Increase in Brain Volumes after Implementation of a Nutrition Regimen in Infants Born Extremely Preterm
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...
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| Published in: | The Journal of pediatrics Vol. 223; pp. 57 - 63.e5 |
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01-08-2020
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| Abstract | 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. |
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| AbstractList | OBJECTIVETo 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. STUDY DESIGNWe 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. RESULTSMean 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. CONCLUSIONSAn optimized nutrition protocol in the first 28 days of life is associated with temporarily improved early life brain volumes. 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. To assess the effect of early life nutrition on structural brain development in two cohorts of extremely preterm infants, before and after implementation of a nutrition regimen containing more protein and lipid. 178 infants were retrospectively included (median gestational age 26.6 wks, 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 MRI was performed at 30 weeks post-menstrual age (PMA) (IQR 30.3-31.4) and term-equivalent age (TEA) (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/day; p<0.001 and 109 kCal/kg/day; P = .038) were higher than in cohort A (2.7 g/kg/day; 104 kCal/kg/day). At 30 weeks, 22 regions were significantly larger in cohort B compared with cohort A, whereas at TEA, 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. |
| Author | Claessens, Nathalie H.P. Groenendaal, Floris Counsell, Serena J. de Vries, Linda S. Makropoulos, Antonios van Beek, Pauline E. Benders, Manon J.N.L. |
| Author_xml | – sequence: 1 givenname: Pauline E. surname: van Beek fullname: van Beek, Pauline E. organization: Department of Neonatology, Wilhelmina Children's Hospital, Utrecht, the Netherlands – sequence: 2 givenname: Nathalie H.P. surname: Claessens fullname: Claessens, Nathalie H.P. organization: Department of Neonatology, Wilhelmina Children's Hospital, Utrecht, the Netherlands – sequence: 3 givenname: Antonios surname: Makropoulos fullname: Makropoulos, Antonios organization: Department of Computing, Imperial College London, London, UK – sequence: 4 givenname: Floris orcidid: 0000-0002-9284-1637 surname: Groenendaal fullname: Groenendaal, Floris organization: Department of Neonatology, Wilhelmina Children's Hospital, Utrecht, the Netherlands – sequence: 5 givenname: Linda S. surname: de Vries fullname: de Vries, Linda S. organization: Department of Neonatology, Wilhelmina Children's Hospital, Utrecht, the Netherlands – sequence: 6 givenname: Serena J. surname: Counsell fullname: Counsell, Serena J. organization: Centre for the Developing Brain, Division of Imaging Science & Biomedical Engineering, King's College London, London, UK – sequence: 7 givenname: Manon J.N.L. surname: Benders fullname: Benders, Manon J.N.L. email: m.benders@umcutrecht.nl organization: Department of Neonatology, Wilhelmina Children's Hospital, Utrecht, the Netherlands |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32389719$$D View this record in MEDLINE/PubMed |
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| Title | Increase in Brain Volumes after Implementation of a Nutrition Regimen in Infants Born Extremely Preterm |
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