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dc.contributor.authorKempley, Sen_US
dc.contributor.authorGupta, Nen_US
dc.contributor.authorLinsell, Len_US
dc.contributor.authorDorling, Jen_US
dc.contributor.authorMcCormick, Ken_US
dc.contributor.authorMannix, Pen_US
dc.contributor.authorJuszczak, Een_US
dc.contributor.authorBrocklehurst, Pen_US
dc.contributor.authorLeaf, Aen_US
dc.contributor.authorADEPT Trial Collaborative Groupen_US
dc.date.accessioned2015-09-02T08:03:24Z
dc.date.issued2014-01en_US
dc.identifier.urihttp://qmro.qmul.ac.uk/xmlui/handle/123456789/8409
dc.description.abstractOBJECTIVE: To describe feeding and gastrointestinal outcomes in growth-restricted infants <29 weeks' gestation and to determine the rate of feed advancement which they tolerate. DESIGN: Analysis of prospectively collected data from a randomised feeding trial, the Abnormal Doppler Enteral Prescription Trial (ADEPT). SETTING: 54 neonatal units in the UK and Ireland. PARTICIPANTS: 404 preterm, growth-restricted infants with abnormal antenatal Doppler studies from ADEPT. 83 infants <29 weeks and 312 infants ≥ 29 weeks' gestation were included in this analysis. INTERVENTIONS: In ADEPT, infants were randomised to start milk 'early' on day 2 after birth, or 'late' on day 6. Subsequent feed advancement followed a regimen, which should have achieved full feeds by day 16 in the early and day 20 in the late group. MAIN OUTCOME MEASURES: Full feeds were achieved later in infants <29 weeks; median age 28 days {IQR 22-40} compared with 19 days {IQR 17-23} in infants ≥ 29 weeks (HR 0.35, 95% CI 0.3 to 0.5). The incidence of necrotising enterocolitis was also higher in this group; 32/83 (39%) compared to 32/312 (10%) in those ≥ 29 weeks (RR 3.7, 95% CI 2.4 to 5.7). Infants <29 weeks tolerated very little milk for the first 10 days of life and reached full feeds 9 days later than predicted from the trial regimen. CONCLUSIONS: Growth-restricted infants born <29 weeks' gestation with abnormal antenatal Doppler failed to tolerate even the careful feeding regimen of ADEPT. A slower advancement of feeds may be required for these infants. TRIAL REGISTRATION NUMBER: ISRCTN87351483.en_US
dc.format.extentF6 - F11en_US
dc.languageengen_US
dc.relation.ispartofArch Dis Child Fetal Neonatal Eden_US
dc.subjectFetal Medicineen_US
dc.subjectGastroenterologyen_US
dc.subjectNeonatologyen_US
dc.subjectNutritionen_US
dc.subjectAnimalsen_US
dc.subjectBreast Feedingen_US
dc.subjectEnteral Nutritionen_US
dc.subjectEnterocolitis, Necrotizingen_US
dc.subjectFemaleen_US
dc.subjectFetal Growth Retardationen_US
dc.subjectGestational Ageen_US
dc.subjectHumansen_US
dc.subjectInfant Formulaen_US
dc.subjectInfant, Newbornen_US
dc.subjectInfant, Prematureen_US
dc.subjectInfant, Premature, Diseasesen_US
dc.subjectInfant, Very Low Birth Weighten_US
dc.subjectIrelanden_US
dc.subjectMaleen_US
dc.subjectPregnancyen_US
dc.subjectProspective Studiesen_US
dc.subjectTime Factorsen_US
dc.subjectTreatment Outcomeen_US
dc.subjectUltrasonography, Prenatalen_US
dc.subjectUnited Kingdomen_US
dc.titleFeeding infants below 29 weeks' gestation with abnormal antenatal Doppler: analysis from a randomised trial.en_US
dc.typeArticle
dc.rights.holderCopyright © 2014 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health
dc.identifier.doi10.1136/archdischild-2013-304393en_US
pubs.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/23973795en_US
pubs.issue1en_US
pubs.notes12 monthsen_US
pubs.organisational-group/Queen Mary University of London
pubs.organisational-group/Queen Mary University of London/Faculty of Medicine & Dentistry
pubs.organisational-group/Queen Mary University of London/Faculty of Medicine & Dentistry/Blizard Institute
pubs.organisational-group/Queen Mary University of London/Faculty of Medicine & Dentistry/Blizard Institute/Genomics and Child Health
pubs.publication-statusPublisheden_US
pubs.volume99en_US


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