Victoria A Power1, Alicia J Spittle2, Katherine J Lee3, Peter J Anderson4, Deanne K Thompson5, Lex W Doyle6, Jeanie L Y Cheong7. 1. Department of Medicine, University of Melbourne, Melbourne, Australia. 2. Department of Physiotherapy, University of Melbourne, Melbourne Australia; Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne Australia. 3. Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne Australia; Department of Pediatrics, University of Melbourne, Melbourne Australia. 4. Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne Australia; Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne Australia. 5. Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne Australia; Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne Australia; Developmental Imaging, Murdoch Children's Research Institute, Melbourne Australia; Florey Institute of Neurosciences and Mental Health, Melbourne, Australia. 6. Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne Australia; Department of Pediatrics, University of Melbourne, Melbourne Australia; Department of Obstetrics and Gynecology, University of Melbourne, Melbourne, Australia; Neonatal Services, Royal Women's Hospital, Parkville, Australia. 7. Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne Australia; Department of Obstetrics and Gynecology, University of Melbourne, Melbourne, Australia; Neonatal Services, Royal Women's Hospital, Parkville, Australia. Electronic address: Jeanie.cheong@thewomens.org.au.
Abstract
OBJECTIVE: To explore the associations between nutrition in the first 28 days after birth with somatic growth from birth to term-equivalent age, brain volumes at term-equivalent age, and neurodevelopment at 24 months of corrected age. STUDY DESIGN: Prospective cohort study of 149 infants born from 2011 to 2014 at <30 weeks of gestation in a tertiary neonatal nursery in Australia. The following data were collected: average daily energy, protein, fat, and carbohydrate intakes from birth until 28 days, and the difference in weight and head circumference z scores between birth and term-equivalent. Total brain tissue volumes were calculated from brain magnetic resonance imaging at term-equivalent age. Children were assessed at 2 years of corrected age with the Bayley Scales of Infant and Toddler Development-Third Edition. Relationships of nutritional variables with growth, brain volumes, and cognitive, language, and motor development were explored using linear regression. RESULTS: Complete nutritional data were available for 116 (78%) of the cohort. A 1 g/kg/day higher mean protein intake was associated with a mean increase in weight z score per week of 0.05 (95% CI 0.05, 0.10; P = .04). There was a lack of evidence for associations of any nutritional variables with head circumference growth, with brain volumes at term-equivalent age, or with 2-year neurodevelopment. CONCLUSIONS: Only higher protein intakes in the first 28 days after birth were associated with better weight growth between birth and term-equivalent age in very preterm infants. Nutrition in the first 28 days was otherwise not substantially related to brain size or to neurodevelopmental outcomes.
OBJECTIVE: To explore the associations between nutrition in the first 28 days after birth with somatic growth from birth to term-equivalent age, brain volumes at term-equivalent age, and neurodevelopment at 24 months of corrected age. STUDY DESIGN: Prospective cohort study of 149 infants born from 2011 to 2014 at <30 weeks of gestation in a tertiary neonatal nursery in Australia. The following data were collected: average daily energy, protein, fat, and carbohydrate intakes from birth until 28 days, and the difference in weight and head circumference z scores between birth and term-equivalent. Total brain tissue volumes were calculated from brain magnetic resonance imaging at term-equivalent age. Children were assessed at 2 years of corrected age with the Bayley Scales of Infant and Toddler Development-Third Edition. Relationships of nutritional variables with growth, brain volumes, and cognitive, language, and motor development were explored using linear regression. RESULTS: Complete nutritional data were available for 116 (78%) of the cohort. A 1 g/kg/day higher mean protein intake was associated with a mean increase in weight z score per week of 0.05 (95% CI 0.05, 0.10; P = .04). There was a lack of evidence for associations of any nutritional variables with head circumference growth, with brain volumes at term-equivalent age, or with 2-year neurodevelopment. CONCLUSIONS: Only higher protein intakes in the first 28 days after birth were associated with better weight growth between birth and term-equivalent age in very preterm infants. Nutrition in the first 28 days was otherwise not substantially related to brain size or to neurodevelopmental outcomes.
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