Parenterale voeding bij de neonaat

41 Pages·2013·3.22 MB·English

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Parenterale voeding bij de neonaat
Dr Femke Maingay-de Groof
Kinderarts-neonatoloog Medisch Centrum Alkmaar
Survival by Gestational Age for Live-Born Infants
90
80
70
60
50
England 1995
40
Sweden '04-'07
30
20
10
0
23 24 25 26
Drawing by Tom Prentiss.
In: Cowan MW 1979. The
Sophia Kinderziekenhuis

development of the brain.
Scientific American 113;
113-133
Sophia Kinderziekenhuis

25 wk
term
Govaert et al
24 wk premature, now 12 wks Term newborn
old
Sophia Children’s Hospital
Relationship of IQ and GA
120
n=
24 73 144 27 23 39 67 92 103 162 252 397 414 348 415 465 917 289 100
110
C 100
P
M

C
90
B
A
-
n
a 80
m
f
u
a
70
K Mean +SEM
Bavarian Study 4.8y
60
EPICure Study 6y
adjusted for comparison GCA
50
22 24 26 28 30 32 34 36 38 40 42
Gestational age (w)
Lagercrantz Acta Paed. 2008 with permission from Marlow and Wolke
Sophia Kinderziekenhuis

Goal:
To mimick intra-uterine growth and
body composition
and to obtain a functional outcome
comparable to infants born at term
Sophia Kinderziekenhuis

Early nutrition (first weeks-
months) has a profound impact
on later functional outcome
IQ after
preterm
formula or
standard
formula
during the
first month
of life

Lucas et al
BMJ 1998
In-hospital growth velocity and
neurodevelopmental outcome
Sophia Children’s Hospital
§  Cohort study, 600 infants with birth weight 501 to 1000g
MDI < 70 PDI < 70
(P<0.01) (P<0.001)
40 40
30 30
% 20 % 20
10 10
0 0
12.0 15.6 17.8 21.2 12.0 15.6 17.8 21.2
Weight gain quartiles (g/(kg.d)) Weight gain quartiles (g/(kg.d))
Cerebral palsy Neurodevelopmental impairment
(P<0.01) (P<0.001)
25 60
50
20
40
15
% % 30
10
20
5
10
0 0
12.0 15.6 17.8 21.2 12 15.6 17.8 21.2
Weight gain quartiles (g/(kg.d)) Weight gain quartiles (g/(kg.d))
Ehrenkranz, R.A. Pediat. 2006;117:1253-1261 .