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Preterm nutritional intake and MRI phenotype at term age: a prospective observational study
Vimal Vasu1, Giuliana Durighel2, E Louise Thomas
1Section of Neonatal Medicine, Department of Medicine, Imperial College London, Chelsea & Westminster Hospital Campus, London, UK Department of Child Health, William Harvey Hospital, Ashford, Kent, UK.
Insights
Preterm infants show distinct phenotypes compared to term infants, with adiposity negatively impacting brain volume. Human milk intake may benefit cerebral arterial vessel tortuosity in these vulnerable infants.
Area of Science:
- Neonatal physiology and developmental outcomes.
- Perinatal nutrition and its impact on infant development.
Background:
- Preterm infants (<32 weeks gestation) exhibit unique phenotypes at term-corrected age.
- Understanding the relationship between nutrition, body composition, and neurodevelopment in preterm infants is crucial.
Purpose of the Study:
- To investigate the relationship between nutrition and the preterm-at-term infant phenotype.
- To compare phenotypic differences between preterm-at-term and healthy term infants.
- To examine associations between somatic and brain magnetic resonance imaging (MRI) outcomes.
Main Methods:
- A prospective observational study was conducted in a UK tertiary neonatal unit.
- Participants included 22 preterm infants (<32 weeks gestation) and 39 healthy term infants.
- Outcomes measured were preterm nutrient intake, adipose tissue (AT) volumes, brain volume, and cerebral arterial vessel tortuosity (CAVT).
Main Results:
- Preterm infants had altered nutrient intake (deficient protein, high carbohydrate/fat) but this did not correlate with AT volumes, brain volume, or CAVT.
- Preterm infants exhibited increased total adiposity, comparable brain volumes, and reduced proximal CAVT scores versus term infants.
- A negative correlation was found between deep subcutaneous abdominal AT volume and brain volume in preterm infants (r=-0.58, p=0.01).
Conclusions:
- Significant phenotypic differences exist between preterm-at-term and term infants, independent of macronutrient intake.
- Preliminary findings suggest human milk intake may positively influence cerebral arterial vessel tortuosity.
- A negative association between adiposity and brain volume in preterm infants at term warrants further investigation.
Objective:
To describe (1) the relationship between nutrition and the preterm-at-term infant phenotype, (2) phenotypic differences between preterm-at-term infants and healthy term born infants and (3) relationships between somatic and brain MRI outcomes.
Design:
Prospective observational study.
Setting:
UK tertiary neonatal unit.
Participants:
Preterm infants (<32 weeks gestation) (n=22) and healthy term infants (n=39) MAIN OUTCOME MEASURES: Preterm nutrient intake; total and regional adipose tissue (AT) depot volumes; brain volume and proximal cerebral arterial vessel tortuosity (CAVT) in preterm infants and in term infants.
Results:
Preterm nutrition was deficient in protein and high in carbohydrate and fat. Preterm nutrition was not related to AT volumes, brain volume or proximal CAVT score; a positive association was noted between human milk intake and proximal CAVT score (r=0.44, p=0.05). In comparison to term infants, preterm infants had increased total adiposity, comparable brain volumes and reduced proximal CAVT scores. There was a significant negative correlation between deep subcutaneous abdominal AT volume and brain volume in preterm infants (r=-0.58, p=0.01).
Conclusions:
Though there are significant phenotypic differences between preterm infants at term and term infants, preterm macronutrient intake does not appear to be a determinant. Our preliminary data suggest that (1) human milk may exert a beneficial effect on cerebral arterial vessel tortuosity and (2) there is a negative correlation between adiposity and brain volume in preterm infants at term. Further work is warranted to see if our findings can be replicated and to understand the causal mechanisms.
