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Long-term effect of active parenteral nutrition support regimen in preterm infants with a gestational age of <34
Ren-Hui Jiang1, Yu-Jie Shen, Xiao-Chen Liu
1Department of Child Health Care, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.
Insights
Early, high-dose parenteral nutrition in preterm infants (<34 weeks gestation) significantly improved long-term neurodevelopmental outcomes. This active nutritional support regimen enhanced motor and social behaviors by 13 months of age.
Area of Science:
- Neonatal Medicine
- Pediatric Nutrition
- Neurodevelopmental Pediatrics
Background:
- Preterm infants, particularly those with a gestational age less than 34 weeks, face significant risks for suboptimal neurodevelopment.
- Early nutritional support is critical for the growth and development of these vulnerable infants.
- Parenteral nutrition (PN) is often essential, but optimal strategies for macronutrient delivery require further investigation.
Purpose of the Study:
- To evaluate the long-term neurodevelopmental effects of an active parenteral nutrition support regimen in preterm infants (<34 weeks gestation).
- To compare the developmental outcomes between infants receiving active PN versus conventional PN.
Main Methods:
- A cohort of preterm infants (<34 weeks gestation), admitted within 24 hours of birth, was divided into active PN and conventional PN groups based on early fat emulsion and amino acid doses.
- Infants were assessed at 6 and 13 months corrected age using the Gesell Development Scale.
- Physical development indices (weight, height, head circumference) were also monitored.
Main Results:
- At 6 months, the active PN group showed significantly higher developmental quotients in gross motor, fine motor, and personal-social domains compared to the conventional PN group.
- At 13 months, the active PN group continued to demonstrate superior developmental quotients in adaptive behavior, gross motor, and personal-social domains.
- No significant differences in physical growth parameters (weight, height, head circumference) were observed between the groups throughout the follow-up period.
Conclusions:
- An active parenteral nutrition strategy, characterized by high doses of fat emulsion and amino acids initiated within 24 hours of birth, positively impacts long-term neurodevelopment in preterm infants (<34 weeks gestation).
- This approach appears to enhance key neurodevelopmental trajectories without adversely affecting physical growth.
Objectives:
To study the long-term effect of active parenteral nutrition support regimen in preterm infants with a gestational age of <34 weeks.
Methods:
According to the different doses of fat emulsion and amino acids used in the early stage, the preterm infants with a gestational age of <34 weeks, who were admitted to the hospital within 24 hours after birth from May to December 2019, were divided into an active parenteral nutrition group and a conventional parenteral nutrition group (n=50). Physical indices and the measurements of the Gesell Development Scale were collected at the age of 6 months and 13 months.
Results:
At the age of 6 months, the active parenteral nutrition group (n=46) had higher developmental quotients of gross motor, fine motor, and personal-social behavior than the conventional parenteral nutrition group (n=34) (P<0.05). At the age of 13 months, the active parenteral nutrition group (n=25) had higher developmental quotients of adaptive behavior, gross motor, and personal-social behavior than the conventional parenteral nutrition group (n=19) (P<0.05). There were no significant differences in the physical development indices such as body weight, body height, and head circumference between the two groups during follow-up (P>0.05).
Conclusions:
For preterm infants with a gestational age of <34 weeks, an active parenteral nutrition support strategy with high doses of fat emulsion and amino acids within 24 hours after birth can improve their long-term neurodevelopment.
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