Energy-enhanced parenteral nutrition and neurodevelopment of preterm newborns: A cohort study.

Autor: Terrin G; Department of Maternal and Child Health, University of Rome La Sapienza, Rome, Italy. Electronic address: gianluca.terrin@uniroma1.it., Boscarino G; Department of Maternal and Child Health, University of Rome La Sapienza, Rome, Italy., Gasparini C; Department of Maternal and Child Health, University of Rome La Sapienza, Rome, Italy., Di Chiara M; Department of Maternal and Child Health, University of Rome La Sapienza, Rome, Italy., Faccioli F; Department of Maternal and Child Health, University of Rome La Sapienza, Rome, Italy., Onestà E; Department of Maternal and Child Health, University of Rome La Sapienza, Rome, Italy., Parisi P; Child Neurology, NESMOS Department, Faculty of Medicine & Psychology, University of Rome La Sapienza, Rome, Italy., Spalice A; Department of Maternal and Child Health, University of Rome La Sapienza, Rome, Italy., De Nardo MC; Department of Maternal and Child Health, University of Rome La Sapienza, Rome, Italy., Dito L; Department of Maternal and Child Health, University of Rome La Sapienza, Rome, Italy., Regoli D; Department of Maternal and Child Health, University of Rome La Sapienza, Rome, Italy., Di Mario C; Department of Maternal and Child Health, University of Rome La Sapienza, Rome, Italy., De Curtis M; Department of Maternal and Child Health, University of Rome La Sapienza, Rome, Italy.
Jazyk: angličtina
Zdroj: Nutrition (Burbank, Los Angeles County, Calif.) [Nutrition] 2021 Sep; Vol. 89, pp. 111219. Date of Electronic Publication: 2021 Feb 26.
DOI: 10.1016/j.nut.2021.111219
Abstrakt: Objectives: Preterm births are at higher risk for neurodevelopment (NDV) disabilities. To limit long-term consequences, guidelines recommend aggressive parenteral nutrition (PN) soon after birth. The aim of this study was to examine the effects of energy-enhanced PN in the first week of life on long-term NDV in preterm neonates.
Methods: We compared two cohorts of newborns (group A: energy-enhanced PN and group B: energy-standard PN) with different energy intake in the first 7 d of life (DoL) given by PN with the same protein amount, to study the influences of an energy-enhanced PN on NDV at 24 mo of life evaluated with the Bayley Scale of Infant Development-III edition.
Results: We analyzed 51 newborns (A: n = 24 versus B: n = 27). The two cohorts were similar in baseline characteristics (gestational age group A 29 wk, 95% confidence interval [CI], 28-30 wk versus group B 29 wk, 95% CI, 28-30 wk; birth weight A: 1214 g, 95% CI, 1062-1365 g versus B 1215 g, 95% CI, 1068-1363 g; boys A 62.5% versus B 55.6%). Infants in cohort B showed significantly (P < 0.05) better gross motor, total scaled, and total composite motor scores (A: 8 (1) versus B 9 (2); A 17 (4) versus B 19 (5); A 91 (12) versus B 97 (15); respectively). Cohort A showed a higher percentage of infants with delayed socioemotional competence (A 30.4% versus B 7.7%, P < 0.05). No differences were found in growth parameters at 24 mo of life. Linear regression analysis showed that socioemotional competence and motor score were negatively associated with energy intake of the first 7 DoL given by PN.
Conclusions: A more aggressive PN strategy results in lower motor score and socioemotional competence performance at 24 mo of life. More caution might be advocated for an energy-enhanced PN protocol, particularly in neonates with lower birth weight, for long-term NDV in preterm neonates.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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