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Energy-enhanced parenteral nutrition and neurodevelopment of preterm newborns: A cohort study

Gianluca Terrin1, Giovanni Boscarino1, Corinna Gasparini1

  • 1Department of Maternal and Child Health, University of Rome La Sapienza, Rome, Italy.

Nutrition (Burbank, Los Angeles County, Calif.)
|April 9, 2021
PubMed

Insights

Aggressive parenteral nutrition (PN) in preterm infants may negatively impact neurodevelopmental outcomes. Standard PN is associated with better motor and socioemotional skills at 24 months.

Area of Science:

  • Neonatology
  • Neurodevelopmental Pediatrics
  • Nutritional Science

Background:

  • Preterm infants face elevated risks for neurodevelopmental disabilities.
  • Aggressive parenteral nutrition (PN) is recommended to mitigate long-term consequences.
  • The impact of early energy-enhanced PN on long-term neurodevelopment requires further investigation.

Purpose of the Study:

  • To evaluate the long-term neurodevelopmental (NDV) effects of energy-enhanced parenteral nutrition (PN) in the first week of life for preterm neonates.
  • To compare neurodevelopmental outcomes at 24 months between preterm infants receiving energy-enhanced PN versus standard PN.

Main Methods:

  • A comparative study of two newborn cohorts (n=51) receiving either energy-enhanced PN (Group A) or energy-standard PN (Group B) for the first 7 days of life.
  • Both groups received equivalent protein amounts via PN.
  • Neurodevelopment at 24 months was assessed using the Bayley Scale of Infant Development-III edition.

Main Results:

  • Infants receiving standard PN (Group B) demonstrated significantly better gross motor, total scaled, and total composite motor scores (P < 0.05).
  • Group A (energy-enhanced PN) exhibited a higher incidence of delayed socioemotional competence (30.4% vs. 7.7%, P < 0.05).
  • No significant differences in growth parameters were observed at 24 months between groups. Linear regression indicated a negative association between early PN energy intake and motor/socioemotional scores.

Conclusions:

  • An aggressive parenteral nutrition strategy, particularly energy-enhanced, may lead to poorer motor and socioemotional outcomes in preterm infants at 24 months.
  • Increased caution is advised when implementing energy-enhanced PN protocols, especially for lower birth weight neonates.
  • Findings suggest a potential detrimental effect of high early energy PN on long-term neurodevelopment in preterm infants.
Abstract

Keywords:
Bayley ScaleEnergy intakeMotor scoreNutritional intakeSocioemotional delayVery-low birth weight (VLBW)

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