Nutrition and respiratory morbidity in extremely premature infants
Research type
Research Study
Full title
Nutrition and respiratory morbidity in extremely premature infants: a retrospective five-year whole population study of neonatal networks in England.
IRAS ID
259225
Contact name
Theodore Dassios
Contact email
Sponsor organisation
King's College London
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Extremely premature infants face numerous challenges and distinct pathologies that explain their increased morbidity and mortality. Among them, respiratory morbidity in the form of respiratory distress syndrome initially and chronic lung disease later constitutes the largest burden that will influence survival and fitness for discharge. A significant number of these infants suffer from profound respiratory impairment and are often discharged home on supplemental oxygen. Concurrently, postnatally these infants suffer from growth failure (commonly dropping more than two standard deviations below birth weight) and in the absence of targeted aggressive nutritional support, end up falling far short of their target growth trajectory.
Infants with respiratory disorders have increased energy needs because of an increased work of breathing, while later factors such as the inability to advance oral feeds, restrictive fluid regimens of intravenous nutrition, oral aversion related to prolonged ventilation and episodes of infection preclude the provision of adequate nutritional support. Invasive mechanical ventilation and the ensuing triggering of the inflammatory pathways could also render such infants susceptible to oxidative damage which is not adequately repaired in the face of inadequate nutrition.
Our hypothesis is that respiratory morbidity (prolonged ventilation and supplementary oxygen) in extremely premature infants is significantly negatively related to weight gain and that neonatal mortality is significantly and independently higher in extremely premature infants with respiratory disease and lower weight gain. We aim to test this hypothesis in a population-wide basis using data from the national neonatal database.REC name
West Midlands - Edgbaston Research Ethics Committee
REC reference
19/WM/0172
Date of REC Opinion
15 May 2019
REC opinion
Favourable Opinion