Neurodevelopmental Outcome of Extremely Low Birth Weight Infants Fed an Exclusive Human Milk Diet Is Not Affected by...

Area of Science:

• Neonatology
• Pediatric Nutrition
• Neurodevelopmental Pediatrics

Background:

• Exclusive human milk (EHM) diets in extremely low birth weight (ELBW) infants are linked to higher rates of extrauterine growth restriction (EUGR).
• Previous research suggests EUGR is associated with poorer neurodevelopmental (ND) outcomes.
• The impact of EUGR on ND outcomes in ELBW infants specifically fed an EHM diet remains unclear.

Purpose of the Study:

• To determine if EUGR adversely affects 2-year ND outcomes in ELBW infants fed an EHM diet.
• To compare short-term morbidities and growth trajectories up to 2 years corrected age (CA) between EUGR and non-EUGR groups.

Main Methods:

• A prospective cohort study included ELBW infants fed an EHM diet until 34 weeks corrected gestational age.
• Infants were assessed at 2 years CA using the Bayley Scales of Infant Development 3rd Edition (BSID-III) for ND outcomes.
• Comparison of ND outcomes, morbidities, and growth between infants with and without EUGR.

Main Results:

• Of 81 surviving ELBW infants, 44 were followed up; 16 (36%) experienced EUGR.
• No significant differences in cognition, language, or motor composite scores were observed at 2 years CA between EUGR and non-EUGR groups.
• While weight z-scores declined during NICU stay, more significantly in the EUGR group, linear and head growth showed no differences between groups.

Conclusions:

• In this cohort, EUGR status did not adversely affect 2-year ND outcomes for ELBW infants consuming an EHM diet.
• The findings suggest a potential neuroprotective effect of an EHM diet in ELBW infants, irrespective of EUGR.
• Further research is warranted to confirm the neuroprotective role of EHM in this vulnerable population.