scholarly journals Nutrient Restriction has Limited Short-Term Effects on Gut, Immunity, and Brain Development in Preterm Pigs

2020 ◽  
Vol 150 (5) ◽  
pp. 1196-1207 ◽  
Author(s):  
Agnethe May Ahnfeldt ◽  
Ole Bæk ◽  
Yan Hui ◽  
Charlotte Holme Nielsen ◽  
Karina Obelitz-Ryom ◽  
...  
Keyword(s):  
Brain Development ◽  
Preterm Infants ◽  
Bovine Milk ◽  
Nutrition Support ◽  
Physiological Adaptation ◽  
Preterm Neonates ◽  
Negative Consequences ◽  
Large White ◽  
Brain Functions ◽  
Gut Immunity

ABSTRACT Background Extrauterine growth restriction (EUGR) in preterm infants is associated with higher morbidity and impaired neurodevelopment. Early nutrition support may prevent EUGR in preterm infants, but it is not known if this improves organ development and brain function in the short and long term. Objective Using pigs as models for infants, we hypothesized that diet-induced EUGR impairs gut, immunity, and brain development in preterm neonates during the first weeks after birth. Methods Forty-four preterm caesarean-delivered pigs (Danish Landrace × Large White × Duroc, birth weight 975 ± 235 g, male:female ratio 23:21) from 2 sows were fed increasing volumes [32–180 mL/(kg·d)] of dilute bovine milk (EUGR group) or the same diet fortified with powdered bovine colostrum for 19 d (CONT group, 50–100% higher protein and energy intake than the EUGR group). Results The EUGR pigs showed reduced body growth (−39%, P < 0.01), lower plasma albumin, phosphate, and creatine kinase concentrations (−35 to 14%, P < 0.05), increased cortisol and free iron concentrations (+130 to 700%, P < 0.05), and reduced relative weights of the intestine, liver, and spleen (−38 to 19%, all P < 0.05). The effects of EUGR on gut structure, function, microbiota, and systemic immunity were marginal, although EUGR temporarily increased type 1 helper T cell (Th1) activity (e.g. more blood T cells and higher Th1-related cytokine concentrations on day 8) and reduced colon nutrient fermentation (lower SCFA concentration; −45%, P < 0.01). Further, EUGR pigs showed increased relative brain weights (+19%, P < 0.01), however, memory and learning, as tested in a spatial T-maze, were not affected. Conclusion Most of the measured organ growth, and digestive, immune, and brain functions showed limited effects of diet-induced EUGR in preterm pigs during the first weeks after birth. Likewise, preterm infants may show remarkable physiological adaptation to deficient nutrient supply during the first weeks of life although early life malnutrition may exert negative consequences later.

scholarly journals Milk Osteopontin for Gut, Immunity and Brain Development in Preterm Pigs

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2675
Author(s):  
Karoline Aasmul-Olsen ◽  
Nicole Lind Henriksen ◽  
Duc Ninh Nguyen ◽  
Anne Birgitte Heckmann ◽  
Thomas Thymann ◽  
...  
Keyword(s):  
Brain Development ◽  
Cognitive Performance ◽  
Infant Formula ◽  
Motor Development ◽  
Bovine Milk ◽  
Developmental Differences ◽  
Systemic Immunity ◽  
Immune Parameters ◽  
Gut Immunity ◽  
Relevant Dose

Deficient levels of milk osteopontin (OPN) in infant formula may partly account for developmental differences between infants fed formula or maternal milk. We hypothesized that a milk diet supplemented with bovine milk OPN improves gut, immunity and brain development and tested this in a preterm pig model. Preterm pigs delivered by cesarean section (90% gestation) were fed raw bovine milk (CON, n = 19) or the same diet supplemented with a physiologically relevant dose of OPN (46 mg/(kg·d), n = 16). Endpoints related to clinical outcomes, systemic immunity and neurocognitive development were assessed during the study and gut tissues were collected at Day 19. Growth pattern, early motor development and most systemic immune parameters were similar between OPN and CON pigs. The OPN pigs had higher villus-to-crypt ratios than CON pigs and higher monocyte and lymphocyte counts on Day 8. Gut digestive and absorptive functions and cognitive performance (T-maze test) were similar between OPN and CON pigs. In conclusion, dietary supplementation with OPN above basal bovine milk levels induced minor improvements in gut structure and systemic immunity without any effects on cognitive performance. The minimal levels of OPN in infant formula to secure optimal adaptation in the immediate neonatal period remain to be determined.

A systematic review on brain injury and altered brain development in moderate-late preterm infants

2020 ◽  
Vol 148 ◽  
pp. 105094
Author(s):  
Vivian Boswinkel ◽  
Jacqueline Nijboer-Oosterveld ◽  
Ingrid M. Nijholt ◽  
Mireille A. Edens ◽  
Susanne M. Mulder - de Tollenaer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Brain Injury ◽  
Brain Development ◽  
Preterm Infants ◽  
Late Preterm ◽  
Late Preterm Infants

scholarly journals Bovine Milk Oligosaccharides with Sialyllactose for Preterm Piglets

Nutrients ◽  
2018 ◽  
Vol 10 (10) ◽  
pp. 1489 ◽  
Author(s):  
Karina Obelitz-Ryom ◽  
Amalie Rendboe ◽  
Duc Nguyen ◽  
Silvia Rudloff ◽  
Anne Brandt ◽  
...  
Keyword(s):  
Bacterial Colonization ◽  
Bovine Milk ◽  
Protective Effects ◽  
Gut Development ◽  
Artificial Rearing ◽  
Milk Oligosaccharides ◽  
Term Infants ◽  
Brain Functions ◽  
Near Term ◽  
Dietary Treatments

Oligosaccharides support gut development and bacterial colonization in term infants, but it is unknown if they benefit preterm infants. Using preterm pigs, we investigated effects of bovine milk supplements enriched with oligosaccharides to improve gut development and colonization. Caesarean-delivered preterm pigs (n = 57) were reared for 19 days. The pigs were fed bovine milk supplemented with an oligosaccharide-enriched whey containing sialyllactose, or a heterogeneous oligosaccharide ingredient. To evaluate the influence of artificial rearing, near-term, vaginally born pigs raised by their sow (n = 12) were compared with artificially reared, caesarean-delivered near-term pigs (n = 14). In preterm pigs, the clinical outcome, gut function, gut microbiota, and systemic immunity were similar among dietary treatments. Natural rearing increased growth rates, gut functions, colon short chain fatty acid concentrations and bacterial diversity, relative to artificial rearing. In conclusion, supplements with bovine milk oligosaccharides were well tolerated, but did not improve gut maturation or clinical outcomes in artificially reared preterm piglets. Immaturity at birth, coupled with artificial rearing, may render the neonate unresponsive to the gut-protective effects of milk oligosaccharides. Whether bovine milk oligosaccharides may affect other endpoints (e.g., brain functions) in conditions of immaturity remains to be investigated.

scholarly journals Thyroid dysfunction in preterm neonates exposed to iodine

2017 ◽  
Vol 45 (1) ◽  
Author(s):  
Fiona L.R. Williams ◽  
Jennifer Watson ◽  
Chris Day ◽  
Aung Soe ◽  
Sateesh K. Somisetty ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Contrast Media ◽  
Preterm Infants ◽  
Breast Feeding ◽  
Thyroid Dysfunction ◽  
Exposed Group ◽  
Preterm Neonates ◽  
Iodinated Contrast Media ◽  
Iodinated Contrast ◽  
Blood Spot

AbstractBackground:Infants <32 weeks’ gestation should not be exposed to topical iodine and its avoidance is recommended during pregnancy and breast feeding. Exposure to contrast media and topical iodine is frequently used in many preterm neonates.Aim:To determine whether thyrotropin levels in preterm infants are affected by exposure to intrapartum/neonatal topical iodine and/or the use of iodinated contrast media.Design:Infants <32 weeks’ gestation were recruited. Maternal and neonatal exposures to iodinated contrast media and topical iodine were recorded; levels of thyrotropin and thyroxine were measured from blood-spot cards on postnatal days 7, 14, 28 and the equivalent of 36 weeks’ gestation.Results:One hundred and twenty-five infants were exposed to topical iodine/contrast media and 48 infants were unexposed. No infants were treated for hypothyroidism; three infants (exposed group) had transient hyperthyrotropinaemia. Mean thyrotropin levels were significantly higher on postnatal days 7, 14 and 28 in infants exposed to topical iodine prior to caesarean section compared to unexposed infants, a relationship which persisted after adjustment.Conclusions:In the context of this study, neonatal thyroid dysfunction was seen following exposure to iodine via caesarean section but not via exposure to contrast media.

scholarly journals IV Paracetamol for closure of patent ductus arteriosus in preterm neonates admitted to a tertiary care centre

2018 ◽  
Vol 5 (2) ◽  
pp. 294 ◽  
Author(s):  
Sunil B. ◽  
Shruthi Patel ◽  
Girish N.
Keyword(s):  
Side Effects ◽  
Preterm Infants ◽  
Ductus Arteriosus ◽  
Treatment Options ◽  
Tertiary Care ◽  
Current Treatment ◽  
Preterm Neonates ◽  
Tertiary Care Centre ◽  
Vascular Connection ◽  
Intravenous Paracetamol

Background: Ductus arteriosus is a vascular connection between the pulmonary artery and descending aorta. The incidence is inversely related to birth weight and gestational age (GA). In preterm infants it varies between 40% and 60% on the third day of life. At present, the choice of treatment of clinically significant PDA is with either ibuprofen or indomethacin, but they carry many contraindications and potential side effects. Hence it is important to consider that paracetamol may be used as an alternative to other non steroidal anti-inflammatory drugs and is effective in ductal closure with minimal side effects.Methods:Thirty six preterm infants with hemodynamically significant PDA(hs-PDA) were treated with intravenous paracetamol and subsequent closure was evaluated clinically and by follow-up 2D-Echo.Results: PDA closure following intravenous paracetamol was evident in 27 babies (75%). There were no significant side effects noted with paracetamol therapy.Conclusions: This study shows that paracetamol could offer favourable safety profile in comparison to current treatment options. Therefore, paracetamol may be accepted as a first-line drug treatment for PDA in preterm infants. 

scholarly journals Preterm infants comfort before and after capillary blood sampling procedure

2021 ◽  
Vol 31 (Supplement_2) ◽  
Author(s):  
Karolina Balciunaite ◽  
Alina Vaskelyte
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Inverse Relationship ◽  
Sampling Procedure ◽  
Capillary Blood ◽  
Blood Sampling ◽  
University Hospital ◽  
Negative Consequences ◽  
Before And After ◽  
Capillary Blood Sampling

Abstract Background Because of the immaturity and severe condition preterm infants undergoes a lot of painful and stressful procedures during their care that can cause short-term and long-term negative consequences. Maintenance of optimal comfort is essential for good clinical practice. To assess the comfort of preterm infants before and after the capillary blood sampling procedure. Methods The quantitative observational study was conducted in May 2019—February 2020 in the University hospital NICU. The research instrument was a neonatal comfort scale COMFORTneo, which total scores ranged 6–30. Higher scores indicated higher discomfort. Preterm infant comfort was assessed before the capillary blood sampling procedure and 30 min. after applying non-pharmacological pain relief and comfort assurance methods and implementing the procedure. The research was conducted in accordance with ethical principles. Results Comfort was assessed in 157 preterm newborns with a gestational age of 30 ± 3.3 weeks and a postnatal age of 6.0 ± 5.7 days. The mean value of neonatal comfort before the capillary blood sampling procedure was 10.0 ± 3.2 points, after the procedure 9.1 ± 2.4 points. A statistically significant inverse relationship was found between pre-procedure and post-procedure comfort (Z = -5.374; P &lt; 0.001). A statistically significant weak inverse relationship was found between gestational age and comfort scores before the procedure (r = -0.204; P = 0.01) and after the procedure (r = -0.321; P = 0.008). Conclusions In most cases, preterm infants were feeling moderate discomfort before and after the capillary blood sampling procedure. Newborns had more discomfort before the procedure than 30 min. after the completion of the procedure. Lower gestational age newborns were feeling greater discomfort.

scholarly journals cfDNA and DNases: New Biomarkers of Sepsis in Preterm Neonates—A Pilot Study

Cells ◽  
2022 ◽  
Vol 11 (2) ◽  
pp. 192
Author(s):  
Moritz Lenz ◽  
Thomas Maiberger ◽  
Lina Armbrust ◽  
Antonia Kiwit ◽  
Axel Von der Wense ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Late Onset ◽  
Dnase I ◽  
Sepsis Group ◽  
Preterm Neonates ◽  
Control Group ◽  
Suspected Sepsis ◽  
Epidemiological Characteristics

Introduction: An early and accurate diagnosis of early onset neonatal sepsis (EONS) and late onset neonatal sepsis (LONS) is essential to improve the outcome of this devastating conditions. Especially, preterm infants are at risk. Reliable biomarkers are rare, clinical decision-making depends on clinical appearance and multiple laboratory findings. Markers of NET formation and NET turnover might improve diagnostic precision. Aim of this study was to evaluate the diagnostic value of NETs in sepsis diagnosis in neonatal preterm infants. Methods: Plasma samples of neonatal preterm infants with suspected sepsis were collected. Blood samples were assayed for markers of NET formation and NET turnover: cfDNA, DNase1, nucleosome, NE, and H3Cit. All clinical findings, values of laboratory markers, and epidemiological characteristics were collected retrospectively. Two subpopulations were created to divide EONS from LONS. EMA sepsis criteria for neonatal sepsis were used to generate a sepsis group (EMA positive) and a control group (EMA negative). Results: A total of 31 preterm neonates with suspected sepsis were included. Out of these, nine patients met the criteria for sepsis according to EMA. Regarding early onset neonatal sepsis (3 EONS vs. 10 controls), cfDNA, DNase I, nucleosome, and CRP were elevated significantly. H3Cit and NE did not show any significant elevations. In the late onset sepsis collective (6 LONS vs. 12 controls), cfDNA, DNase I, and CRP differed significantly compared to control group.

scholarly journals Evaluation of the Short-Term Music Therapy on Brain Functions of Preterm Infants Using Functional Near-Infrared Spectroscopy

2021 ◽  
Vol 12 ◽  
Author(s):  
Haoran Ren ◽  
Liangyan Zou ◽  
Laishuan Wang ◽  
Chunmei Lu ◽  
Yafei Yuan ◽  
...  
Keyword(s):  
Infrared Spectroscopy ◽  
Functional Connectivity ◽  
Music Therapy ◽  
Preterm Infants ◽  
Near Infrared ◽  
Music Intervention ◽  
Short Term ◽  
Functional Near Infrared Spectroscopy ◽  
Brain Functions ◽  
The Brain

Music contains substantial contents that humans can perceive and thus has the capability to evoke positive emotions. Even though neonatal intensive care units (NICUs) can provide preterm infants a developmental environment, they still cannot fully simulate the environment in the womb. The reduced maternal care would increase stress levels in premature infants. Fortunately, music intervention has been proved that it can improve the NICU environment, such as stabilize the heart rate and the respiratory rate, reduce the incidence of apnea, and improve feeding. However, the effects of music therapy on the brain development of preterm infants need to be further investigated. In this paper, we evaluated the influence of short-term music therapy on the brain functions of preterm infants measured by functional near-infrared spectroscopy (fNIRS). We began by investigating how premature babies perceive structural information of music by calculating the correlations between music features and fNIRS signals. Then, the influences of short-term music therapy on brain functions were evaluated by comparing the resting-state functional connectivity before and after the short-term music therapy. The results show that distinct brain regions are responsible for processing corresponding musical features, indicating that preterm infants have the capability to process the complex musical content. However, the results of network analysis show that short-term music intervention is insufficient to cause the changes in cerebral functional connectivity. Therefore, long-term music therapy may be required to achieve the deserved effects on brain functional connectivity.

scholarly journals Germinal Matrix-Intraventricular Hemorrhage: A Tale of Preterm Infants

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Walufu Ivan Egesa ◽  
Simon Odoch ◽  
Richard Justin Odong ◽  
Gloria Nakalema ◽  
Daniel Asiimwe ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Intraventricular Hemorrhage ◽  
Very Low Birth Weight ◽  
Preterm Neonates ◽  
Low Birth Weight Infants ◽  
Neurodevelopmental Outcomes ◽  
Germinal Matrix ◽  
Posthemorrhagic Hydrocephalus ◽  
Management Interventions ◽  
Incidence Risk

Germinal matrix-intraventricular hemorrhage (GM-IVH) is a common intracranial complication in preterm infants, especially those born before 32 weeks of gestation and very-low-birth-weight infants. Hemorrhage originates in the fragile capillary network of the subependymal germinal matrix of the developing brain and may disrupt the ependymal lining and progress into the lateral cerebral ventricle. GM-IVH is associated with increased mortality and abnormal neurodevelopmental outcomes such as posthemorrhagic hydrocephalus, cerebral palsy, epilepsy, severe cognitive impairment, and visual and hearing impairment. Most affected neonates are asymptomatic, and thus, diagnosis is usually made using real-time transfontanellar ultrasound. The present review provides a synopsis of the pathogenesis, grading, incidence, risk factors, and diagnosis of GM-IVH in preterm neonates. We explore brief literature related to outcomes, management interventions, and pharmacological and nonpharmacological prevention strategies for GM-IVH and posthemorrhagic hydrocephalus.

Glucocorticosteroids effects on brain development in the preterm infants: a role for microglia?

2021 ◽  
Vol 19 ◽  
Author(s):  
Zinni Manuela ◽  
Pansiot Julien ◽  
Elodie Billion ◽  
Baud Olivier ◽  
Mairesse Jérôme
Keyword(s):  
Brain Development ◽  
Preterm Infants ◽  
Adverse Outcomes ◽  
Mortality And Morbidity ◽  
Respiratory Problems ◽  
Neurodevelopmental Impairment ◽  
Short And Long Term ◽  
Abnormal Brain

: Prematurity, observed in 15 million births worldwide each year, is a clinical condition that is a major cause of neonatal mortality and morbidity in short and long term. Preterm infants are at high risk for developing respiratory problems, sepsis, and other morbidities leading to neurodevelopmental impairment and neurobehavioral disorders. Perinatal glucocorticosteroids have been widely used for the prevention and treatment of adverse outcomes linked to prematurity. However, despite their shortterm benefits due to their maturational properties, some clinical trials have shown an association between steroids exposure and abnormal brain development in infants born preterm. Neuroinflammation has emerged as a preeminent factor for brain injury in preterm infants, and the major role of microglia, the brain resident immune cells, has been recently highlighted. Considering the role of microglia in the modulation of brain development, the aim of this review is to summarize the effects of endogenous and exogenous glucocorticosteroids on brain development and discuss the possible role of microglia as a mediator of these effects.

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