Abstract Aim The aim of the study was to measure compliance with parenteral nutrition guidelines after the implementation of individualized prescription software for extremely low-birth-weight preterm infants and the impact of these guidelines on postnatal growth at 36 weeks. Materials and methods All newborns with a birthweight of less than 1000 g who were born between January 2012 and December 2015 (period A), between January 2019 and September 2021 (period B), without malformation or congenital anomalies, and admitted to the University Hospital of Rennes within the first 24 hours of life were included. Compliance to the ESPGHAN recommendations was compared between Periods A and B. Caloric and protein intakes were considered compliant if both the median caloric and protein intakes over days 5 to 7 were in agreement with the 2018 ESPGHAN recommendations. The association between the weight delta Z-score and weight at birth and at 36 weeks was assessed by multivariate analysis after weighting for the propensity score for adequate early intake. Results Following the implementation of individualized prescription software, compliance to ESPGHAN recommendations significantly increased. In period B, there was 82% compliance to the protein intake recommendations from D5 to D7 and 63% agreement for total calories. After adjustment and weighting, a correlation was observed between noncompliance intake and reduced growth velocity, measured as the weight delta Z-score of weight. However, this correlation was not significantly associated with a lower rate of EUGR. Conclusion The deployment of individualized prescription software with responsive calculations of anticipated intakes was associated with an improvement in the compliance of parenteral nutrition guidelines for preterm infants.
Grelon et al. (Thu,) studied this question.