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Glutamine effects on brain growth in very preterm children in the first year of life
Jorrit F de Kieviet1, Pieter J Vuijk1, Anemone van den Berg2
1VU University Amsterdam, Department of Clinical Neuropsychology, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands.
Insights
Neonatal glutamine supplementation specifically increased head circumference growth in very preterm infants during the first year of life. This suggests early growth differences may explain later brain structure volume variations observed at school-age.
Area of Science:
- Neonatal research
- Pediatric neurology
- Nutritional science
Background:
- Neonatal glutamine supplementation is linked to larger brain volumes in very preterm children at school-age.
- Understanding the timing and specificity of these brain structure differences is crucial.
Purpose of the Study:
- To investigate the emergence and specificity of brain structure volume differences.
- To analyze growth trajectories of head circumference, weight, and length in relation to supplementation.
Main Methods:
- Study included 65 very preterm children from a randomized controlled trial on glutamine.
- Measurements included head circumference, weight, and length from birth through the first year.
- School-age Magnetic Resonance Imaging assessed brain structure volumes; multilevel modeling analyzed growth trajectories.
Main Results:
- Head circumference in the first year correlated positively with school-age white and grey matter volumes (r = 0.55-0.81).
- Neonatal glutamine supplementation was associated with increased head circumference growth (p=0.008) in the first year.
- No significant association was found between glutamine and weight or length growth.
Conclusions:
- Neonatal glutamine supplementation specifically enhances head circumference growth in very preterm infants.
- Brain structure volume differences at school-age may originate from growth patterns established within the first year of life.
Background & Aims:
Glutamine supplementation in the neonatal period has been associated with increased brain structure volumes at school-age in very preterm children. The aim of this study was to clarify the emergence and specificity of differences in brain structure volumes, using growth trajectories of head circumference, weight, and length.
Methods:
Sixty-five very preterm (<32 weeks gestation) children, who originally took part in a randomized controlled trial on glutamine supplementation, participated. Head circumference, weight, and length, were measured at the neonatal intensive care unit, and at routine follow-up assessments at the outpatient clinic and well baby clinics. Magnetic Resonance Imaging was used to determine brain structure volumes at school-age. Growth trajectories were investigated using multilevel modeling analyses.
Results:
Head circumference in the first year of life was positively associated with white matter volume and grey matter volume (range r = 0.55-0.81, all p < 0.002) at school-age. Furthermore, neonatal glutamine supplementation was associated with increased head circumference growth (p = 0.008) in the first year of life, but not with increased growth in weight (p = 0.44) and length (p = 0.73).
Conclusions:
This study indicates a specific increase in head circumference growth in very preterm children that received neonatal glutamine supplementation, and suggests that group differences in brain structure volumes at school-age may have emerged during the first year of life.
