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Impact of Early Nutritional Intake on Preterm Brain: A Magnetic Resonance Imaging Study
Lydie Beauport1, Juliane Schneider2, Mohamed Faouzi3
1Clinic of Neonatology, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland; Division of Neonatology, Department of Pediatrics, Centre Hospitalier Chrétien, Site St-Vincent, Rocourt, Belgium.
Insights
Early high energy and lipid intake in preterm neonates is linked to better brain development and fewer lesions. This nutritional support is crucial for improving brain maturation in premature infants.
Area of Science:
- Neonatal neuroscience
- Developmental pediatrics
- Nutritional science
Background:
- Premature birth, especially before 30 weeks gestational age, poses significant risks for brain development.
- Early life nutrition is a critical factor influencing neurodevelopment in vulnerable neonates.
- Magnetic resonance imaging (MRI) is a key tool for assessing brain maturation and detecting injury in infants.
Purpose of the Study:
- To examine the relationship between early nutritional intake and brain development in preterm neonates.
- To identify specific macronutrients associated with improved brain maturation and reduced injury.
- To correlate nutritional intake with neuroimaging findings in extremely preterm infants.
Main Methods:
- A cohort of neonates born at ≤30 weeks gestational age was studied.
- Brain development was assessed using MRI and the Kidokoro score at term equivalent age.
- Logistic regression analyzed associations between macronutrient intake (first 2 weeks), clinical factors, and MRI scores.
Main Results:
- Infants with more abnormal MRI scores (Group 2) had significantly lower energy, lipid, and carbohydrate intake.
- Higher energy and lipid intake were significantly associated with better MRI scores, particularly in gray matter.
- Lower nutritional intake in Group 2 correlated with higher rates of sepsis and clinical risk.
Conclusions:
- Increased energy and lipid intake in the first two weeks of life are associated with reduced brain lesions and dysmaturation.
- Early nutrition plays a vital role in promoting favorable brain development outcomes in preterm infants.
- Optimizing early nutrition may be a key strategy to improve neurodevelopmental trajectories in extremely preterm neonates.
Objectives:
To investigate the association between early nutritional intake and brain development assessed by magnetic resonance imaging (MRI).
Study Design:
A cohort of neonates born at ≤30 weeks gestational age underwent MRI at term equivalent age. Brain maturation and injury were assessed using the Kidokoro score. Two groups were defined by severity of the scores. The associations between macronutrients intake during the first 2 weeks of life, clinical factors, and imaging scores were analyzed using logistic regression.
Results:
MRI scores from group 1 patients (n = 27) were normal to mildly abnormal (0-5). Group 2 (n = 15) had more abnormal scores (6-12). The median gestational ages (IQR) were 27.4 (1.9) weeks in group 1 and 27.0 (2.9) weeks in group 2, with birth weights of 900 (318) g (group 1) and 844 (293) g (group 2). In group 2, energy, lipid, and carbohydrate intake were significantly lower than in group 1. Group 2 also showed higher rates of sepsis and clinical risk scores than group 1. After adjustments in bivariate models, higher energy and lipid intake remained significantly associated with improved scores on MRI. This association was stronger for the gray matter component of the score.
Conclusions:
Higher energy and lipid intake during the first 2 weeks after birth was associated with a lower incidence of brain lesions and dysmaturation at term equivalent age in preterm neonates.
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