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Published on: November 20, 2015
Impact of early aggressive nutrition on retinal development in premature infants
N Lenhartova1, K Matasova, Z Lasabova
1Clinic of Neonatology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital, Martin, Slovakia. matasova.katarina@gmail.com.
Insights
Early aggressive nutrition, including parenteral and breast milk feeding, can decrease retinopathy of prematurity (ROP). Ensuring adequate nutrient intake is crucial for normal retinal development in preterm infants.
Area of Science:
- Neonatalogy
- Ophthalmology
- Developmental Biology
Background:
- Preterm birth disrupts normal retinal development, leading to retinopathy of prematurity (ROP).
- ROP involves abnormal retinal vessel formation influenced by risk factors like low Insulin-like Growth Factor I (IGF-1).
- IGF-1 is vital for retinal vascularization and endothelial cell survival; insufficient levels halt angiogenesis, causing ROP.
Purpose of the Study:
- To highlight the role of nutrition in preventing retinopathy of prematurity (ROP).
- To emphasize the importance of early and aggressive nutritional support for preterm infants.
- To discuss the benefits of parenteral and enteral feeding in managing ROP risk.
Main Methods:
- Review of studies on nutritional interventions in preterm infants.
- Analysis of the impact of IGF-1 and VEGF on retinal angiogenesis.
- Evaluation of early parenteral nutrition and mother's own breast milk feeding.
Main Results:
- Adequate nutrition, particularly early aggressive feeding, improves growth and neurodevelopment in preterm infants.
- Sufficient nutrient and energy balance is associated with a decreased incidence of ROP.
- Early parenteral nutrition combined with enteral feeding of breast milk is a safe and effective strategy.
Conclusions:
- Maintaining a positive energy balance through early aggressive nutrition is critical for preterm infants.
- Nutritional support plays a key role in preventing ROP by supporting normal retinal vascularization.
- Further research is needed on the long-term effects of early aggressive nutrition on growth and development.
Abstract:
The normal retinal development is interrupted by preterm birth and a retinopathy of prematurity (ROP) may develop as its consequence. ROP is characterized by aberrant vessel formation in the retina as a response to multiple risk factors influencing the process of retinal angiogenesis. Insulin-like growth factor I (IGF-1) and vascular endothelial growth factor (VEGF) play an important role in the process of normal retinal vascularization. Insufficient nutrition during the first 4 postnatal weeks results in low serum levels of IGF-1, which is essential for correct retinal vessels formation, ensuring survival of the newly formed endothelial cells. Low IGF-1 level results in stop of angiogenesis in the retina, leaving it avascular and prompting the onset of ROP. Keeping the newborns in a positive energetic balance by providing enough nutrients and energy has a beneficial impact on their growth, neurodevelopment and decreased incidence of ROP. The best way to achieve this is the early parenteral nutrition with the high content of nutrients combined with early enteral feeding by the own mother´s breast milk. Multiple studies confirmed the safety and efficacy of early aggressive nutrition but information about its long-term effects on the metabolism, growth and development is still needed.
