@article{Webbe:2022:10.1136/archdischild-2021-321643,
author = {Webbe, J and Longford, N and Battersby, C and Ougham, K and Uthaya, S and Modi, N and Gale, C},
doi = {10.1136/archdischild-2021-321643},
journal = {Archives of Disease in Childhood: Fetal and Neonatal Edition},
pages = {131--136},
title = {Outcomes in relation to early parenteral nutrition use in preterm neonates born between 30 and 33 weeks gestation: a propensity score matched observational study},
url = {http://dx.doi.org/10.1136/archdischild-2021-321643},
volume = {107},
year = {2022}
}

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TY  - JOUR
AB  - ObjectiveTo evaluate whether in preterm neonates parenteral nutrition use in the first sevenpostnatal days, compared with no parenteral nutrition use, is associated withdifferences in survival and other important morbidities. Randomised trials in criticallyill older children show that harms, such as nosocomial infection, outweigh benefits ofearly parenteral nutrition administration; there is a paucity of similar data inneonates.DesignRetrospective cohort study using propensity matching including 35 maternal, infantand organisational factors to minimise bias and confounding.SettingNational, population-level clinical data obtained for all National Health Serviceneonatal units in England and Wales.PatientsPreterm neonates born between 30+0 and 32+6 weeks+days.InterventionsThe exposure was parenteral nutrition administered in the first seven days ofpostnatal life; the comparator was no parenteral nutrition.Main outcome measuresThe primary outcome was survival to discharge from neonatal care. Secondaryoutcomes comprised the neonatal core outcome set.Results16,292 neonates were compared in propensity score matched analyses. Comparedwith matched neonates not given parenteral nutrition in the first postnatal week, neonates who received parenteral nutrition had higher survival at discharge(absolute rate increase 0.91%; 95% CI 0.53% to 1.30%), but higher rates ofnecrotising enterocolitis (absolute rate increase 4.6%), bronchopulmonary dysplasia(absolute rate increase 3.9%), late-onset sepsis (absolute rate increase 1.5%) andneed for surgical procedures (absolute rate increase 0.92%).ConclusionsIn neonates born between 30+0 and 32+6 weeks gestation, those given parenteralnutrition in the first postnatal week had a higher rate of survival but higher rates ofimportant neonatal morbidities. Clinician equipoise in this area should be resolvedby prospective, randomised trials.
AU  - Webbe,J
AU  - Longford,N
AU  - Battersby,C
AU  - Ougham,K
AU  - Uthaya,S
AU  - Modi,N
AU  - Gale,C
DO  - 10.1136/archdischild-2021-321643
EP  - 136
PY  - 2022///
SN  - 1359-2998
SP  - 131
TI  - Outcomes in relation to early parenteral nutrition use in preterm neonates born between 30 and 33 weeks gestation: a propensity score matched observational study
T2  - Archives of Disease in Childhood: Fetal and Neonatal Edition
UR  - http://dx.doi.org/10.1136/archdischild-2021-321643
UR  - http://hdl.handle.net/10044/1/91123
VL  - 107
ER  - 

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