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Published on: August 25, 2014
Impact of early nutrition on brain development and neurocognitive outcomes in very preterm infants
Nima Naseh1, Tânia F Vaz2, Hugo Ferreira2
1Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. nima.naseh@uu.se.
Insights
Early macronutrient intake in preterm infants did not affect brain growth or neurodevelopment. Meeting current nutritional recommendations appears sufficient for supporting brain development in these vulnerable infants.
Area of Science:
- Neonatalogy
- Neuroscience
- Nutritional Science
Background:
- Malnutrition in preterm infants can impair brain growth and neurocognitive outcomes.
- Understanding the impact of early nutrition on brain development is crucial for preterm infants.
Purpose of the Study:
- To investigate the association between macronutrient intake in very preterm infants and brain MRI at term.
- To examine the relationship between early nutrition and neurodevelopment at two years of age.
Main Methods:
- Retrospective cohort study of extremely and very preterm infants (2011-2014).
- Assessed fluid, protein, carbohydrate, fat, and calorie intake during the first 28 days.
- Correlated nutritional intake with brain MRI at term and cognitive scores (BSID-III) at 2 years using multivariable regression.
Main Results:
- Lower caloric intake in extremely preterm infants did not correlate with differences in brain volumes.
- Initial correlations between macronutrient intake and white matter/diffusion metrics were not significant after adjustment.
- No significant associations were found between nutrient intake and cognitive development after adjusting for covariates.
Conclusions:
- Individual variations in macronutrient intake did not influence brain growth or neurodevelopment in preterm infants meeting current recommendations.
- Early postnatal nutrition, when adequate, was not associated with brain volumes or neurocognitive outcomes.
- Standardized, adequate macronutrient intake may suffice for supporting brain development in preterm infants.
Background:
Malnutrition of preterm infants may negatively affect brain growth and later neurocognitive function. We aimed to investigate the association between very preterm infants' macronutrient intakes, and brain MRI at term and neurodevelopment at 2 years.
Methods:
Single-center, retrospective cohort including extremely (22-27w) and very (28-31w) preterm infants born 2011-2014. The intakes of fluid, protein, carbohydrate, fat, and total calories during days 0-28 together with body weights were assessed in relation to brain MRI (morphology, volumetry, diffusion-weighted imaging) at term, and cognition (BSID-III) at 2 years, using adjusted multivariable regression analyses.
Results:
Seventy-two infants were included. A lower (p < 0.001) caloric intake in extremely preterm (n = 26) than in very preterm (n = 46) infants did not translate to any differences in brain volumes. While bivariate correlations (p < 0.01) were found between the enteral intakes of all macronutrients, and white matter volume and apparent diffusion coefficients, none of the correlations remained significant after adjusting for covariates in the multivariable analysis. Similarly, no associations between nutrient intakes and cognitive development remained after covariate adjustment.
Conclusion:
In a cohort of preterm infants receiving macronutrient intakes meeting current recommendations, individual variations in nutrition did not influence brain growth or neurodevelopment.
Impact:
Early postnatal macronutrient intake was not associated with brain volumes at term or neurocognitive outcomes at 2 years in very preterm infants All infants received nutritional intakes meeting current recommendations Adequate macronutrient intake based on a standardized protocol may eliminate the need for further minor adjustments in the pursuit of supporting brain growth and neurodevelopment in preterm infants.
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