Impact of early nutrition on brain development and neurocognitive outcomes in very preterm infants.

Abstract

Background: Malnutrition of preterm infants may negatively affect brain growth and later neurocognitive function. We aimed to investigate the association between very preterm infants' macronutrient intakes, and brain MRI at term and neurodevelopment at 2 years.

Methods: Single-center, retrospective cohort including extremely (22-27w) and very (28-31w) preterm infants born 2011-2014. The intakes of fluid, protein, carbohydrate, fat, and total calories during days 0-28 together with body weights were assessed in relation to brain MRI (morphology, volumetry, diffusion-weighted imaging) at term, and cognition (BSID-III) at 2 years, using adjusted multivariable regression analyses.

Results: Seventy-two infants were included. A lower (p < 0.001) caloric intake in extremely preterm (n = 26) than in very preterm (n = 46) infants did not translate to any differences in brain volumes. While bivariate correlations (p < 0.01) were found between the enteral intakes of all macronutrients, and white matter volume and apparent diffusion coefficients, none of the correlations remained significant after adjusting for covariates in the multivariable analysis. Similarly, no associations between nutrient intakes and cognitive development remained after covariate adjustment.

Conclusion: In a cohort of preterm infants receiving macronutrient intakes meeting current recommendations, individual variations in nutrition did not influence brain growth or neurodevelopment.

Impact: Early postnatal macronutrient intake was not associated with brain volumes at term or neurocognitive outcomes at 2 years in very preterm infants All infants received nutritional intakes meeting current recommendations Adequate macronutrient intake based on a standardized protocol may eliminate the need for further minor adjustments in the pursuit of supporting brain growth and neurodevelopment in preterm infants.