scholarly journals Improving long-term health outcomes of preterm infants: how to implement the findings of nutritional intervention studies into daily clinical practice

2021 ◽  
Author(s):  
Charlotte A. Ruys ◽  
Monique van de Lagemaat ◽  
Joost Rotteveel ◽  
Martijn J. J. Finken ◽  
Harrie N. Lafeber
Keyword(s):  
Preterm Infants ◽  
Intervention Studies ◽  
High Energy ◽  
Growth Restriction ◽  
Cardiometabolic Diseases ◽  
Cardiometabolic Risks ◽  
Postconceptional Age ◽  
Extrauterine Growth Restriction ◽  
Neurodevelopmental Problems

AbstractPreterm-born children are at risk for later neurodevelopmental problems and cardiometabolic diseases; early-life growth restriction and suboptimal neonatal nutrition have been recognized as risk factors. Prevention of these long-term sequelae has been the focus of intervention studies. High supplies of protein and energy during the first weeks of life (i.e., energy > 100 kcal kg−1 day−1 and a protein-to-energy ratio > 3 g/100 kcal) were found to improve both early growth and later neurodevelopmental outcome. Discontinuation of this high-energy diet is advised beyond 32–34 weeks postconceptional age to prevent excess fat mass and possible later cardiometabolic diseases. After discharge, nutrition with a higher protein-to-energy ratio (i.e., > 2.5–3.0 g/100 kcal) may improve growth and body composition in the short term.Conclusion: Preterm infants in their first weeks of life require a high-protein high-energy diet, starting shortly after birth. Subsequent adjustments in nutritional composition, aimed at achieving optimal body composition and minimizing the long-term cardiometabolic risks without jeopardizing the developing brain, should be guided by the growth pattern. The long-term impact of this strategy needs to be studied. What is Known:• Preterm infants are at risk for nutritional deficiencies and extrauterine growth restriction.• Extrauterine growth restriction and suboptimal nutrition are risk factors for neurodevelopmental problems and cardiometabolic disease in later life. What is New:• Postnatally, a shorter duration of high-energy nutrition may prevent excess fat mass accretion and its associated cardiometabolic risks and an early switch to a protein-enriched diet should be considered from 32-34 weeks postconceptional age.• In case of formula feeding, re-evaluate the need for the continuation of a protein-enriched diet, based on the infant’s growth pattern.

“Extrauterine growth restriction” and “postnatal growth failure” are misnomers for preterm infants

2020 ◽  
Vol 40 (5) ◽  
pp. 704-714 ◽  
Author(s):  
Tanis R. Fenton ◽  
Barbara Cormack ◽  
Dena Goldberg ◽  
Roseann Nasser ◽  
Belal Alshaikh ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Growth Failure ◽  
Postnatal Growth ◽  
Growth Restriction ◽  
Extrauterine Growth Restriction ◽  
Postnatal Growth Failure

scholarly journals Nitrogen balance of very preterm infants with extrauterine growth restriction

2019 ◽  
Vol 61 (3) ◽  
pp. 352
Author(s):  
Rong Wu ◽  
Li-hua Li ◽  
Zhao-fang Tian ◽  
Wen-ying Xu ◽  
Jin-hui Hu ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Nitrogen Balance ◽  
Growth Restriction ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Extrauterine Growth Restriction

scholarly journals Plasma Metabolome Alterations Associated with Extrauterine Growth Restriction

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 1188
Author(s):  
Danuta Dudzik ◽  
Isabel Iglesias Platas ◽  
Montserrat Izquierdo Renau ◽  
Carla Balcells Esponera ◽  
Beatriz del Rey Hurtado de Mendoza ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Growth Failure ◽  
Growth Restriction ◽  
Plasma Metabolites ◽  
Very Preterm Infants ◽  
Adverse Health Outcomes ◽  
Plasma Metabolome ◽  
Definition Of ◽  
Extrauterine Growth Restriction ◽  
Gestational Age At Birth

Very preterm infants (VPI, born at or before 32 weeks of gestation) are at risk of adverse health outcomes, from which they might be partially protected with appropriate postnatal nutrition and growth. Metabolic processes or biochemical markers associated to extrauterine growth restriction (EUGR) have not been identified. We applied untargeted metabolomics to plasma samples of VPI with adequate weight for gestational age at birth and with different growth trajectories (29 well-grown, 22 EUGR) at the time of hospital discharge. A multivariate analysis showed significantly higher levels of amino-acids in well-grown patients. Other metabolites were also identified as statistically significant in the comparison between groups. Relevant differences (with corrections for multiple comparison) were found in levels of glycerophospholipids, sphingolipids and other lipids. Levels of many of the biochemical species decreased progressively as the level of growth restriction increased in severity. In conclusion, an untargeted metabolomic approach uncovered previously unknown differences in the levels of a range of plasma metabolites between well grown and EUGR infants at the time of discharge. Our findings open speculation about pathways involved in growth failure in preterm infants and the long-term relevance of this metabolic differences, as well as helping in the definition of potential biomarkers.

scholarly journals ExtraUterine Growth Restriction (EUGR) in Preterm Infants: Growth Patterns, Nutrition, and Epigenetic Markers. A Pilot Study

2018 ◽  
Vol 6 ◽  
Author(s):  
Maria Giulia Tozzi ◽  
Francesca Moscuzza ◽  
Angela Michelucci ◽  
Francesca Lorenzoni ◽  
Cinzia Cosini ◽  
...  
Keyword(s):  
Pilot Study ◽  
Preterm Infants ◽  
Growth Patterns ◽  
Growth Restriction ◽  
Epigenetic Markers ◽  
Extrauterine Growth Restriction

scholarly journals Incidence and associated factors of extrauterine growth restriction (EUGR) in preterm infants, a cross-sectional study in selected NICUs in Ethiopia

2020 ◽  
Vol 4 (1) ◽  
pp. e000765
Author(s):  
Netsanet Workneh Gidi ◽  
Robert L Goldenberg ◽  
Assaye K Nigussie ◽  
Elizabeth McClure ◽  
Amha Mekasha ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Low Income ◽  
Associated Factors ◽  
Cross Sectional Study ◽  
Growth Restriction ◽  
Sectional Study ◽  
Cross Sectional ◽  
Increased Risk ◽  
Extrauterine Growth Restriction

BackgroundPreterm infants have high risk of developing growth restriction and long-term complications. Enteral feeding is often delayed in neonatal intensive care units (NICUs) for the fear of feeding intolerance and the associated necrotising enterocolitis, and recent advances in nutritional support are unavailable in low-income countries.ObjectiveThe aim of this study was to assess the incidence and associated factors of extrauterine growth restriction (EUGR) among preterm infants in selected NICUs in Ethiopia.MethodThis was a cross-sectional study involving a subgroup analysis of preterm infants admitted to hospitals, from a multicentre descriptive study of cause of illness and death in preterm infants in Ethiopia, conducted from 2016 to 2018. EUGR was defined as weight at discharge Z-scores <−1.29 for corrected age. Clinical profiles of the infants were analysed for associated factors. SPSS V.23 software was used for analysis with a significance level of 5% and 95% CI.ResultFrom 436 preterm infants included in the analysis, 223 (51%) were male, 224 (51.4%) very low birth weight (VLBW) and 185 (42.4%) small for gestational age (SGA). The mean (SD) of weight for corrected age Z-score at the time of discharge was −2.5 (1.1). The incidence of EUGR was 86.2%. Infants who were SGA, VLBW and longer hospital stay over 21 days had increased risk of growth restriction (p-value<0.01). SGA infants had a 15-fold higher risk of developing EUGR at the time of discharge from hospital than those who were appropriate or large for gestational age (OR (95% CI)=15.2 (4.6 to 50.1).ConclusionThe majority of the infants had EUGR at the time of discharge from the hospital, which indicates suboptimal nutrition. Revision of national guidelines for preterm infants feeding and improvement in clinical practice is highly required.

Preterm Infants Have Altered Adiponectin Levels at Term-Equivalent Age Even if They Do Not Present with Extrauterine Growth Restriction

2013 ◽  
Vol 80 (3) ◽  
pp. 147-153 ◽  
Author(s):  
Yuya Nakano ◽  
Kazuo Itabashi ◽  
Motoichiro Sakurai ◽  
Madoka Aizawa ◽  
Kazushige Dobashi ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Growth Restriction ◽  
Equivalent Age ◽  
Extrauterine Growth Restriction

Comorbidities in childhood associated with extrauterine growth restriction in preterm infants: a scoping review

2020 ◽  
Vol 179 (8) ◽  
pp. 1255-1265 ◽  
Author(s):  
MD Martínez-Jiménez ◽  
FJ Gómez-García ◽  
M Gil-Campos ◽  
JL Pérez-Navero
Keyword(s):  
Preterm Infants ◽  
Scoping Review ◽  
Growth Restriction ◽  
Extrauterine Growth Restriction

Association between extrauterine growth restriction and changes of intestinal flora in Chinese preterm infants

2019 ◽  
Vol 10 (5) ◽  
pp. 513-521
Author(s):  
J. Zhang ◽  
Y. Dai ◽  
S. Fan ◽  
K. Zhang ◽  
C. Shuai ◽  
...  
Keyword(s):  
Preterm Infants ◽  
High Throughput Sequencing ◽  
Intestinal Flora ◽  
Intestinal Bacteria ◽  
Growth Restriction ◽  
Control Group ◽  
False Discovery ◽  
Multivariate Logistic Model ◽  
Extrauterine Growth Restriction ◽  
Total Abundance Of Bacteria

AbstractThe aim of the study was to investigate any association between extrauterine growth restriction (EUGR) and intestinal flora of <30-week-old preterm infants. A total of 59 preterm infants were assigned to EUGR (n=23) and non-EUGR (n=36) groups. Intestinal bacteria were compared by using high-throughput sequencing of bacterial rRNA. The total abundance of bacteria in 344 genera (7568 v. 13,760; P<0.0001) and 456 species (10,032 v. 18,240; P<0.0001) was significantly decreased in the EUGR group compared with the non-EUGR group. After application of a multivariate logistic model and adjusting for potential confounding factors, as well as false-discovery rate corrections, we found four bacterial genera with higher and one bacterial genus with lower abundance in the EUGR group compared with the control group. In addition, the EUGR group showed significantly increased abundances of six species (Streptococcus parasanguinis, Bacterium RB5FF6, two Klebsiella species and Microbacterium), but decreased frequencies of three species (one Acinetobacter species, Endosymbiont_of_Sphenophorus_lev and one Enterobacter_species) compared with the non-EUGR group. Taken together, there were significant changes in the intestinal microflora of preterm infants with EUGR compared to preterm infants without EUGR.

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