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Early amino-acid administration improves preterm infant weight
C J Valentine1, S Fernandez, L K Rogers
1Department of Pediatrics, Neonatal Nutrition Team, Nationwide Children's Hospital, Ohio State University, Columbus, OH 43205, USA. Christina.Valentine@nationwidechildrens.org
Insights
Early amino acid supplementation for premature infants under 1500g improved growth outcomes. This early nutritional support is critical for better weight gain and development in high-risk neonates.
Area of Science:
- Neonatalogy
- Pediatric Nutrition
- Perinatal Medicine
Background:
- Premature infants, particularly those under 1500g, often experience suboptimal growth post-birth.
- Inadequate early nutritional support is a significant factor contributing to poor growth in these vulnerable infants.
Purpose of the Study:
- To investigate the impact of early amino acid administration on growth outcomes in preterm infants weighing less than 1500g.
- To test the hypothesis that initiating amino acids within the first few hours of life reduces the incidence of infants falling below the 10th percentile at 36 weeks post-conceptual age.
Main Methods:
- A prospective study compared early amino-acid (EAA) supplementation (initiated before 24 hours) with a retrospective cohort receiving late amino-acid (LAA) supplementation (initiated after 24 hours).
- The primary outcome measured was the proportion of infants below the 10th percentile at 36 weeks post-conceptual age.
Main Results:
- Significantly fewer infants in the EAA group fell below the 10th percentile compared to the LAA group (P<0.001).
- EAA supplementation was associated with significantly greater infant weight gains (P<0.003) and a shorter duration of parenteral nutrition (P<0.001).
Conclusions:
- Early amino acid administration in preterm infants (<1500g) is linked to improved weight gain.
- Nutritional strategies including amino acids within the first 24 hours of life are crucial for optimizing growth in preterm neonates.
Objective:
Premature infants, especially those born less than 1500 g, often exhibit slow overall growth after birth and lack of early nutritional support may be an important element. We tested the hypothesis that early administration of amino acids (within the first few hours of life) to infants born at less than 1500 g would be associated with fewer infants that were less than the 10th percentile at 36 weeks post-conceptual age than infants that received amino acids after the first 24 h of life.
Study Design:
A prospective intervention of early amino-acid (EAA) supplementation, began before 24 h of life, in preterm infants, <1500 g, was compared to a retrospective cohort of preterm infants receiving late amino-acid (LAA) supplementation, began after 24 h of life. The primary outcome variable was the proportion of infants at less than the 10th percentile at 36 weeks post-conceptual age.
Result:
Fewer infants fell below the 10th percentile (P<0.001) in the EAA group. Furthermore, infants in the EAA groups had significantly greater weight gains than did the LAA group (P<0.003) after adjusting for gestational age and time from birth to discharge. In addition, shorter duration of parenteral nutrition was associated with EAA supplementation (P<0.001).
Conclusion:
A prospective strategy of EAA in preterm infants <1500 g was associated with an improved weight gain, suggesting that nutrition that included amino acids may be critical during the first 24 h of life.
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