Neonatal Nutrition: Defining Growth Outcomes

Inadequate growth is a significant problem for extremely preterm infants. Nutritional intake is hypothesized to be the most important strategy to improve growth. However, there is a lack of consensus in defining adequate nutrition. Much is being written about improving growth outcomes through conducting clinical studies in the area of neonatal nutrition. Growth is often used as the primary outcome variable in nutrition research. Variability exists among neonatal nutrition researchers in relation to the measurement of growth. This limits the ability of clinicians to compare findings across studies and, ultimately, change practice. The purpose of this study was to examine variability across neonatal nutrition studies in relation to how growth outcomes are reported. An extensive literature search, spanning the last 10 years, was conducted for published research in the area of neonatal nutrition. For a study to be included, preterm infants were the population of interest and growth had to be an important outcome variable. Thirty-seven studies met the inclusion criteria. Data abstracted included: growth parameters used, calculation of growth velocity, growth chart or reference used, and whether infants categorized as small-for-gestational age (SGA) were included. Data are currently being analyzed and will be reported using frequencies and percentages. Preliminary analyses indicate that researchers do include infants with SGA and do not report which growth reference is used to determine whether an infant is SGA, variability exists as to the starting point for calculating growth velocity, and variability exists in reporting weight measures. In addition, researchers used measures of growth not commonly seen in clinical practice. It is anticipated that the findings will highlight the discrepancies that exist among the reported research and begin a discussion about how best to measure growth so that findings from research can be effectively applied to improve growth of extremely preterm infants.No embarg