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First-week protein and energy intakes are associated with 18-month developmental outcomes in extremely low birth

Bonnie E Stephens1, Rachel V Walden, Regina A Gargus

  • 1Department of Pediatrics, Alpert Brown Medical School, Providence, Rhode Island, USA. bstephens@wihri.org

Pediatrics
|May 1, 2009
PubMed

Insights

Early protein and energy intake in the first week of life positively impacts neurodevelopment and growth for extremely low birth weight infants. Optimal nutrition during this critical period is crucial for better long-term outcomes.

Area of Science:

  • Neonatal nutrition
  • Pediatric neurodevelopment
  • Growth assessment

Background:

  • Extremely low birth weight (ELBW) infants (<1000 g) face significant risks for impaired neurodevelopment and growth.
  • Early nutritional intake is hypothesized to play a critical role in mitigating these risks.
  • Optimal protein and energy provision in the neonatal period is essential for ELBW survivors.

Purpose of the Study:

  • To investigate the association between early protein and energy intake and neurodevelopmental and growth outcomes in ELBW infants.
  • To determine if nutritional intake in the first four weeks of life predicts cognitive and psychomotor development at 18 months corrected age.
  • To assess the relationship between early nutrition and linear growth in ELBW survivors.

Main Methods:

  • Chart review collected daily protein and energy intakes for the first 4 weeks in 148 ELBW survivors.
  • 124 infants (84%) were evaluated at 18 months corrected age for neurodevelopment (Bayley Scales) and growth.
  • Bivariate analysis and regression models assessed the impact of protein and energy intake on development and growth, controlling for confounders.

Main Results:

  • First-week energy and protein intakes were independently associated with the Mental Development Index (MDI) at 18 months.
  • Each 42 kJ/kg/day increase in week 1 energy intake correlated with a 4.6-point MDI increase.
  • Each 1 g/kg/day increase in week 1 protein intake correlated with an 8.2-point MDI increase; higher protein was linked to reduced risk of length <10th percentile.

Conclusions:

  • Higher protein and energy intake during the first week of life is associated with improved MDI scores in ELBW infants.
  • Increased first-week nutrition is linked to a lower likelihood of length growth restriction at 18 months.
  • Prioritizing optimal protein and energy delivery in the first week is crucial for ELBW infant outcomes.
Abstract

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