Comparing Outcome of Early Versus Late Trophic Feeding in VLBW Preterm Infants Hospitalized in Al –Zahra NICU.

Abstract

Abstract: Introduction: Recent advances intensive neonatal cares and improved survival of preterm infants, beneficial effects of trophic feeding and limited data on timing of enteral feeding for VLBW (very low birth weight) preterm infants needs more researches to determine the optimal starting time and increasing pattern. This study aims to compare crucial neonatal outcomes of early (<48 h) versus late (>72h) trophic feeding. Aims: Main outcomes were comparing duration of intravenous feeding, time to regain birth weight, feeding tolerance and duration of hospital stay in early and late trophic groups. Methods: In a prospective cohort study, a total of 170 preterm infant ((1000 -1500gr, 26-31 week without congenital birth defect): 125 in early group (receiving trophic feeding internally within first 48 hours of birth) and 45 in late group) randomly entered the study. Infants were daily followed up for main outcomes until discharge. Results: There were no statistically significant difference in the clinical and maternal characteristics of infants in two groups. The time to gain birth weight (13.75±5.21 vs 20.53±6.31 (p<0.0005)), duration of parenteral nutrition (9.26±4.57 days vs 14.11±6.41 days (p<0.0005)), hospital stay (12.14±8.61 vs 21.11±1.14 (p<0.00005)) and time to tolerate total enteral feeding (10.31±4.25 vs 13.20±7.11 (p=0.01)) were significantly shorter in early comparing to late feeding group; late group did not experience a higher incidence of late onset sepsis 5.2% vs 4.4% (p=0.73). There was 1 cases of confirmed NEC in every group through the difference was no significant. Conclusion: The benefits of early trophic feeding shown by this study strongly support its use for the preterm infants without additional complications. However, there is need for more comprehensive studies considering crucial clinical outcomes to determine if trophic feeding can be initiated in early time to improve survival and decrease severe morbidities.