Imperial College London
Alternate

Dr Sabita Uthaya

Faculty of Medicine, School of Public Health

Professor of Practice (Neonatal Medicine)
 
 
 
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Contact

 

+44 (0)20 3315 7975s.uthaya

 
 
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Location

 

Neonatal UnitChelsea and Westminster HospitalChelsea and Westminster Campus

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Summary

 

Publications

Citation

BibTex format

@article{Uthaya:2022:10.1136/archdischild-2021-322383,
author = {Uthaya, S and Longford, N and Battersby, C and Ougham, K and Lanoue, J and Modi, N},
doi = {10.1136/archdischild-2021-322383},
journal = {Archives of Disease in Childhood: Fetal and Neonatal Edition},
title = {Early versus later initiation of parenteral nutrition for very preterm infants: a propensity score matched observational study},
url = {http://dx.doi.org/10.1136/archdischild-2021-322383},
volume = {107},
year = {2022}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: A current standard of care based on expert opinion is to commence parenteral nutrition (PN) within hours of birth in very preterm infants. Trials in critically ill adults and children, including term infants have found short and long-term harms from early initiation of PN.  Methods: We included all infants born below 31 weeks gestation between January 2008 and December 2019 and admitted to National Health Service neonatal units in England and Wales. The source of data was the National Neonatal Research Database. The exposure was PN initiated within the first two days after birth (early) versus after the second postnatal day (late). We used propensity matched analysis to balance the two groups on background variables. The primary outcome was survival to discharge without major morbidity. Findings: Of 65,033 infants included, 16,294 infants formed the matched cohort, 8147 in each group. There was no evidence of a difference in survival to discharge without major morbidity (absolute rate difference (ARD) between early versus late 0·50%; 95% Confidence Interval (CI), -1·45, 0·45; p=0·29). Survival to discharge was higher in the early group (ARD -3·25%; 95% CI, -3·82 to -2·68; p<0·001) but they also had higher rates of late-onset sepsis (ARD -0·84%; 95% CI, -1·20 to -0·48; p<0·001), bronchopulmonary dysplasia (ARD -1·24%; 95% CI, -2·17 to -0·30; p=0·01), treatment for retinopathy of prematurity (ARD (-0·5%; 95% CI, -0·84 to -0.17; p<0·001), surgical procedures (ARD -0·8%; 95% CI, -1·40 to -0·20; p=0·01) and greater drop in weight z-score between birth and discharge (absolute difference 0·019; 95% CI, 0·003 to 0·039; p=0·02). Among infants that died the median age (days) at death was shorter in the late group (ARD 6; 95% CI, 6; p<0.001).   Interpretation: These o
AU  - Uthaya,S
AU  - Longford,N
AU  - Battersby,C
AU  - Ougham,K
AU  - Lanoue,J
AU  - Modi,N
DO  - 10.1136/archdischild-2021-322383
PY  - 2022///
SN  - 1359-2998
TI  - Early versus later initiation of parenteral nutrition for very preterm infants: a propensity score matched observational study
T2  - Archives of Disease in Childhood: Fetal and Neonatal Edition
UR  - http://dx.doi.org/10.1136/archdischild-2021-322383
UR  - https://fn.bmj.com/content/107/2/137
UR  - http://hdl.handle.net/10044/1/92139
VL  - 107
ER  -
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