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Optimum feeding and growth in preterm neonates
J E Harding1, J G B Derraik1, M J Berry1
1Liggins Institute, University of Auckland, Auckland, New Zealand.
Insights
Preterm birth, a global health concern, is linked to poor growth and long-term health issues. Interventions for preterm infants may improve neurological outcomes but increase later cardiovascular risk.
Area of Science:
- Neonatal care
- Perinatal health
- Developmental pediatrics
Background:
- Preterm birth affects 10% of infants globally, leading to significant perinatal mortality.
- The causal link between preterm birth and adverse health outcomes is debated, with intrauterine environment potentially playing a role.
- Both preterm and reduced fetal growth share common origins and long-term health consequences.
Purpose of the Study:
- To investigate the relationship between preterm birth, fetal growth, and long-term health outcomes.
- To evaluate the impact of neonatal interventions on postnatal growth and development in preterm infants.
- To explore the trade-offs between neurological and cardiovascular outcomes associated with rapid postnatal growth in preterm infants.
Main Methods:
- Review of existing evidence on preterm birth and growth trajectories.
- Analysis of short-term risks and benefits of neonatal nutritional interventions.
- Examination of long-term health consequences, including neurological and cardiovascular health.
Main Results:
- Suboptimal intrauterine environment may contribute to reduced fetal growth and preterm birth.
- Preterm infants often experience suboptimal postnatal growth, impacting long-term health.
- Neonatal interventions for growth may improve neurological outcomes but increase later cardiovascular risk.
Conclusions:
- The long-term health consequences of preterm birth and associated growth patterns require further investigation.
- Careful consideration of neonatal interventions is needed due to potential long-term trade-offs.
- Understanding the complex interplay between intrauterine environment, birth timing, and postnatal growth is crucial for optimizing preterm infant health.
Abstract:
Approximately 10% of all babies worldwide are born preterm, and preterm birth is the leading cause of perinatal mortality in developed countries. Although preterm birth is associated with adverse short- and long-term health outcomes, it is not yet clear whether this relationship is causal. Rather, there is evidence that reduced foetal growth, preterm birth and the long-term health effects of both of these may all arise from a suboptimal intrauterine environment. Further, most infants born preterm also experience suboptimal postnatal growth, with potential adverse effects on long-term health and development. A number of interventions are used widely in the neonatal period to optimise postnatal growth and development. These commonly include supplementation with macronutrients and/or micronutrients, all of which have potential short-term risks and benefits for the preterm infant, whereas the long-term health consequences are largely unknown. Importantly, more rapid postnatal growth trajectory (and the interventions required to achieve this) may result in improved neurological outcomes at the expense of increased cardiovascular risk in later life.
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