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Long-term enteral glutamine supplementation in very low birth weight infants: effects on growth parameters
Ayşe Korkmaz1, Murat Yurdakök, Sule Yiğit
1Section of Neonatology, Department of Pediatrics, Hacettepe University, Faculty of Medicine, Ankara, Turkey.
Insights
Long-term enteral glutamine supplementation improved growth in very-low-birth-weight (VLBW) preterm infants. Supplemented infants showed significantly better weight, length, and circumference measurements by four months of age.
Area of Science:
- Neonatal nutrition
- Pediatric growth studies
- Clinical nutrition research
Background:
- Enteral and parenteral glutamine supplementation in preterm infants shows controversial benefits for neonatal outcomes.
- Optimal nutritional strategies are crucial for the growth and development of very-low-birth-weight (VLBW) infants.
Purpose of the Study:
- To investigate the impact of long-term enteral glutamine supplementation on growth parameters in VLBW preterm infants.
- To determine if glutamine supplementation influences weight, length, and circumference measurements over a four-month period.
Main Methods:
- A randomized controlled trial involving VLBW preterm infants (birth weight <= 1500 g).
- Infants received either enteral glutamine (300 mg/kg/day) or placebo for 112 days (4 months).
- Growth parameters including weight, length, head circumference, mid-arm circumference (MAC), and mid-thigh circumference (MTC) were measured monthly.
Main Results:
- The glutamine-supplemented group (n=36) exhibited significantly higher mean weight, length, head circumference, MAC, and MTC compared to the placebo group (n=33) at four months.
- These improvements in growth parameters were observed in VLBW infants receiving sustained enteral glutamine.
Conclusions:
- Long-term enteral glutamine supplementation appears to promote significant improvements in overall growth in VLBW infants.
- The positive effects on growth may manifest in a time-dependent manner, suggesting potential for sustained benefits.
Abstract:
Enteral and parenteral glutamine supplementation in preterm infants has been shown to have some beneficial effects on neonatal morbidity and mortality, although the results are controversial. In this study, we aimed to determine if long-term glutamine-supplemented enteral nutrition affects growth parameters in very-low-birth-weight (VLBW) preterm infants. Preterm infants with a birth weight of < or = 1500 g were assigned to receive enteral glutamine supplementation (300 mg/kg/day) or placebo between 8-120 days (4 months) of life. At the end of each month, growth parameters [weight, length, head circumference, left upper mid-arm circumference (MAC) and left mid-thigh circumference (MTC)] were determined and enteral glutamine dose was adjusted according to the current weight. In VLBW infants (n = 69), the glutamine-supplemented group (n = 36) had significantly higher mean weight, length, head circumference, MAC and MTC than the control group (n=33) at the end of the fourth month. These findings suggest that long-term enteral glutamine supplementation may lead to significant improvements in growth in all body measures in VLBW infants, possibly in a time-dependent pattern.
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