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[Multiple-factor analysis of weight gain in very low birth weight infants].

OBJECTIVE
To investigate the correlative factors of weight gain in very low birth weight infants (VLBW).


METHODS
Fifty-one cases of VLBW from July 1998 to March 2004 were analyzed retrospectively.


RESULTS
Twenty two cases were small for gestational age (SGA) and 29 cases were appropriate for gestational age (AGA). The age of first feeding was (2.35 +/- 2.29) d. Caloric intake was (377.61 +/- 121.50) kJ/(kg.d) [(90.25 +/- 29.04) kcal/(kg.d)] and protein intake was (2.18 +/- 0.83) g/(kg.d). The age of birth weight regained was (7.41 +/- 3.57) d and the velocity of weight gain was (16.38 +/- 9.29) g/d or (12.63 +/- 7.15) g/(kg.d). Single factor analysis found that early feeding and caloric supply and protein supply had significant influence on weight gain (P < 0.05). The result of multivariate linear analysis showed that the significant risk factors were associated with supply of calorie and protein. The equation was Y (weight gain) = -6.426 + 0.120X(1) (caloric supply) + 3.737X(2) (protein supply) (P < 0.01). The caloric supply of the cases that achieved the nutritional goal was (468.19 +/- 67.11) kJ/(kg.d), [(111.90 +/- 16.04) kcal/(kg.d)], and that with enteral nutrition and partial parenteral nutrition was [(520.62 +/- 21.59) kJ/(kg.d)], [(124.43 +/- 5.16) kcal/(kg.d), (451.49 +/- 68.41) kJ/(kg.d)], [(107.98 +/- 16.35) kcal/(kg.d)] respectively. There was significant difference between the two groups (P < 0.05). The mean rank of time of birth weight regaining, the time in hospital stay and duration of parenteral nutrition providing at least 75% of the total daily fluid volume was 18.58, 20.24 and 20.11 in the group of early feeding, and it was 33.00, 32.48 and 31.83 in the group of late feeding, respectively. There were significant differences between the two groups (P < 0.05).


CONCLUSION
Sufficient supply of calorie and protein should be ensured in VLBW infants, especially in SGA and severely ill infants. It was very important to feed VLBW infants as early as possible, which could improve feeding tolerance and gastrointestinal maturation. VLBW infants should receive parenteral nutrition as supplements to enteral feeding.