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DOI: 10.1055/s-0038-1675833
Relationship between Early Antibiotic Exposure and Short-Term Growth Velocity in Premature Neonates
Publication History
01 July 2018
01 October 2018
Publication Date:
30 November 2018 (online)
Abstract
Objective To characterize the relationship between the duration of antibiotic administration during the first week of life and subsequent growth velocity during hospitalization.
Study Design This was a retrospective study comparing the inhospital growth of infants born between 30 and 326/7 weeks' gestational age (GA) admitted to the Montefiore Weiler and Wakefield neonatal intensive care units between January 2009 and December 2015. Antibiotic duration during the first week of life was classified as no antibiotics, <5 days of antibiotics, or ≥5 days of antibiotics. Differences between discharge and birth weight Z-scores were compared between the three groups using analysis of variance.
Results Of the infants, 87% received antibiotics during the first week of life, with 16% of infants completing ≥5 days. Compared with infants receiving ≤ 5 days of antibiotics, infants treated with ≥5 days had a lower GA, lower Apgar scores, more invasive respiratory support, longer duration of total parenteral nutrition, delayed initiation of enteral feeding, and a higher weight Z-score on admission and discharge (p < 0.05). However, there was no distinction in growth between the three groups assessed by the difference between admission and discharge weight Z-scores (p = 0.64), growth velocity (gram/kilogram/day) (p = 0.104), or an exponential growth velocity outcome (p = 0.423).
Conclusion Early antibiotic exposure was not associated with increased growth velocity between birth and discharge. Our study was limited by its retrospective nature and lack of follow-up data postdischarge.
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References
- 1 Lapillonne A, Griffin IJ. Feeding preterm infants today for later metabolic and cardiovascular outcomes. J Pediatr 2013; 162 (3, Suppl): S7-S16
- 2 Thomas E, Al Saud NB, Durighel G, Frost G, Bell JD. The effect of preterm birth on adiposity and metabolic pathways and the implications for later life. Clin Lipidol 2012; 7: 275-288
- 3 Hales CN, Barker DJ. Type 2 (non-insulin-dependent) diabetes mellitus: the thrifty phenotype hypothesis. Diabetologia 1992; 35 (07) 595-601
- 4 Barker DJ, Eriksson JG, Forsén T, Osmond C. Fetal origins of adult disease: strength of effects and biological basis. Int J Epidemiol 2002; 31 (06) 1235-1239
- 5 Barker DJ, Osmond C, Forsén TJ, Kajantie E, Eriksson JG. Trajectories of growth among children who have coronary events as adults. N Engl J Med 2005; 353 (17) 1802-1809
- 6 Finken MJ, Keijzer-Veen MG, Dekker FW. , et al; Dutch POPS-19 Collaborative Study Group. Preterm birth and later insulin resistance: effects of birth weight and postnatal growth in a population based longitudinal study from birth into adult life. Diabetologia 2006; 49 (03) 478-485
- 7 Trasande L, Blustein J, Liu M, Corwin E, Cox LM, Blaser MJ. Infant antibiotic exposures and early-life body mass. Int J Obes 2013; 37 (01) 16-23
- 8 Bailey LC, Forrest CB, Zhang P, Richards TM, Livshits A, DeRusso PA. Association of antibiotics in infancy with early childhood obesity. JAMA Pediatr 2014; 168 (11) 1063-1069
- 9 Charbonneau MR, O'Donnell D, Blanton LV. , et al. sialylated milk oligosaccharides promote microbiota-dependent growth in models of infant undernutrition. Cell 2016; 164 (05) 859-871
- 10 Cox LM, Yamanishi S, Sohn J. , et al. Altering the intestinal microbiota during a critical developmental window has lasting metabolic consequences. Cell 2014; 158 (04) 705-721
- 11 Turta O, Rautava S. Antibiotics, obesity and the link to microbes-what are we doing to our children?. BMC Med 2016; 14: 57-62
- 12 Tanaka S, Kobayashi T, Songjinda P. , et al. Influence of antibiotic exposure in the early postnatal period on the development of intestinal microbiota. FEMS Immunol Med Microbiol 2009; 56 (01) 80-87
- 13 Dardas M, Gill SR, Grier A. , et al. The impact of postnatal antibiotics on the preterm intestinal microbiome. Pediatr Res 2014; 76 (02) 150-158
- 14 Hsieh EM, Hornik CP, Clark RH, Laughon MM, Benjamin Jr DK, Smith PB. ; Best Pharmaceuticals for Children Act—Pediatric Trials Network. Medication use in the neonatal intensive care unit. Am J Perinatol 2014; 31 (09) 811-821
- 15 Fenton TR. A new growth chart for preterm babies: Babson and Benda's chart updated with recent data and a new format. BMC Pediatr 2003; 3: 13-22
- 16 Patel AL, Engstrom JL, Meier PP, Kimura RE. Accuracy of methods for calculating postnatal growth velocity for extremely low birth weight infants. Pediatrics 2005; 116 (06) 1466-1473
- 17 Patel AL, Engstrom JL, Meier PP, Jegier BJ, Kimura RE. Calculating postnatal growth velocity in very low birth weight (VLBW) premature infants. J Perinatol 2009; 29 (09) 618-622
- 18 Cotten CM, Taylor S, Stoll B. , et al; NICHD Neonatal Research Network. Prolonged duration of initial empirical antibiotic treatment is associated with increased rates of necrotizing enterocolitis and death for extremely low birth weight infants. Pediatrics 2009; 123 (01) 58-66
- 19 Puopolo KM, Mukhopadhyay S, Hansen NI. , et al; NICHD Neonatal Research Network. Identification of extremely premature infants at low risk for early-onset sepsis. Pediatrics 2017; 140 (05) e20170925
- 20 Parkinson JRC, Hyde MJ, Gale C, Santhakumaran S, Modi N. Preterm birth and the metabolic syndrome in adult life: a systematic review and meta-analysis. Pediatrics 2013; 131 (04) e1240-e1263
- 21 Patel SJ, Saiman L. Principles and strategies of antimicrobial stewardship in the neonatal intensive care unit. Semin Perinatol 2012; 36 (06) 431-436
- 22 Mongkolrattanothai K, Chin S, Srikumar N. , et al. Antimicrobial stewardship in the neonatal intensive care unit (NICU): building and sustaining the effective collaboration. Open Forum Infect Dis 2016; 3: 1914
- 23 Tabb E, Fallaha J, Storey I, Hussain A. G63(P) Antimicrobial stewardship on a neonatal intensive care unit (NICU) in the UK. Arch Dis Child 2016; 101: A35-A36
- 24 Ramasethu J, Kawakita T. Antibiotic stewardship in perinatal and neonatal care. Semin Fetal Neonatal Med 2017; 22 (05) 278-283