Abstract
Background: Early nutritional support of preterm infants is important because it influences long-term health and development. Body composition has an influence on cardiovascular disease, metabolic syndrome, and neurocognitive outcome in the long term.Objective: To assess body composition in preterm infants <32 weeks of gestation at term-equivalent age and to analyze the influence of an optimized nutritional approach.Methods: This is a prespecified secondary outcome analysis of a prospective observational study comparing the body composition in regard to gestational age. The preterm infants were classified according to gestational age as extremely preterm infants (<28 weeks gestation at birth) and very preterm infants (≥28 weeks gestation at birth) and according to weight percentile as appropriate for gestational age and small for gestational age. Body composition was determined by air displacement plethysmography using the PEA POD. The preterm infants obtained nutrition according to the ESPGHAN 2010 Guidelines.Results: Seventy-four preterm infants were analyzed. The mean (SD) gestational age was 28.7 (2.4) weeks, and birth weight was 1,162 (372) g. Fat mass percentage was significantly higher in extremely preterm infants in comparison to very preterm infants [17.0, 95% confidence interval (CI) 15.9–18.1 vs. 15.5, 95% CI 14.7–16.2]. There was no significant difference of fat mass percentage according to weight percentiles.Conclusions: Extremely preterm infants had a significantly higher fat mass percentage compared to very preterm infants at term-equivalent age. There was no significant difference of fat mass percentage according to weight percentiles.
Highlights
Adequate early nutritional support of preterm infants is essential for long-term health and development [1]
One hundred preterm infants born
Twenty-six were excluded for the following reasons: abdominal surgery (n = 11), death before body composition measurement (n = 7), genetic disorder (n = 1), insufficient quality of measurement (n = 2), and loss to follow-up (n = 5) (Figure 1)
Summary
Adequate early nutritional support of preterm infants is essential for long-term health and development [1]. Extreme prematurity is a risk factor for the development of adiposity [8] and, especially, small for gestational age (SGA) infants, who have undergone rapid catch up growth, have been reported to show an altered insulin resistance, and body composition with an increase in fat mass percentage (FM%) [8,9,10]. In previous studies, premature infants with a weight Z-score under −2 SD at term equivalent age showed reduced FM% values, raising some concern that neurocognitive outcome may be impaired in these infants in later life [12]. Nutritional support of preterm infants is important because it influences long-term health and development. Body composition has an influence on cardiovascular disease, metabolic syndrome, and neurocognitive outcome in the long term
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