Safety and Tolerability of Early Minimal Enteral Nutrition from Birth in Preterm Neonates with Antenatal Doppler Abnormalities.

Small-for-gestational-age neonates with absent / reversal of end diastolic flow (AREDF) in umbilical artery doppler are at increased risk of perinatal complications. The authors conducted a retrospective cohort study in SGA neonates (≤34 wk) with AREDF to study the tolerability of early minimal enteral nutrition (MEN) initiated from birth, and compared the outcomes with those without AREDF. Out of 207 SGA neonates, 82 had AREDF. AREDF group had a significantly lower mean birth weight (1185 g vs. 1368 g; p <0.001) and a higher incidence of birth by caesarean section (85.4% vs. 60.8%, p < 0.0001). There was no difference in the primary outcome of feed intolerance [20.7% vs. 12.8%; RR 1.62 (0.87-3.02)]. Mortality, necrotizing enterocolitis (NEC), culture-proven sepsis were also similar between the groups. Multivariable logistic regression analysis revealed that gestational age and not AREDF status was associated with increased odds of feed intolerance.