Abstract
BackgroundPreterm infants are at risk for adverse neurodevelopment. Furthermore, nutrition may play a key role in supporting neurodevelopment. The aim of this study was to evaluate whether a nutrient-enriched formula fed to preterm infants after hospital discharge could improve their neurodevelopment at 24 months (term-corrected age).MethodsWe conducted an observer-blinded, single-center, randomized controlled trial in infants admitted to the Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Italy between 2009 and 2011. Inclusion criteria were gestational age < 32 weeks and/or birth weight < 1500 g, and being fed human milk for < 20% of the total milk intake. Exclusion criteria were congenital malformations or conditions that could interfere with growth or body composition. Included infants were randomized to receive a standard full-term formula or a nutrient-enriched formula up until 6 months of corrected age, using two computer-generated randomization lists; one appropriate for gestational age (AGA) and one for small for gestational age (SGA) infants. We assessed neurodevelopment at 24 months of corrected age using the Griffiths Mental Development Scale and related subscales (locomotor, personal-social, hearing and speech, hand and eye coordination, and performance).ResultsOf the 207 randomized infants, 181 completed the study. 52 AGA and 35 SGA infants were fed a nutrient-enriched formula, whereas 56 AGA and 38 SGA infants were fed a standard full-term formula. The general quotient at 24 months of corrected age was not significantly different between infants randomized to receive a nutrient-enriched formula compared with a standard term formula up until 6 months of corrected age (AGA infants: 93.8 ± 12.6 vs. 92.4 ± 10.4, respectively; SGA infants: 96.1 ± 9.9 vs. 98.2 ± 9, respectively). The scores of related subscales were also similar among groups.ConclusionsThis study found that feeding preterm infants a nutrient-enriched formula after discharge does not affect neurodevelopment at 24 months of corrected age, in either AGA or SGA infants, free from major comorbidities.Trial registrationCurrent Controlled Trials (http://www.controlled-trials.com/ISRCTN30189842) London, UK.
Highlights
Preterm infants are at risk for adverse neurodevelopment
This study found that feeding preterm infants a nutrient-enriched formula after discharge does not affect neurodevelopment at 24 months of corrected age, in either appropriate for gestational age (AGA) or small for gestational age (SGA) infants, free from major comorbidities
There is paucity of data in the literature concerning the effect of high protein and energy intake after hospital discharge in preterm infants, who are randomized and separately evaluated on neurodevelopmental outcome according to intrauterine growth pattern
Summary
Preterm infants are at risk for adverse neurodevelopment. nutrition may play a key role in supporting neurodevelopment. Tan et al [4] found that limiting early energy deficits by providing high energy intake in association with increased protein intake during the hospital stay, may support adequate postnatal brain growth and improve neurodevelopmental indices at 3 months of corrected age. Consistent with these findings, Stephens et al [5] reported a positive, independent association between first week protein and energy intake, and Mental Developmental Index Scores assessed using the Bayley Scales of Infant Development II, in extremely preterm infants at 18 months of corrected age. There is paucity of data in the literature concerning the effect of high protein and energy intake after hospital discharge in preterm infants, who are randomized and separately evaluated on neurodevelopmental outcome according to intrauterine growth pattern
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