Early Nutrition and Growth until the Corrected Age of 2 Years in Extremely Preterm Infants
Henni Hiltunen1, Eliisa Löyttyniemi, Erika Isolauri
1Department of Pediatrics, University of Turku, Turku, Finland.
Insights
Early energy intake in extremely preterm infants significantly impacts growth up to two years. Aggressive nutritional management in the first week is crucial for better long-term development.
Area of Science:
- Neonatal nutrition
- Pediatric growth and development
- Preterm infant care
Background:
- Extremely preterm birth (<28 weeks' gestation) poses risks for extrauterine growth retardation and adverse developmental outcomes.
- Early nutritional management is critical for the growth trajectory of preterm infants.
- Understanding the impact of early nutrition on long-term growth is essential for optimizing infant health.
Purpose of the Study:
- To investigate the association between nutritional management in the first 7 days of life and growth patterns in extremely preterm infants.
- To determine if early energy and macronutrient intake influences growth until corrected age of 2 years.
- To provide evidence supporting optimal nutritional strategies for extremely preterm neonates.
Main Methods:
- Retrospective study of 78 extremely preterm neonates (<28 weeks' gestation).
- Collected data on parenteral and enteral intake of energy, protein, lipids, and carbohydrates during the first 7 days.
- Utilized hierarchical-linear mixed models to analyze growth (weight, height, head circumference Z scores) at term-equivalent, 1, and 2 years corrected age.
Main Results:
- Nutritional intake during the first week did not meet current recommendations.
- Total energy intake in the first 7 days was significantly associated with weight, length, and head circumference up to 2 years corrected age.
- Individual macronutrient intake showed no significant association with growth patterns.
Conclusions:
- Early energy intake is a significant predictor of growth in extremely preterm infants up to 2 years corrected age.
- Aggressive early nutritional management, particularly focusing on energy, is supported by these findings.
- Optimizing early nutrition can mitigate growth deficits and potentially improve developmental outcomes in this vulnerable population.
Background:
Extremely preterm birth is associated with a high risk of extrauterine growth retardation, which has been linked with adverse developmental outcomes.
Objective:
We investigated whether nutritional management during the first 7 days of life affects growth patterns until the corrected age of 2 years in extremely preterm infants.
Study Design:
A retrospective study of 78 extremely preterm (<28 weeks' gestation) neonates was conducted. Data regarding parenteral and enteral intake of energy, protein, lipids, and carbohydrates during the first 7 days of life were collected from patient records. The outcome measures included weight, height, and head circumference with Z scores at term-equivalent age and the corrected ages of 1 and 2 years. Analyses were performed with hierarchical-linear mixed models.
Results:
Nutritional intake during the first week of life did not reach the current recommendations. The total energy intake during the first 7 days of life was statistically significantly associated with weight, length, and head circumference until the corrected age of 2 years after adjusting for potential confounding factors. Individual macronutrient intake displayed no association with growth patterns.
Conclusions:
Energy intake during the first 7 days of life is associated with growth until the corrected age of 2 years. These results provide support for the aggressive early nutritional management of extremely preterm infants.
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