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Early Enteral Feeding Restores Neurofilament Light Chain Serum Levels in Preterm Newborns
Maria Di Chiara1, Gianluca Terrin1, Marco Fiore2
1Department of Mother and Child Health, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
Insights
Early enteral nutrition (EN) within the first week of life significantly reduced neurofilament light chain (NfL) levels in preterm neonates. This suggests EN is a valuable strategy for minimizing neurological damage in vulnerable infants.
Area of Science:
- Neonatalogy
- Neuroscience
- Pediatric Nutrition
Background:
- Early nutritional strategies impact neurological outcomes in neonates.
- Enteral nutrition (EN) is preferred, especially within the first week of life.
- Serum neurofilament light chain (NfL) is a biomarker for neuronal damage.
Purpose of the Study:
- To evaluate the effect of early EN on neuroaxonal damage.
- To assess serum NfL levels in preterm neonates receiving early EN.
- To determine if early EN minimizes neurological impairment.
Main Methods:
- Study included 54 preterm neonates and 20 full-term controls.
- Blood samples collected at birth (DoL 0) and day 28 (DoL 28).
- Preterm infants categorized into Early-EN (within 3rd DoL) and Late-EN groups.
Main Results:
- Preterm neonates had higher NfL levels than full-term at birth (DoL 0).
- At DoL 28, Early-EN group showed significantly lower NfL levels compared to Late-EN group (15.22 ± 2.0 vs. 50.05 ± 17.9 pg/ml; p = 0.03).
Conclusions:
- Early enteral feeding within the first week is beneficial.
- EN can limit neurological impairment in preterm infants.
- Restoring NfL levels indicates reduced neurological damage.
Background:
Positive effects of early nutritional strategies on neurological outcomes have been observed when nutrients were administered by the enteral route, especially during the first week of life. Evidence reports that serum neurofilament light chain (NfL), a structural protein of neurons, is a specific and reliable biomarker of neuronal damage.
Objective:
The present study aimed to investigate the effect of early enteral nutrition (EN) in minimizing neuroaxonal damage and assessing NfL serum levels in preterm neonates.
Methods:
Fifty-four preterm neonates without severe brain impairment and 20 full-term babies as controls were enrolled from the Neonatal Intensive Care Unit at the Policlinico Umberto I in Rome. We performed blood sampling at birth (day of life 0 - DoL 0) in 20 full-term newborns and in 19 pre-term infants. Furthermore, we executed blood sampling at DoL 28 in other 22 pre-term newborns who received early enteral nutrition (EN) within the third DoL (Early-EN) and in 13 other pre-term newborns who received EN after the third DoL (Late-EN).
Results:
Serum levels of NfL were higher in preterm babies when compared to full-term neonates, at DoL 0 (48.81 ± 9.4 vs. 11.67 ± 1.4 pg/ml; p = 0.007). Interestingly, at DoL 28, serum NfL was significantly decreased in the Early-EN newborns compared to the Late-EN groups (15.22 ± 2.0 vs. 50.05 ± 17.9 pg/ml; p = 0.03).
Conclusion:
It was shown that early enteral feeding, within the first week of life, could be a useful tool for limiting neurological impairment in pre-term neonates by restoring NfL.
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