@article{adf8cc7a5a8a43daa41d237c7ca6d8fb,
title = "Variation in Enteral Feeding Practices and Growth Outcomes among Very Premature Infants: A Report from the New York State Perinatal Quality Collaborative",
abstract = "Background Extrauterine growth restriction (EUGR) is inversely related to neurodevelopmental outcome. We analyzed growth outcomes and enteral nutrition practices among preterm infants at New York State (NYS) regional perinatal centers (RPCs) to identify practices associated with risk of EUGR. Methods Surviving infants<31 weeks' gestation admitted to a NYS RPC during 2010 were identified and data collected on their growth and enteral nutrition from a statewide database. Neonatologists at NYS RPCs were surveyed to identify center-specific nutritional practices. Survey responses, nutrition, and growth data were then analyzed to identify factors associated with risk of EUGR. Results Of the 1,387 infants, 32.6% were discharged with EUGR. Incidence of EUGR varied more than fivefold among RPCs. Nutritional practices directly related to EUGR included age at first enteral feeding and full enteral feedings. Among the surveyed nutrition practices, longer duration of trophic feeding before advancing was associated with an increased risk of EUGR while later discontinuation of total parenteral nutrition and larger trophic feeding volume were associated with lower risk. Conclusion Our study found marked variation in nutrition practices and incidence of EUGR among preterm infants at NYS RPCs. A statewide quality improvement initiative to reduce practice variation and improve growth in preterm infants is underway.",
keywords = "extrauterine growth restriction, infant, infant growth, neonatal nutrition, premature, quality improvement",
author = "Stevens, {Timothy P.} and Eileen Shields and Deborah Campbell and Adriann Combs and Michael Horgan and {La Gamma}, {Edmund F.} and Xiong, {Kuang Nan} and Marilyn Kacica",
note = "Funding Information: The New York State Department of Health (NYSDOH) provided financial support to the New York State Perinatal Quality Collaborative (NYSPQC) for the quality improvement activities reported here. Funding was also made possible by grant U38DP003782 from the Centers forDisease Control and Prevention (CDC). The NYS Department of Health provided support for NYSPQC and the NYS Statewide Perinatal Data System (NYS SPDS) NICU module. We wish to recognize Christopher Kus, MD, MPH, Associate Medical Director of the Division of FamilyHealth at the NYSDOH, Kristen Lawless, MS, Program Manager of the NYPSQC at the NYSDOH, and the administrative and organizational support of Colleen Signer and Tamara Carruth,NYSDOH,Albany,NY.Wewould also like to acknowledge Patricia Heinrich, RN, MSN of the National Initiative for Children?sHealthQuality (NICHQ)who served as the project?s quality improvement advisor. The following investigators, in addition to those listed as authors, participated in this study: Pauline Graziano, BSN, NNP, Upender Munshi, MD, Angel Rios, MD, Children?s Hospital at Albany Medical Center, Albany, NY. Elena Wachtel, MD, Zina Jones, RN, Roslyn Mayer, Bellevue Hospital, New York, NY.Michelle Bode, MD, Crouse Hospital, Syracuse, NY. Sandra Asanjarani, RNC-OB,MS,NP,C-EFM, Jaime Fernandez, MD, Karen Dorio, RN, BSN, Jacobi Medical Center, New York, NY. Christine Grippi, RN, MS, CNS, Lyssa Lamport, MS, RD, CNSC, Cynthia Pesce, RN, BSN, IBCLC, Robert Koppel, MD, Long Island Jewish Medical Center, New Hyde Park, NY. Alok Bhutada, MD; Natasha Nurse, RN, CNS; ShantanuRastogi, MD; Maimonides Medical Center, Brooklyn, NY. Melissa Vega, R-PAC,MPAS; Children?s Hospital atMontefiore Weiler Hospital Division, Albert Einstein College of Medicine, Bronx, NY. Anastasia Stekas, RNC,MSN, IBCLC, Kathleen Gibbs, MD, Mount Sinai Hospital, New York, NY. Martha Caprio, MD, Priscilla Barr, MS, RDN, Karen Ronan, RN, NM,Michelle DeSomma, RN, New York University Langone Medical Center, New York, NY. Marianne Garland, MD; Joy Henderson, PhD, RNC, CPNP, Karilin Salcedo, BS, New York Presbyterian Columbia University Medical Center, New York, NY. Bella Fridman, MD, Joy Henderson, PhD, RNC, CPNP, Karilin Salcedo, BS, New York Presbyterian Weill Cornell Medical Center, New York, NY. Richard Schanler, MD, Nancy Pupke, DNP, RNC, Lyssa Lamport, RD, MS, Debra Potak, RN, BSN; Cohen Children?s Medical Center at North Shore University Hospital, Manhasset, NY. Susan Mathieson, RD, CSP, CLC; Shanthy Sridhar, MD; Stony Brook University Hospital, Stony Brook, NY. Carrie Gale, RD; Jeffrey Meyers, MD, Lori Scholer, RD, Manisha Srivastava, RD, University of Rochester Medical Center, Golisano Children?s Hospital, Rochester, NY. Gloria Valencia, MD, Joanne Oderinde, University Hospital-Brooklyn, Brooklyn, NY. Heather Brumberg, MD, MPH, FAAP; Rachel Hochstadt, RD; Boriana Parvez, MD; Isabel Vachon, RD; WestchesterMedical Center, Maria Fareri Children?s Hospital, Valhalla, NY. Matthew Cuaycong, MD, Teofilita Isaacson, MD, Susan E. Richter, MPA; Winthrop University Hospital, Mineola, NY. Anne Marie Reynolds, MD, James Shelton, MS, Women and Children?s Hospital of Buffalo, Buffalo, NY. Publisher Copyright: Copyright {\textcopyright} 2016 by Thieme Medical Publishers, Inc.",
year = "2015",
month = jun,
day = "17",
doi = "10.1055/s-0035-1554794",
language = "English (US)",
volume = "33",
pages = "9--19",
journal = "American Journal of Perinatology",
issn = "0735-1631",
publisher = "Thieme Medical Publishers",
number = "1",
}