Jang, Hyo-Jeong
(Department of Pediatrics, Keimyung University School of Medicine)
,
Park, Jae Hyun
(Department of Pediatrics, Keimyung University School of Medicine)
,
Kim, Chun Soo
(Department of Pediatrics, Keimyung University School of Medicine)
,
Lee, Sang Lak
(Department of Pediatrics, Keimyung University School of Medicine)
,
Lee, Won Mok
(Department of Laboratory Medicine, Keimyung University School of Medicine)
Purpose: We investigated fecal calprotectin (FC) levels in preterm infants with and without feeding intolerance (FI), and compared the FC levels according to the type of feeding. Methods: The medical records of 67 premature infants were reviewed retrospectively. The fully enteral-fed infants were cl...
Purpose: We investigated fecal calprotectin (FC) levels in preterm infants with and without feeding intolerance (FI), and compared the FC levels according to the type of feeding. Methods: The medical records of 67 premature infants were reviewed retrospectively. The fully enteral-fed infants were classified into two groups; the FI group (29 infants) and the control group (31 infants). Seven infants with necrotizing enterocolitis, sepsis, and perinatal asphyxia were excluded. If breast milk (BM) or preterm formula (PF) could not be tolerated by infants with FI, amino acid-based formula (AAF) was tried temporarily. Once FI improved, AAF was discontinued, and BM or PF was resumed. We investigated the FC levels according to the type of feeding. Results: Significant differences were found in gestational age, birth weight, age when full enteral feeding was achieved, and hospital stay between the FI and control group (p<0.05). The FC levels in the FI group were significantly higher than those in the control group (p<0.05). The FC levels in the AAF-fed infants with FI were significantly lower than those in the BM- or PF-fed infants (p0.05). Conclusion: The FC levels in AAF-fed infants with FI showed significantly lower than those in the BM- or PF-fed infants with FI. The mitigation of gut inflammation through the decrease of FC levels in AAF-fed infants with FI could be presumed.
Purpose: We investigated fecal calprotectin (FC) levels in preterm infants with and without feeding intolerance (FI), and compared the FC levels according to the type of feeding. Methods: The medical records of 67 premature infants were reviewed retrospectively. The fully enteral-fed infants were classified into two groups; the FI group (29 infants) and the control group (31 infants). Seven infants with necrotizing enterocolitis, sepsis, and perinatal asphyxia were excluded. If breast milk (BM) or preterm formula (PF) could not be tolerated by infants with FI, amino acid-based formula (AAF) was tried temporarily. Once FI improved, AAF was discontinued, and BM or PF was resumed. We investigated the FC levels according to the type of feeding. Results: Significant differences were found in gestational age, birth weight, age when full enteral feeding was achieved, and hospital stay between the FI and control group (p<0.05). The FC levels in the FI group were significantly higher than those in the control group (p<0.05). The FC levels in the AAF-fed infants with FI were significantly lower than those in the BM- or PF-fed infants (p0.05). Conclusion: The FC levels in AAF-fed infants with FI showed significantly lower than those in the BM- or PF-fed infants with FI. The mitigation of gut inflammation through the decrease of FC levels in AAF-fed infants with FI could be presumed.
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문제 정의
[16] studied FC levels in preterm infants with and those without FI, and suggested a cutoff value for FI screening. The result of the study showed that the significantly higher level of FC in the FI group even with various types of feeding, which is in line with the result of our study. Some studies researched about the relationship between the types of feeding and FC levels.
제안 방법
The following variables were analyzed for the perinatal factors: gestational age (GA), birth weight (BW), sex, delivery mode (vaginal delivery or cesarean section), multiple gestation, small for GA (SGA), oligohydramnios, pregnancy-induced hypertension (PIH), antenatal steroid, premature rupture of membrane, gestational diabetes mellitus (GDM), and Apgar score at 1 and 5 minutes.
대상 데이터
Seven infants with perinatal asphyxia (Apgar score at 5 minutes, ≤5), sepsis, and NEC were excluded.
The study population included 60 preterm infants (34 males and 26 females), of whom 29 (48.3%) were grouped as the FI group. The mean age at FI onset was 3.
데이터처리
Descriptive results were reported as the mean±SD. Statistical analysis between groups were conducted with the Student t-test for independent samples for normally distributed data and with the MannWhitney U-test for non-normally distributed data. The chi-square test was performed for categorical variables, and the Pearson correlation test was used to evaluate the relationship between the selected variable and FC values.
Statistical analysis between groups were conducted with the Student t-test for independent samples for normally distributed data and with the MannWhitney U-test for non-normally distributed data. The chi-square test was performed for categorical variables, and the Pearson correlation test was used to evaluate the relationship between the selected variable and FC values. For the interpretation of results, p-values of ＜0.
이론/모형
The growth velocity was calculated using the following formula: (body weight at discharge [g]−BW [g])/hospital stay[d], g/d). The z score was calculated using the Lambda Mu Sigma method [19]. L determines a nonlinear transformation of BW, M stands for the mean of normal distribution, and S stands for its standard deviation (SD).
성능/효과
05). However, no significant differences were shown in sex, delivery mode, multiple gestation, SGA, oligohydramnios, PIH, antenatal steroid use, GDM, and Apgar score at 1 and 5 minutes between the two groups (p＞0.05).
[13] compared the infants fed with AAF with the controls fed with PF in terms of time to full enteral feeding, time on parenteral nutrition, time on central venous line, gastric residual volume, and the outcomes on growth at discharge and at 12 months of life. The result and conclusion of the study were that AAF was a safe nutritional alternative for rescuing VLBW infants with intrauterine growth restriction with severe FI. The mean duration of AAF feeding was 15.
Few studies investigated FC levels in preterm infants with FI, and the reference level was investigated a little in term and preterm infants. The studies found higher FC levels in newborns and younger infantsthan in children and adults, which could suggest greater intestinal permeability and different immunological status of the gut in newborns. Mussa et al.
05). There was no statistically significant difference between the two groups regarding body weight at discharge, growth velocity, and z scores (p＞0.05).
후속연구
Due to those differences, there would be a limit to compare the FC levels between the infants fed with BM and those fed with PF. Further prospective studies will be needed to investigate the levels of FC in preterm infants according to the more specific type of feeding. However, no study has been conducted yet about the investigation of FC levels according to the change of feeding regimen in preterm infants with FI, which was shown in the present data.
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