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Enhanced Nutrient Supply to Very Low Birth Weight Infants is Associated with Improved White Matter Maturation and Head Growth.
MedLine Citation:
PMID:  25401387     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: Extrauterine growth restriction is common among very low birth weight infants (VLBW, BW <1,500 g). Optimal postnatal nutrient supply is essential to limit growth restriction and ensure adequate growth and neurodevelopment. Objectives: We compared an enhanced postnatal nutrient supply to a standard supply and evaluated the effects on growth velocity, head circumference growth and cerebral maturation - the latter by magnetic resonance diffusion tensor imaging (DTI). We hypothesized increased growth velocity, head circumference growth and decreased mean diffusivity (MD) in cerebral white matter (WM) areas, suggesting improved cerebral maturation among infants on the enhanced nutrient supply. Methods: In this randomized controlled trial, infants on the enhanced nutrient supply received increased amounts of energy, protein, fat, essential fatty acids and vitamin A until discharge. DTI was performed close to term equivalent age. Outcomes were growth velocity, head circumference growth and WM mean diffusivity. Results: Among the 50 included infants, 14 in the intervention group and 11 controls underwent a successful DTI. Infants on the enhanced diet achieved improved growth velocity (16.5 vs. 13.8 g/kg/day, p = 0.01) and increased head circumference (Δz score: 0.24 vs. -0.12, p = 0.15). A significantly lower MD was seen in a large WM area such as the superior longitudinal fasciculi (1.19 × 10(-3) vs. 1.24 × 10(-3) mm(2)/s, p = 0.04, adjusted for age when scanned). Conclusions: Enhanced nutrient supply to VLBW infants is associated with improved growth velocity, increased head circumference growth and decreased regional WM mean diffusivity, suggesting improved maturation of cerebral connective tracts. © 2014 S. Karger AG, Basel.
Authors:
Kenneth Strømmen; Elin W Blakstad; Sissel J Moltu; Astrid N Almaas; Ane C Westerberg; Inge K Amlien; Arild E Rønnestad; Britt Nakstad; Christian A Drevon; Atle Bjørnerud; Frederic Courivaud; Per K Hol; Marit B Veierød; Anders M Fjell; Kristine B Walhovd; Per O Iversen
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-11-14
Journal Detail:
Title:  Neonatology     Volume:  107     ISSN:  1661-7819     ISO Abbreviation:  Neonatology     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-11-17     Completed Date:  -     Revised Date:  2014-11-18    
Medline Journal Info:
Nlm Unique ID:  101286577     Medline TA:  Neonatology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  68-75     Citation Subset:  -    
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