The Nutritional Dilemma for Preterm Infants: How to Promote Neurocognitive Development and Linear Growth, but Reduce the Risk of Obesity

AbstractAdiponectin and leptin are involved in appetite control and body weight regulation. We aimed to evaluate the relationship between breast milk adipokine levels and short-term growth of preterm and term infants. Thirty-one preterm (median=35.3 weeks) and 34 term (median=38.7 weeks) infants were enrolled. Enzyme-linked immunosorbent assay was used to detect adipokines in mature milk. Infant growth was followed during the first 3 months. Although weight gain in the first month was insufficient, positive linear growth was observed in the following months for preterm infants, while term infants had positive steady linear growth. The median level of adipokines was found to be higher in preterm infants (P>0.05). Adiponectin showed significant negative correlations with some anthropometric measurements of term infants. However, in preterm infants, adiponectin was negatively correlated with length increment and positively correlated with body mass index (BMI) increment in the second–third month. In addition, leptin was negatively associated with the head circumference at birth in preterm infants and the triceps skinfold thickness increment in the first–second month term infants (P<0.05). In linear regression models, while gestational age, adiponectin and leptin were not related, maternal age and pre-pregnancy BMI had effects on body weight increment in 0–1 months (P<0.05). In conclusion, adiponectin may affect short-term growth, while leptin has no important effect. It would be beneficial to carry out longitudinal studies to evaluate the effects of these adipokines on the growth of infants.

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Can Children Catch up from the Consequences of Undernourishment? Evidence from Child Linear Growth, Developmental Epigenetics, and Brain and Neurocognitive Development

Advances in Nutrition ◽

10.1093/advances/nmaa020 ◽

2020 ◽

Vol 11 (4) ◽

pp. 1032-1041 ◽

Cited By ~ 1

Author(s):

Jef L Leroy ◽

Edward A Frongillo ◽

Pragya Dewan ◽

Maureen M Black ◽

Robert A Waterland

Keyword(s):

Linear Growth ◽

Maternal Nutrition ◽

Normal Velocity ◽

Neurocognitive Development ◽

Child Undernutrition ◽

Irreversible Effects ◽

Absolute Height ◽

Catch Up ◽

Developmental Epigenetics

ABSTRACT Recovery from nutritionally induced height deficits continues to garner attention. The current literature on catch-up growth, however, has 2 important limitations: wide-ranging definitions of catch-up growth are used, and it remains unclear whether children can recover from the broader consequences of undernutrition. We addressed these shortcomings by reviewing the literature on the criteria for catch-up in linear growth and on the potential to recover from undernutrition early in life in 3 domains: linear growth, developmental epigenetics, and child brain and neurocognitive development. Four criteria must be met to demonstrate catch-up growth in height: after a period in which a growth-inhibiting condition (criterion 1) causes a reduction in linear growth velocity (criterion 2), alleviation of the inhibiting condition (criterion 3) leads to higher-than-normal velocity (criterion 4). Accordingly, studies that are observational, do not use absolute height, or have no alleviation of an inhibiting condition cannot be used to establish catch-up growth. Adoption and foster care, which provide dramatic improvements in children's living conditions not typically attained in nutrition interventions, led to some (but incomplete) recovery in linear growth and brain and neurocognitive development. Maternal nutrition around the time of conception was shown to have long-term (potentially permanent) effects on DNA methylation in the offspring. Undernourishment early in life may thus have profound irreversible effects. Scientific, program, and policy efforts should focus on preventing maternal and child undernutrition rather than on correcting its consequences or attempting to prove they can be corrected.

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The neorule: a new instrument to measure linear growth in preterm infants

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/adc.2002.019448 ◽

2004 ◽

Vol 89 (4) ◽

pp. F360-F363 ◽

Cited By ~ 7

Author(s):

C J Lawn

Keyword(s):

Preterm Infants ◽

Linear Growth ◽

New Instrument

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Short-Term Measurement of Linear Growth in Preterm Infants: Validation of a Hand-Held Knemometer

Pediatric Research ◽

10.1203/00006450-199111000-00013 ◽

1991 ◽

Vol 30 (5) ◽

pp. 464-468 ◽

Cited By ~ 51

Author(s):

Kim Fleischer Michaelsen ◽

Liselotte Skov ◽

Jens Henrik Badsberg ◽

Merete Jørgensen

Keyword(s):

Preterm Infants ◽

Linear Growth ◽

Short Term

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The Relationship of Poor Linear Growth Velocity with Neonatal Illness and Two-Year Neurodevelopment in Preterm Infants

Neonatology ◽

10.1159/000336127 ◽

2012 ◽

Vol 102 (1) ◽

pp. 19-24 ◽

Cited By ~ 102

Author(s):

Sara E. Ramel ◽

Ellen W. Demerath ◽

Heather L. Gray ◽

Noelle Younge ◽

Christopher Boys ◽

...

Keyword(s):

Preterm Infants ◽

Growth Velocity ◽

Linear Growth ◽

Relationship Of ◽

The Relationship

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Growth and biochemical markers of preterm newborns up to six months of corrected age

Journal of Human Growth and Development ◽

10.7322/jhgd.138687 ◽

2018 ◽

Vol 28 (1) ◽

pp. 18 ◽

Cited By ~ 1

Author(s):

Grasiely Masotti Scalabrin Barreto ◽

Sandra Lucinei Balbo ◽

Milene Sedrez Rover ◽

Beatriz Rosana Gonçalves de Oliveira Toso ◽

Hugo Razini de Oliveira ◽

...

Keyword(s):

Preterm Infants ◽

Premature Infants ◽

Biochemical Markers ◽

Linear Growth ◽

Plasma Concentrations ◽

Initial Sample ◽

Chi Square ◽

Delayed Growth ◽

Preterm Newborns

Introduction: Due to advances in recent decades in maternal-foetal and neonatal medicine, a greater survival of preterm infants with progressively smaller birth weight and gestational age is observed, increasing the risk of future morbidities on those infants. Among these morbidities, alterations in growth and metabolism are found. Objective: To analyze the evolution of the growth and the metabolic profile of preterm infants’ cohort from birth at six months of corrected age (CA).Methods: A descriptive and prospective study with a sample of 107 mothers and 115 preterm infants at birth and 72 preterm infants and 68 mothers at the end of follow-up. Growth (body weight, height, cephalic perimeter) was evaluated at six time points. Plasma concentrations of cholesterol, triglycerides, glucose and insulin of premature infants were assessed during three periods, from birth to 6 months of CA. Comparative analysis of the initial sample and the sample that finished the follow-up was used in chi-square family tests. To Evaluate the growth over the 6-month period by using repeated measurements.Results: Sociodemographic variables and maternal biochemical profile without statistical differences in the comparison of the mothers of the initial sample with those who completed the follow-up. Linear growth of preterm infants at six months of CA, however without recovery of growth. Plasma concentrations of triglycerides (birth = 48.1, 6 months = 151.1) and cholesterol (birth = 82.7, 6 months = 139.9) increased during the evaluations. Glycaemia remained stable (birth 80.4, 6 months = 83.3) and insulin decreased from 11.0 to 4.2.Conclusion: Growth of preterm infants, although linear, was lower than expected for age. Lipid profiles presented an ascending curve from birth onward. Therefore, this group is prone to delayed growth and to developing cardiovascular changes throughout life.

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