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A Scoping Review: Urinary Markers of Metabolic Maturation in Preterm Infants and Future Interventions to Improve

Luise V Marino1,2,3, Simone Paulson1, James J Ashton3,4,5

  • 1Paediatric Intensive Care Unit, Southampton Children's Hospital, NIHR Southampton Biomedical Research Centre, University Hospital Southampton, NHS Foundation Trust, Southampton S016 6YD, UK.

Nutrients
|October 14, 2022
PubMed

Insights

Growth failure in preterm infants is linked to poor development. This review highlights gaps in understanding metabolic maturation and its connection to growth in these vulnerable infants, suggesting a need for better assessment tools.

Area of Science:

  • Neonatal Medicine
  • Metabolomics
  • Developmental Biology

Background:

  • Preterm birth poses risks for infant growth, neurodevelopment, and metabolic health.
  • The first 1000 days are critical for biological system maturation, including metabolic development.
  • Limited knowledge exists on metabolic maturation in preterm infants and its impact on growth.

Purpose of the Study:

  • To review evidence on urinary markers of metabolic maturation in preterm infants.
  • To explore the relationship between these markers and infant growth.

Main Methods:

  • Scoping review of qualitative and quantitative studies.
  • Included studies published between 1998 and 2021.
  • Analyzed urinary metabolites from 1131 preterm infants across multiple countries.

Main Results:

  • Identified four key themes: metabolic maturation vs. gestational age, metabolic signatures over time, nutrition, and growth.
  • Data synthesized from 15 studies conducted globally.
  • Highlighted significant knowledge gaps in understanding metabolic instability and normal maturation patterns.

Conclusions:

  • Considerable gaps exist in understanding factors influencing metabolic instability in preterm infants.
  • Defining normal metabolic maturation is crucial for this population.
  • Developing reference phenome age z-scores for metabolites could enhance nutritional and growth outcomes.

Keywords:
growthinfantsmetabolic maturationpretermurinary metabolites

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