Increase in Brain Volumes after Implementation of a Nutrition Regimen in Infants Born Extremely Preterm

• Published in: The Journal of pediatrics Vol. 223; pp. 57 - 63.e5
• Main Authors: van Beek, Pauline E., Claessens, Nathalie H.P., Makropoulos, Antonios, Groenendaal, Floris, de Vries, Linda S., Counsell, Serena J., Benders, Manon J.N.L.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-08-2020
• Subjects: brain volumes; MRI; protein; TEA; NICU; brain volumes; MRI; PMA; protein; Protein
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2020.04.063

To assess the effect of early life nutrition on structural brain development in 2 cohorts of extremely preterm infants, before and after the implementation of a nutrition regimen containing more protein and lipid.
We included 178 infants retrospectively (median gestational age, 26.6 weeks; IQR, 25.9-27.3), of whom 99 received the old nutrition regimen (cohort A, 2011-2013) and 79 the new nutrition regimen (cohort B, 2013-2015). Intake of protein, lipids, and calories was calculated for the first 28 postnatal days. Brain magnetic resonance imaging (MRI) was performed at 30 weeks postmenstrual age (IQR, 30.3-31.4) and term-equivalent age (IQR, 40.9-41.4). Volumes of 42 (left + right) brain structures were calculated.
Mean protein and caloric intake in cohort B (3.4 g/kg per day [P < .001] and 109 kcal/kg per day [P = .038]) was higher than in cohort A (2.7 g/kg per day; 104 kcal/kg per day). At 30 weeks, 22 regions were significantly larger in cohort B compared with cohort A, whereas at term-equivalent age, only the caudate nucleus was significantly larger in cohort B compared with cohort A.
An optimized nutrition protocol in the first 28 days of life is associated with temporarily improved early life brain volumes.