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Abstract
This study aimed to determine if time to achieve full enteral feeding (TFF) directly impacted long-term neurodevelopmental delay (NDD) and whether long-term postnatal growth failure (PGF) was a mediator of this association in very-low-birth-weight (VLBW) infants. Using prospectively collected cohort data from the Korean Neonatal Network, we included eligible VLBW infants who achieved TFF at least once and classified enrolled infants into four groups using exposure severity (P1 to P4 as TFF < 16, 16–30, 31–45, and > 45 postnatal days, respectively). After adjusting for confounding variables, survival without NDD was significantly decreased in P4 infants compared with that in P2 infants. P1 infants had a lower risk of weight and height PGF than P2 infants; however, P4 infants had higher risks of height and head circumference PGF than P2 infants. Weight and height PGF were significantly associated with an increased risk of NDD. In mediation analysis, early and delayed TFF revealed direct positive and negative impacts, respectively, on the risk of NDD without mediation by PGF. TFF impacted survival without NDD, and PGF did not mediate this association in VLBW infants. Additionally, these results can be translated into evidence-based quality improvement practice.
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Details
1 Chungbuk National University School of Medicine, Department of Pediatrics, Chungbuk National University Hospital, Cheongju, Republic of Korea (GRID:grid.254229.a) (ISNI:0000 0000 9611 0917)
2 Social Information Research Institute, Research and Statistical Center, Seoul, Republic of Korea (GRID:grid.254229.a); Institute of Biomedical and Clinical Research, MEDITOS, Seoul, Republic of Korea (GRID:grid.254229.a)
3 Sungkyunkwan University School of Medicine, Department of Pediatrics, Samsung Medical Center, Seoul, Republic of Korea (GRID:grid.264381.a) (ISNI:0000 0001 2181 989X); Sungkyunkwan University, Department of Health Sciences and Technology, SAIHST, Seoul, Republic of Korea (GRID:grid.264381.a) (ISNI:0000 0001 2181 989X); Cell and Gene Therapy Institute, Samsung Medical Center, Seoul, Republic of Korea (GRID:grid.414964.a) (ISNI:0000 0001 0640 5613)