Role of Nutrition in Prevention of Neonatal Spontaneous Intestinal Perforation and Its Complications: A Systematic Review.
Spontaneous intestinal perforation (SIP) is a devastating complication of prematurity, and extremely low birthweight (ELBW < 1000 g) infants born prior to 28 weeks are at highest risk. The role of nutrition and feeding practices in prevention and complications of SIP is unclear. The purpose of this review is to compile evidence to support early nutrition initiation in infants at risk for and after surgery for SIP. : A search of PubMed, EMBASE and Medline was performed using relevant search terms according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Abstracts and full texts were reviewed by co-first authors. Studies with infants diagnosed with SIP that included information on nutrition/feeding practices prior to SIP and post-operatively were included. Primary outcome was time to first feed. Secondary outcomes were incidence of SIP, time to full enteral feeds, duration of parenteral nutrition, length of stay, neurodevelopmental outcomes and mortality. : Nineteen articles met inclusion criteria-nine studies included feeding/nutrition data prior to SIP and ten studies included data on post-operative nutrition. Two case series, one cohort study and sixteen historical control studies were included. Three studies showed reduced incidence of SIP with initiation of enteral nutrition in the first three days of life. Two studies showed reduced mortality and neurodevelopmental impairment in infants with early feeding. : Available data suggest that early enteral nutrition in ELBW infants reduces incidence of SIP without increased mortality.
['Olaloye|Oluwabunmi|O|', 'Swatski|Matthew|M|', 'Konnikova|Liza|L|']
D004435:Eating D004750:Enteral Nutrition D005248:Feeding Methods D005260:Female D006801:Humans D052577:Infant, Extremely Low Birth Weight D007231:Infant, Newborn D007416:Intestinal Perforation D007902:Length of Stay D008297:Male D065886:Neurodevelopmental Disorders D009747:Nutritional Physiological Phenomena D010288:Parenteral Nutrition D011182:Postoperative Care D011183:Postoperative Complications D000072663:Spontaneous Perforation D013997:Time Factors
nutrition spontaneous intestinal perforation prematurity feeding