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Neurodevelopment of Preterm Infants at 24 Months After Neonatal Supplementation of a Prebiotic Mix: A Randomized

Jolice P van den Berg1, Elisabeth A M Westerbeek, Tinka Bröring-Starre

  • 1*Department of Paediatrics, Division of Neonatology, VU University Medical Center, Amsterdam, The Netherlands †Department of Internal Medicine, Division of Gastroenterology, Rush University Medical Center, Chicago ‡Department of Medical Psychology, VU University Medical Center, Amsterdam §Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences ||Nutricia Research, Utrecht ¶Department of Pediatrics, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands.

Journal of Pediatric Gastroenterology and Nutrition
|February 10, 2016
PubMed

Insights

Preterm infants supplemented with scGOS/lcFOS/pAOS showed no improved neurodevelopmental outcomes. Neonatal infections, lower bifidobacteria, and higher cytokine levels were linked to poorer outcomes.

Area of Science:

  • Neonatal research
  • Neuroscience
  • Microbiome studies

Background:

  • Preterm birth disrupts fetal brain maturation.
  • Neonatal inflammation can negatively impact neurodevelopmental outcomes.
  • Understanding factors influencing preterm infant neurodevelopment is critical.

Purpose of the Study:

  • To evaluate the effect of short-chain galacto-oligosaccharides/long-chain fructo-oligosaccharides/pectin-derived acidic oligosaccharides (scGOS/lcFOS/pAOS) supplementation on neurodevelopmental outcomes in preterm infants.
  • To assess neurodevelopment using the Bayley Scales of Infant and Toddler Development at 24 months corrected age.
  • To explore associations between neonatal factors (cytokines, gut bacteria) and neurodevelopmental outcomes.

Main Methods:

  • A randomized controlled trial involving preterm infants supplemented with scGOS/lcFOS/pAOS or placebo from day 3 to 30.
  • Analysis of serum cytokine levels and stool bacterial counts (including bifidobacteria) at multiple time points.
  • Neurodevelopmental assessment using Bayley Scales of Infant and Toddler Development II or III at 24 months corrected age by blinded evaluators.

Main Results:

  • No significant difference in neurodevelopmental outcomes between the scGOS/lcFOS/pAOS and placebo groups at 24 months.
  • Neonatal infections, lower bifidobacteria percentages at days 7 and 14, and elevated IL-1β and IL-8 at day 7 were associated with lower mental developmental index scores.
  • Lower psychomotor outcomes correlated with IL-2 and IL-4 at birth, and interferon gamma at day 7.

Conclusions:

  • scGOS/lcFOS/pAOS supplementation did not improve neurodevelopmental outcomes in preterm infants at 24 months.
  • Neonatal infections, gut microbiome composition (bifidobacteria), and immune responses (cytokine levels) are significant factors influencing neurodevelopmental trajectories in preterm infants.
  • These findings highlight the importance of the microbiome and immune system in the neurodevelopment of preterm infants.
Abstract

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