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KMID : 0361720150260010046
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Korean Journal of perinatology
2015 Volume.26 No. 1 p.46 ~ p.52
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Comparison of Enteral Feeding in Early Neonatal Period in Very Low Birthweight Infants with Hypothyroidism
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Choi Eui-Kyung
Lee Hyeon-Seung
Lee Eun-Hee
Kim Sae-Yun
Lee Byoung-Kook
Jung Young-Hwa
Heo Ju-Sun
Shin Seung-Han
Kim Ee-Kyung
Kim Han-Suk
Choi Jung-Hwan
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Abstract
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Purpose: We investigated the effects of hypothyroidism on feeding advancement in very low birth weight infants (VLBW).
Methods: This study was a retrospective case-control study of 14 very low birth weight infants (VLBWIs) diagnosed with hypothyroidism and other 14 infants were recruited as age- and weight-matched controls without hypothyroidism or hypothyroxinemia in Seoul National University Children’s Hospital between January 2007 and August 2009. We examined whether these infants gained weight more, achieved full-volume enteral feedings sooner, had fewer episodes of increased pre-gavage residuals, and had fewer days of parenteral nutrition.
Results: Until full enteral feeding (120 mL/kg/day) was not statistically significant between the groups. In the hypothyroidism group, during the first 14 days after birth, the volume of feeding was smaller [14.7 (0.5-84.0) mL/kg/day, P=0.041], the episodes of increased pre-gavage residuals were frequently observed [16.7 (0.2-78) times, P=0.036], and the duration of central line was significantly longer [18 (10-50) days, P=0.018]. In hypothyroidism group, mean day at first L-thyroxine supplementation was 24.2±10.2 days after birth. L-thyroxine administration boosted thyroid function for hypothyroidism infants, helped them tolerate a larger amount of enteral feeding [from 89.5 (2.9-160.8) to 146.9 (31.8-178.8) mL/kg/day, P=0.002] and decreased episodes of excessive gastric residuals [from 5.5 (0-41.6) to 0 (0-44) time, P=0.026]. However, no more weight gain was statistically found.
Conclusion: In VLBW infants, hypothyroidism may induce feeding intolerance. L-thyroxine supplementation was effective in feeding advancement on preterm infants with hypothyroidism.
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KEYWORD
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Very low birth weight infant, Premature infant, Hypothyroidism, Enteral feeding
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