Personalized weight change prediction in the first week of life
| Autor: | Olav Lapaire, Tania Coscia, Sven Wellmann, Isabella Mancino, Marc Pfister, Julia Gromann, Johannes N. van den Anker, Mélanie Wilbaux, Severin Kasser |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Adult Male medicine.medical_specialty Adolescent Birth weight Population 030209 endocrinology & metabolism Critical Care and Intensive Care Medicine Weight Gain 03 medical and health sciences Young Adult 0302 clinical medicine Sex Factors Weight loss Weight Loss medicine Birth Weight Humans Longitudinal Studies Prospective Studies education Infant Nutritional Physiological Phenomena Retrospective Studies education.field_of_study 030109 nutrition & dietetics Nutrition and Dietetics Obstetrics business.industry Cesarean Section Weight change Age Factors Infant Newborn Gestational age Infant Middle Aged Delivery mode Infant Formula NONMEM Breast Feeding Female medicine.symptom business Weight gain |
| Zdroj: | Clinical nutrition (Edinburgh, Scotland). 38(2) |
| ISSN: | 1532-1983 |
| Popis: | Summary Background & aims Almost all neonates show physiological weight loss and consecutive weight gain after birth. The resulting weight change profiles are highly variable as they depend on multiple neonatal and maternal factors. This limits the value of weight nomograms for the early identification of neonates at risk for excessive weight loss and related morbidities. The objective of this study was to characterize weight changes and the effect of supplemental feeding in late preterm and term neonates during the first week of life, to identify and quantify neonatal and maternal influencing factors, and to provide an educational online prediction tool. Methods Longitudinal weight data from 3638 healthy term and late preterm neonates were prospectively recorded up to 7 days of life. Two-thirds (n = 2425) were randomized to develop a semi-mechanistic model characterizing weight change as a balance between time-dependent rates of weight gain and weight loss. The dose-dependent effect of supplemental feeding on weight gain was characterized. A population analysis applying nonlinear mixed-effects modeling was performed using NONMEM 7.3. The model was evaluated on the remaining third of neonates (n = 1213). Results Key population characteristics (median [range]) of the whole sample were gestational age 39.9 [34.4–42.4] weeks, birth weight 3400 [1980–5580] g, maternal age 32 [15–51] years, cesarean section 26%, and girls 50%. The model demonstrated good predictive performance (bias 0.01%, precision 0.56%), and is able to accurately predict individual weight change (bias 0.15%, precision 1.43%) and the dose-dependent effects of supplemental feeding up to 1 week after birth based on weight measurements during the first 3 days of life, including birth weight, and the following characteristics: gestational age, gender, delivery mode, type of feeding, maternal age, and parity. Conclusions We present the first mathematical model not only to describe weight change in term and late preterm neonates but also to provide an educational online tool for personalized weight prediction in the first week of life. |
| Databáze: | OpenAIRE |
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