Feeding tolerance of preterm infants appropriate for gestational age (AGA) as compared to those small for gestational age (SGA)

J Matern Fetal Neonatal Med. 2013 Nov;26(16):1610-5. doi: 10.3109/14767058.2012.746303. Epub 2013 Jul 26.


Preterm infants are often considered too unstable to be fed enterally so they are exposed to complications related to a prolonged enteral fasting. Our study aims to compare feeding tolerance of adequate for gestational age (AGA) versus small for gestational age (SGA) infants and to evaluate which perinatal factors affect feeding tolerance (measured as time to achieve full enteral feeding, FEF). Inborn infants with a gestational age (GA) less than 32 weeks, born from January 2006 to December 2010, were eligible for this study. We enrolled 310 infants. The time to FEF was longer for SGA infants than for AGA, while a longer GA was associated to a reduced time to FEF. A beneficial effect was observed for antenatal steroids, while Apgar score below 7, the administration of inotrops or caffeine, the occurrence of sepsis or NEC and the presence of PDA were associated to a longer time to FEF. When evaluated jointly with a multivariate analysis, GA (p < 0.0001), antenatal steroids prophylaxis (p = 0.002), SGA (p < 0.0001) and occurrence of NEC (p = 0.0002) proved to have independent prognostic impact on the time to FEF. Feeding tolerance is better as GA increases, and worsen in SGA infants. Antenatal betamethasone is effective in reducing the time to FEF in both AGA and SGA.

Publication types

  • Comparative Study

MeSH terms

  • Administration, Oral
  • Birth Weight / physiology
  • Enterocolitis, Necrotizing / epidemiology
  • Enterocolitis, Necrotizing / etiology
  • Feeding Behavior / physiology*
  • Female
  • Gestational Age
  • Humans
  • Ideal Body Weight / physiology*
  • Infant Nutrition Disorders / complications
  • Infant Nutrition Disorders / epidemiology*
  • Infant Nutrition Disorders / therapy
  • Infant, Low Birth Weight / growth & development
  • Infant, Newborn
  • Infant, Premature / physiology*
  • Infant, Premature, Diseases / epidemiology*
  • Infant, Premature, Diseases / etiology
  • Infant, Premature, Diseases / therapy
  • Infant, Small for Gestational Age / growth & development
  • Infant, Small for Gestational Age / physiology*
  • Male
  • Parenteral Nutrition / adverse effects
  • Parenteral Nutrition / statistics & numerical data