Clinical outcomes of preterm infants under 32 weeks who receive early enteral nutrition in a low- and middle-income country.

@article{torresmunoz2026clinical,
  title = {{Clinical outcomes of preterm infants under 32 weeks who receive early enteral nutrition in a low- and middle-income country.}},
  author = {Javier Torres-Muñoz and Lorena Chamorro and Julián Torres-Figueroa and Julieth Ortega and Ruth Garzón and Paola Quintero},
  journal = {Frontiers in pediatrics},
  year = {2026},
  month = oct,
  doi = {10.3389/fped.2026.1952558},
  url = {https://europepmc.org/article/MED/42952906},
  note = {CC BY},
}

TY  - JOUR
TI  - Clinical outcomes of preterm infants under 32 weeks who receive early enteral nutrition in a low- and middle-income country.
AU  - Javier Torres-Muñoz
AU  - Lorena Chamorro
AU  - Julián Torres-Figueroa
AU  - Julieth Ortega
AU  - Ruth Garzón
AU  - Paola Quintero
PY  - 2026
DA  - 2026/10/14
JO  - Frontiers in pediatrics
DO  - 10.3389/fped.2026.1952558
UR  - https://europepmc.org/article/MED/42952906
AB  - Early initiation of enteral nutrition in preterm infants has been considered as a risk factor due to its possible association with adverse outcomes. To determine the clinical outcomes in preterm infants younger than 32 weeks and/or with a birth weight under 1,500 g who received enteral nutrition within the first 48 h in two neonatal units in a middle-income country. This retrospective two-center cohort study compared clinical outcomes between preterm infants with a gestational age ≤32 weeks and/or birth weight <1,500 g who initiated enteral feeding within or after 48 h of life. Categorical variables were compared using the chi-square or Fisher's exact test, and continuous variables using the Mann-Whitney U test. As the primary analysis, separate multivariable logistic regression models with robust standard errors were fitted for NEC, sepsis, BPD, and mortality. All models were adjusted for gestational age, birth weight, 5 min Apgar score, and study institution; the sepsis and BPD models were additionally adjusted for neonatal resuscitation. Propensity scores were estimated among 159 infants with complete data using prespecified baseline characteristics and study institution. One-to-one nearest-neighbor matching with replacement was performed using a caliper of 0.05 and restriction to common support. Covariate balance was assessed using standardized mean differences, and matched outcomes were analyzed using matching weights and robust standard errors. Associations were reported as odds ratios with 95% confidence intervals. Among 173 preterm infants, 117 (67.6%) initiated enteral feeding within 48 h of life and 56 (32.4%) initiated it thereafter. In the primary full-cohort multivariable analyses, delayed initiation was not significantly associated with necrotizing enterocolitis (aOR 1.13; 95% CI, 0.32-4.02; p = 0.848), sepsis (aOR 1.32; 95% CI, 0.54-3.26; p = 0.542), bronchopulmonary dysplasia (aOR 1.08; 95% CI, 0.42-2.79; p = 0.878), or mortality (aOR 0.68; 95% CI, 0.21-2.24; p = 0.523). The propensity score-matched sensitivity analysis included 38 infants with delayed feeding initiation and 38 weighted control observations derived from 18 unique infants with early feeding initiation. In this analysis, delayed initiation was associated with a longer time to achieve full enteral nutrition (weighted mean difference, 6.19 days; 95% CI, 0.10-12.27; p = 0.046) and higher odds of bronchopulmonary dysplasia (OR 8.25; 95% CI, 1.54-44.29; p = 0.014). Delayed enteral feeding was not associated with major neonatal outcomes in the primary analyses. Sensitivity findings suggesting delayed achievement of full enteral nutrition and increased BPD require cautious interpretation.
SN  - 2296-2360
ER  -