Neonatal Nutrition and Brain Structure at 7 Years in Children Born Very Preterm.

Area of Science:

• Neonatal nutrition
• Neurodevelopmental outcomes
• Pediatric imaging

Background:

• Neonatal protein intake significantly influences brain development in very preterm infants.
• The long-term effects of varying protein intake on brain maturation remain unclear.

Purpose of the Study:

• To investigate the association between neonatal protein intake and brain structure at 7 years of age in children born very preterm.
• To compare brain development between infants exposed to different neonatal intensive care unit (NICU) nutritional protocols.

Main Methods:

• A cohort study of very preterm infants before and after a NICU nutritional protocol change increasing protein intake.
• Magnetic resonance imaging (MRI) was used to assess brain structure at 7 years of age.
• Nutritional intake (protein, fat, energy, breast milk) and growth velocity were recorded in the first 1-2 weeks of life.

Main Results:

• Infants in the group with higher protein intake (new protocol) showed thinner lateral occipital and parietal cortices compared to the lower intake group.
• Despite differences in cortical thickness, absolute brain volumes were similar between groups.
• Combined analysis revealed a trend towards more mature white matter diffusion metrics with higher intake of protein, fat, energy, and breast milk.

Conclusions:

• Greater neonatal protein intake in very preterm infants was associated with a more mature brain metric profile at 7 years.
• These findings suggest that the higher protein intake from the revised NICU protocol may promote brain maturation.
• The study contributes to understanding optimal nutrition for very preterm infants to support long-term neurodevelopment.