INFLUENCE OF RESPIRATORY-DISTRESS SYNDROME ON BODY-COMPOSITION AFTER PRETERM BIRTH

Aim-To observe changes in body composition during the first week after birth, in preterm neonates with and without respiratory distress synd rome (RDS), so as to be able to provide optimal fluid and energy intak e. Methods-Twenty four babies with RDS and 19 healthy preterm babies, with gestational ages ranging from 26-36 weeks, were studied daily for the first week after birth. Total body water (TBW) was measured using bioelectrical impedance analysis. The babies were weighed daily and a record made of fluid and energy intake. Body solids were calculated a s the difference between body weight and TBW. Results-There was a high ly significant reduction in body weight by the end of the week, with t he RDS babies losing more than the healthy babies (RDS 7.6%; non-RDS 3 .7%). There was no significant difference in the amount of TBW at birt h in the babies with and without RDS (RDS 85.1%; non-RDS 85.5%) and bo th groups lost the same amount of body water (RDS 10.9%; non-RDS 9.9%) by the end of the first week. The amount of total body water lost was unrelated to the volume of fluid administered. There was a loss of bo dy solids during the first day in the RDS group, but, overall, there w as a highly significant increase in both groups between birth and day 7, which was greater in the healthy babies (RDS 13.0%; non-RDS 42.7%). Conclusions-Loss of body water after birth occurs to the same extent in healthy preterm neonates and in babies with RDS and is unrelated to the volume of fluid administered. Given adequate nutritional support, an increase in body solids can accompany early postnatal weight loss and begins almost immediately after birth, in both healthy preterm bab ies and babies with RDS.