Abstract
Introduction: The effects of “aggressive” neonatal feeding policies of very preterm neonates (VPN) and the risk of metabolic syndrome later in life remain questionable. We aimed to evaluate the effect of our “aggressive” nutrition policies of VPN during hospitalisation on body mass index (BMI) at ages 2 and 8 years. Materials and Methods: Eighty four VPN, who received “aggressive” nutrition during hospitalisation in an effort to minimise postnatal growth restriction (PGR) (group A), and 62 term neonates, as controls (group B), were enrolled in the study. Group A was further divided in four subgroups depending on the type (A1: fortified expressed breast milk and preterm formula; A2: exclusively preterm formula) and quantity of milk received (A3: maximum feeds 180–210 mL/kg/day; A4: maximum feeds 210 and up to 260 mL/kg/day). BMI was calculated at ages 2 and 8 years and plotted on the centile charts. Results: There was no significant difference in BMI between groups A and B at 2 and 8 years, respectively, in both absolute BMI values and their centile chart distribution. There was no significant difference in BMI at 2 and 8 years either between subgroups A1 and A2 or between subgroups A3 and A4. Conclusions: “Aggressive” and individualised feeding policy for VPN did not affect the BMI and obesity rates at ages of 2 and 8 years in our study population. The type and quantity of milk feeds had no impact on their BMI at school age. Further larger studies are needed to confirm our results.
Highlights
Since the late 1990s, when intrauterine growth restriction was first linked with metabolic syndrome in adult life [1], there has been increased scrutiny of the feeding policies for very premature neonates (VPN) during their hospitalisation and their effect on postnatal growth.In the pre-surfactant era, VPN were 3.5 times more likely to develop metabolic syndrome in adult life [2]
There are limited data regarding the association of VPN body mass index (BMI) at school age with the type and quantity of milk feedings in the neonatal period
The initial study population consisted of 84 VPN with birth weight (BW) < 1500 g and gestational age (GA) < 32 weeks admitted to the neonatal intensive care units (NICUs) between 2007 and 2009 who received “aggressive” nutrition according to the unit’s feeding policy and early nCPAP
Summary
Since the late 1990s, when intrauterine growth restriction was first linked with metabolic syndrome in adult life [1], there has been increased scrutiny of the feeding policies for very premature neonates (VPN) during their hospitalisation and their effect on postnatal growth. In the pre-surfactant era, VPN were 3.5 times more likely to develop metabolic syndrome in adult life [2]. A recent meta-analysis, which included preterm neonates from the pre- and post-surfactant era, showed that prematurity is strongly associated with metabolic syndrome in adult life [3]. Metabolic syndrome in adult life is associated with overweight at school age [4]. Determining the body mass index (BMI) at school age can act as a proxy marker for the risk of metabolic syndrome later in life. There are limited data regarding the association of VPN BMI at school age with the type and quantity of milk feedings in the neonatal period
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