Randomized Trial of Early Enhanced Parenteral Nutrition and Later Neurodevelopment in Preterm Infants
Retrospective studies indicate that the parenteral provision of calories, proteins, and lipids in the first week of life is associated with improved later neurodevelopment. We aimed to determine whether infants randomized to an enhanced parenteral nutrition protocol had improved developmental outcom...
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| Veröffentlicht in: | Nutrients 2022-09, Vol.14 (19), p.3890 |
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| creator | Morris, Erin E Miller, Neely C Marka, Nicholas A Super, Jennifer L Nagel, Emily M Gonzalez, Juan David Demerath, Ellen W Ramel, Sara E |
| description | Retrospective studies indicate that the parenteral provision of calories, proteins, and lipids in the first week of life is associated with improved later neurodevelopment. We aimed to determine whether infants randomized to an enhanced parenteral nutrition protocol had improved developmental outcomes at 4, 12, or 24 months corrected age (CA). In total, 90 preterm infants ( |
| doi_str_mv | 10.3390/nu14193890 |
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We aimed to determine whether infants randomized to an enhanced parenteral nutrition protocol had improved developmental outcomes at 4, 12, or 24 months corrected age (CA). In total, 90 preterm infants (<32 weeks gestational age and <1500 g) were randomized to receive enhanced parenteral nutrition (PN) or standard PN during the first week of life. The enhanced group received a higher glucose infusion rate and intralipids. Neurodevelopmental outcomes included pattern-reversal visually evoked potentials (VEP) at 4 months CA (n = 33) and the Bayley Scales of Infant Development (BSID) at 12 (n = 46) and 24 (n = 29) months CA. P100 latency was longer in the intervention group, indicating slower processing speed (145 vs. 178 ms, p = 0.01). This association did not hold in multivariable analysis adjusting for potentially confounding variables. BSID scores were not associated with enhanced PN. Higher enteral energy and protein intake regardless of randomization group were associated with faster processing speed at 4 months CA (p ≤ 0.02 for both). Enhanced early PN was not associated with improved neurodevelopment; however, first-week enteral caloric and protein intake were associated with improved speed of processing.</description><identifier>ISSN: 2072-6643</identifier><identifier>EISSN: 2072-6643</identifier><identifier>DOI: 10.3390/nu14193890</identifier><identifier>PMID: 36235546</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Age ; Birth weight ; Calories ; Child ; Development ; Developmental neurology ; Diet therapy ; Dietitians ; Gestational age ; Glucose ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Infants ; Infants (Premature) ; Latency ; Lipids ; Neonates ; Neurodevelopment ; Newborn babies ; Nutrition ; Parenteral feeding ; Parenteral nutrition ; Parenteral Nutrition - methods ; Parenteral therapy ; Pediatric research ; Premature babies ; Proteins ; Randomization ; Retrospective Studies ; Software ; Testing</subject><ispartof>Nutrients, 2022-09, Vol.14 (19), p.3890</ispartof><rights>COPYRIGHT 2022 MDPI AG</rights><rights>2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2022 by the authors. 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c473t-6d8335306601afc303883d82dda2fb53ca30a0c12e99b5254b43bf519029aceb3</citedby><cites>FETCH-LOGICAL-c473t-6d8335306601afc303883d82dda2fb53ca30a0c12e99b5254b43bf519029aceb3</cites><orcidid>0000-0002-8485-418X ; 0000-0002-4585-4064 ; 0000-0002-5792-009X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9570539/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9570539/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27903,27904,53769,53771</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36235546$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Morris, Erin E</creatorcontrib><creatorcontrib>Miller, Neely C</creatorcontrib><creatorcontrib>Marka, Nicholas A</creatorcontrib><creatorcontrib>Super, Jennifer L</creatorcontrib><creatorcontrib>Nagel, Emily M</creatorcontrib><creatorcontrib>Gonzalez, Juan David</creatorcontrib><creatorcontrib>Demerath, Ellen W</creatorcontrib><creatorcontrib>Ramel, Sara E</creatorcontrib><title>Randomized Trial of Early Enhanced Parenteral Nutrition and Later Neurodevelopment in Preterm Infants</title><title>Nutrients</title><addtitle>Nutrients</addtitle><description>Retrospective studies indicate that the parenteral provision of calories, proteins, and lipids in the first week of life is associated with improved later neurodevelopment. We aimed to determine whether infants randomized to an enhanced parenteral nutrition protocol had improved developmental outcomes at 4, 12, or 24 months corrected age (CA). In total, 90 preterm infants (<32 weeks gestational age and <1500 g) were randomized to receive enhanced parenteral nutrition (PN) or standard PN during the first week of life. The enhanced group received a higher glucose infusion rate and intralipids. Neurodevelopmental outcomes included pattern-reversal visually evoked potentials (VEP) at 4 months CA (n = 33) and the Bayley Scales of Infant Development (BSID) at 12 (n = 46) and 24 (n = 29) months CA. P100 latency was longer in the intervention group, indicating slower processing speed (145 vs. 178 ms, p = 0.01). This association did not hold in multivariable analysis adjusting for potentially confounding variables. BSID scores were not associated with enhanced PN. Higher enteral energy and protein intake regardless of randomization group were associated with faster processing speed at 4 months CA (p ≤ 0.02 for both). 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We aimed to determine whether infants randomized to an enhanced parenteral nutrition protocol had improved developmental outcomes at 4, 12, or 24 months corrected age (CA). In total, 90 preterm infants (<32 weeks gestational age and <1500 g) were randomized to receive enhanced parenteral nutrition (PN) or standard PN during the first week of life. The enhanced group received a higher glucose infusion rate and intralipids. Neurodevelopmental outcomes included pattern-reversal visually evoked potentials (VEP) at 4 months CA (n = 33) and the Bayley Scales of Infant Development (BSID) at 12 (n = 46) and 24 (n = 29) months CA. P100 latency was longer in the intervention group, indicating slower processing speed (145 vs. 178 ms, p = 0.01). This association did not hold in multivariable analysis adjusting for potentially confounding variables. BSID scores were not associated with enhanced PN. 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| subjects | Age Birth weight Calories Child Development Developmental neurology Diet therapy Dietitians Gestational age Glucose Humans Infant Infant, Newborn Infant, Premature Infants Infants (Premature) Latency Lipids Neonates Neurodevelopment Newborn babies Nutrition Parenteral feeding Parenteral nutrition Parenteral Nutrition - methods Parenteral therapy Pediatric research Premature babies Proteins Randomization Retrospective Studies Software Testing |
| title | Randomized Trial of Early Enhanced Parenteral Nutrition and Later Neurodevelopment in Preterm Infants |
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