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.
N1 - Funding Information: Funding: L.M.H. received funding from the Athena grant, ‘Utrecht Center for Food and Health– research program specialized nutrition’, subsidy from the Dutch Ministry of Economic Affairs, Utrecht Province and the municipality of Utrecht. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/10/1
Y1 - 2021/10/1
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 - https://doi.org/10.3390/nu13103409
DO - https://doi.org/10.3390/nu13103409
M3 - Article
C2 - 34684410
SN - 2072-6643
VL - 13
JO - NUTRIENTS
JF - NUTRIENTS
IS - 10
M1 - 3409
ER -