONCLUSIONS: Infants with AREDF are sicker at birth and have more feeding difficulties; after adjusting for BW and GA, Doppler flow was no longer a significant predictor of feeding intolerance.

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KW - Growth restriction

KW - IUGR

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U2 - 10.3233/NPM-1682

DO - 10.3233/NPM-1682

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