Neurodevelopment in preemies unaffected by diet during early life

30 Dec 2019
Premature babies are prone to birth-related complications, with effects running well into their lives if they do not first suPremature babies are prone to birth-related complications, with effects running well into their lives if they do not first succumb to death.

High-protein intake during the first 28 days after birth appears to improve weight growth in very preterm infants, a recent study has found. No such effect is reported for brain outcomes.

Researchers conducted a prospective cohort study of 149 infants who were born <30 weeks of gestation. Dietary information, such as average daily intake of energy, protein, fat and carbohydrates, were collected from birth until 28 days of age. Outcomes included changes in weight, head circumference z-scores and total brain tissue volume.

The mean energy intake during the first 28 days of life was 114.2±10.3 kcal/kg/day, with 71.8 percent of the infants meeting the guideline requirements. Similarly, majority of the population met the recommended intake levels of fat (90.6 percent; mean, 5.4±0.3 g/kg/d) and carbohydrates (96.6 percent; mean, 13.9±0.3 g/kg/d).

On the other hand, only 3.4 percent of the participants were able to satisfy the guideline intake levels for protein, with a mean consumption level of 2.9±0.3 g/kg/d during the first 28 days after birth.

Protein intake appeared to be correlated with better growth. Each additional 1 g/kg/d of mean protein led to an average increase of 0.05 (95 percent confidence intervals, 0.05–0.10; p=0.04) in weight z-scores per week.

However, diet had no effect on brain outcomes. Intake levels of energy (p=0.86), protein (p=0.17), fat (p=0.76) and carbohydrates (p=0.37), for instance, did not lead to significant changes in total volume. Similar null effects were reported for cortical grey matter, white matter, deep nuclear grey matter and cerebellum coefficients.

J Pediatr 2019;215:50-55.e3