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Early Nutrition, Blood Amino Acids and Outcomes in Preterm Babies: Secondary Cohort Analysis of the ProVIDe RCT

Barbara Cormack1,2, Amelia van Duinen1, Nadia Ford1

  • 1Liggins Institute, University of Auckland, Auckland 1023, New Zealand.

Nutrients
|May 27, 2026
PubMed

Insights

Parenteral nutrition in extremely preterm infants affects short-term outcomes, with higher amino acid intake linked to increased risks of bronchopulmonary dysplasia and sepsis. Lipid intake, however, reduced risks for several complications.

Area of Science:

  • Neonatalogy
  • Nutritional Science
  • Pediatric Critical Care

Background:

  • Optimizing parenteral nutrition for extremely preterm infants in the first week is critical but challenging.
  • Nutritional strategies can impact both short- and long-term infant outcomes.

Purpose of the Study:

  • To explore associations between parenteral amino acid and lipid intake and blood spot amino acid concentrations.
  • To investigate the relationship between nutritional intake and clinical outcomes and neurodevelopment in extremely low-birth-weight infants.
  • To analyze data from a secondary cohort of the ProVIDe trial.

Main Methods:

  • Secondary cohort analysis of the multicentre, randomised, controlled ProVIDe trial.
  • Included 382 extremely-low-birth-weight infants; 342 survived to 28 days.
  • Collected nutritional intake data (first week) and newborn metabolic screening data (days 1, 5, 14, 28); assessed neurodevelopment at 2 years corrected age for 294 children.

Main Results:

  • Blood spot amino acid concentrations correlated positively with amino acid intake (p < 0.005).
  • Higher amino acid intake associated with increased odds of bronchopulmonary dysplasia, patent ductus arteriosus, and probable sepsis.
  • Higher lipid intake associated with reduced odds of intraventricular hemorrhage, bronchopulmonary dysplasia, and retinopathy of prematurity.
  • No significant associations found for necrotizing enterocolitis; neurodevelopmental outcomes did not differ based on week 1 intake.

Conclusions:

  • Parenteral nutrition intakes during the first week of life are linked to short-term outcomes in extremely preterm infants.
  • Further research is required to optimize the composition of amino acid solutions for parenteral nutrition.
  • Current findings highlight the importance of tailored nutritional strategies in neonatal intensive care.
Abstract

Keywords:
amino acidslipidneurodevelopmentparenteral nutritionpreterm

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