Early protein intake predicts functional connectivity and neurocognition in preterm born children

Area of Science:

• Neonatal development
• Neuroscience
• Nutritional science

Background:

• Early nutrition is crucial for neonatal brain development, especially in very preterm infants (<32 weeks' gestation).
• Long-term neurodevelopmental outcomes in preterm children are influenced by early life factors.
• Understanding the relationship between neonatal nutrition and later brain function is essential for optimizing care.

Purpose of the Study:

• To investigate the association between early neonatal nutrient intake and long-term brain function and neurocognitive skills in very preterm children.
• To examine the relationship between macronutrient intake in the first weeks of life and brain connectivity at school age.
• To determine if early nutrition predicts cognitive and visual-motor processing abilities at seven years.

Main Methods:

• Longitudinal study of very preterm children followed since birth.
• Assessment of neonatal macronutrient intake (protein, fat, carbohydrates) in the first week and month of life.
• Neuroimaging using resting-state functional MRI (fMRI) to measure thalamic and default mode network (DMN) connectivity at age 7.
• Neurocognitive testing including intelligence (Wechsler Intelligence Scale for Children, 5th Ed) and visual-motor processing (Beery-Buktenica, 5th Ed) at age 7.
• Multivariable regression analysis to assess relationships between nutritional intake, brain connectivity, and neurocognitive outcomes.

Main Results:

• Greater functional connectivity strength between thalamic and default mode networks (DMN) was associated with higher early protein intake (first week and month).
• Higher intake of fat and carbohydrates in the first week was associated with lower thalamic-DMN connectivity strength.
• Increased thalamic-DMN connectivity strength correlated with higher processing speed indices and visual processing scores at age 7.
• Early protein intake showed a positive association with brain network connectivity and neurocognitive function.

Conclusions:

• Optimizing early protein intake in very preterm neonates may be a key strategy for promoting long-term brain health and cognitive development.
• Neonatal nutrition, particularly protein, plays a significant role in the maturation of brain networks and subsequent neurocognitive outcomes.
• These findings highlight the importance of tailored nutritional support in the neonatal period for improving developmental trajectories in preterm infants.