TY - JOUR
T1 - Nutritional intake, white matter integrity, and neurodevelopment in extremely preterm born infants
AU - Hortensius, Lisa M.
AU - Janson, Els
AU - van Beek, Pauline E.
AU - Groenendaal, Floris
AU - Claessens, Nathalie H.P.
AU - Swanenburg de Veye, Henriette F.N.
AU - Eijsermans, Maria J.C.
AU - Koopman-Esseboom, Corine
AU - Dudink, Jeroen
AU - van Elburg, Ruurd M.
AU - Benders, Manon J.N.L.
AU - Tataranno, Maria Luisa
AU - van der Aa, Niek E.
PY - 2021/9/27
Y1 - 2021/9/27
N2 - BACKGROUND: Determining optimal nutritional regimens in extremely preterm infants remains challenging. This study aimed to evaluate the effect of a new nutritional regimen and individual macronutrient intake on white matter integrity and neurodevelopmental outcome.METHODS: Two retrospective cohorts of extremely preterm infants (gestational age < 28 weeks) were included. Cohort B (
n = 79) received a new nutritional regimen, with more rapidly increased, higher protein intake compared to cohort A (
n = 99). Individual protein, lipid, and caloric intakes were calculated for the first 28 postnatal days. Diffusion tensor imaging was performed at term-equivalent age, and cognitive and motor development were evaluated at 2 years corrected age (CA) (Bayley-III-NL) and 5.9 years chronological age (WPPSI-III-NL, MABC-2-NL).
RESULTS: Compared to cohort A, infants in cohort B had significantly higher protein intake (3.4 g/kg/day vs. 2.7 g/kg/day) and higher fractional anisotropy (FA) in several white matter tracts but lower motor scores at 2 years CA (mean (SD) 103 (12) vs. 109 (12)). Higher protein intake was associated with higher FA and lower motor scores at 2 years CA (B = -6.7,
p = 0.001). However, motor scores at 2 years CA were still within the normal range and differences were not sustained at 5.9 years. There were no significant associations with lipid or caloric intake.
CONCLUSION: In extremely preterm born infants, postnatal protein intake seems important for white matter development but does not necessarily improve long-term cognitive and motor development.
AB - BACKGROUND: Determining optimal nutritional regimens in extremely preterm infants remains challenging. This study aimed to evaluate the effect of a new nutritional regimen and individual macronutrient intake on white matter integrity and neurodevelopmental outcome.METHODS: Two retrospective cohorts of extremely preterm infants (gestational age < 28 weeks) were included. Cohort B (
n = 79) received a new nutritional regimen, with more rapidly increased, higher protein intake compared to cohort A (
n = 99). Individual protein, lipid, and caloric intakes were calculated for the first 28 postnatal days. Diffusion tensor imaging was performed at term-equivalent age, and cognitive and motor development were evaluated at 2 years corrected age (CA) (Bayley-III-NL) and 5.9 years chronological age (WPPSI-III-NL, MABC-2-NL).
RESULTS: Compared to cohort A, infants in cohort B had significantly higher protein intake (3.4 g/kg/day vs. 2.7 g/kg/day) and higher fractional anisotropy (FA) in several white matter tracts but lower motor scores at 2 years CA (mean (SD) 103 (12) vs. 109 (12)). Higher protein intake was associated with higher FA and lower motor scores at 2 years CA (B = -6.7,
p = 0.001). However, motor scores at 2 years CA were still within the normal range and differences were not sustained at 5.9 years. There were no significant associations with lipid or caloric intake.
CONCLUSION: In extremely preterm born infants, postnatal protein intake seems important for white matter development but does not necessarily improve long-term cognitive and motor development.
KW - Diffusion tensor imaging
KW - Extremely preterm infant
KW - Neurodevelopmental outcome
KW - Nutrition
KW - White matter
UR - http://www.scopus.com/inward/record.url?scp=85115747491&partnerID=8YFLogxK
U2 - 10.3390/nu13103409
DO - 10.3390/nu13103409
M3 - Article
C2 - 34684410
AN - SCOPUS:85115747491
SN - 2072-6643
VL - 13
JO - Nutrients
JF - Nutrients
IS - 10
M1 - 3409
ER -