252 - Is Preterm Birth a Risk Factor for Malnutrition?

Poster Number: 252
Publication Number: 252.141

Jitsupa Sirinit, Medical College of Wisconsin, Wheaton, IL, United States; Evelyn M. Kuhn, Children's Hospital of Wisconsin, Milwaukee, WI, United States; Theresa Mikhailov, Medical College of Wisconsin, Milwaukee, WI, United States; Tom B. Rice, Medical College of Wisconsin, Arena, WI, United States

Background: Malnutrition is a prevalent problem in the pediatric population, with morbidities including poor wound healing and organ damage. Identification of risk factors for malnutrition can allow for early diagnosis and intervention. An important subset of critically ill patients treated in the pediatric intensive care unit (PICU) are children that were born preterm. Preterm children are at increased risk for long-term adverse effects, such as cardiovascular disease, neurodevelopment deficits, and metabolic disease. As knowledge regarding preterm birth and the associated adverse long-term outcomes are being increasingly recognized, this leads us to ask if critically ill children who were born preterm are at increased risk for malnutrition.

Objective: Our objective was to determine if critically ill children under 2 years of age admitted to the PICU that were born preterm are at an increased risk for malnutrition compared to children who were born at term.

Design/Methods: The Virtual Pediatric Systems (VPS, LLC) is an international data registry that supports research among more than 100 PICUs, and tracks data for quality metrics specifically related to patient nutrition in the PICU including a metric for screening for malnutrition at the time of admission. De-identified data were obtained from the 16 centers participating in the VPS nutrition module from October 2019 to March 2021. All patients under 2 years of age at the time of admission to the PICUs were included. Patients with a history of prematurity were compared to those born at greater than 37 weeks gestation for their risk for malnutrition. Patients were categorized as malnourished/at risk for malnutrition or not malnourished/not at risk for malnutrition based on the screening method used at each institution. Data were compared using Chi-square test of proportions and multivariable logistic regression analysis.

Results: A total of 2438 patients from the VPS data meeting the inclusion criteria were analyzed. Of those, 645 (26.5%) had a history of prematurity and 621 (25.5%) were malnourished. Those with history of prematurity were more likely to screen as malnourished (222/645, 34.4%) than those without history of prematurity (399/1793, 22.3%) in children under 2 years old (p < 0.001).Conclusion(s): One-quarter of pediatric patients under 2 years of age that were admitted to the PICUs participating in the VPS Nutrition Module were malnourished, and those with a history of premature birth were at increased risk. Our results suggest that preterm birth is a risk factor for malnutrition, and therefore should be considered when screening for malnutrition.