Comparaison des protocoles de nutrition entérale chez les nouveau-nés prématurés de moins de 33 SA et 1 500 grammes entre les Unités de Néonatologie de Fort-de- France et Pointe-à-Pitre

Abstract : Introduction. Nutrition of preterm infants is essential for optimal growth and to prevent pathologies during hospitalization. The aim of this study was to compare weight, height and head circumference at 36 weeks of gestational age of premature infants born under 33 weeks of gestation and birth weight less than 1,500 g, between Neonatal Intensive Care Unit (NICU) of Fort-de-France Hospital and Pointe-à-Pitre Hospital, where enteral feeding protocols are different. Secondary objectives were to evaluate the incidence of morbidity and mortality, as well as the duration of therapeutics. Materials and methods. Retrospective study of newborn records from both NICUs for a period from July 1st, 2015 to December 31, 2015. Results. Mother and newborn populations were comparable to inclusion. Means of weight, height and head circumference were significantly higher at 36 weeks in Fort-de-France (2,163 vs 1,864 g (p <0.001), 43.5 vs 41 cm (p <0.001); 31.9 vs 30 cm (p <0.001)). Incidence of enteropathy was higher in Pointe-à-Pitre (32.5% vs 12.8% (p = 0.04)). Mortality was higher in Pointe-à-Pitre (1 vs 7 (p = 0.056)). Catheter and parenteral nutrition durations were higher in Pointe-à-Pitre (21.4 days and 25.4 days vs 9.2 days and 14.4 days (p <0.001)). Discussion. Growth of premature infants under 33 weeks and less than 1,500 g is better in Fort-de-France NICU where human milk is exclusively used, in comparison with Pointe-à-Pitre NICU where formula fed is exclusively used. However, formula fed for preterms improves growth rate but with higher risk of necrotizing enterocolitis. Duration of parenteral nutrition is longer in Pointe-à-Pitre due to a lower digestive tolerance of premature newborns.
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Master Thesis
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Laszlo Kovacic. Comparaison des protocoles de nutrition entérale chez les nouveau-nés prématurés de moins de 33 SA et 1 500 grammes entre les Unités de Néonatologie de Fort-de- France et Pointe-à-Pitre. Pédiatrie. 2017. ⟨dumas-02097291⟩

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