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早期营养和生长对早产儿脑容量、白质微观结构和神经发育结局的影响。

Effects of early nutrition and growth on brain volumes, white matter microstructure, and neurodevelopmental outcome in preterm newborns.

机构信息

Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands.

Image Sciences Institute, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands.

出版信息

Pediatr Res. 2018 Jan;83(1-1):102-110. doi: 10.1038/pr.2017.227. Epub 2017 Oct 25.

Abstract

BackgroundThis study aimed to investigate the effect of nutrition and growth during the first 4 weeks after birth on cerebral volumes and white matter maturation at term equivalent age (TEA) and on neurodevelopmental outcome at 2 years' corrected age (CA), in preterm infants.MethodsOne hundred thirty-one infants born at a gestational age (GA) <31 weeks with magnetic resonance imaging (MRI) at TEA were studied. Cortical gray matter (CGM) volumes, basal ganglia and thalami (BGT) volumes, cerebellar volumes, and total brain volume (TBV) were computed. Fractional anisotropy (FA) in the posterior limb of internal capsule (PLIC) was obtained. Cognitive and motor scores were assessed at 2 years' CA.ResultsCumulative fat and enteral intakes were positively related to larger cerebellar and BGT volumes. Weight gain was associated with larger cerebellar, BGT, and CGM volume. Cumulative fat and caloric intake, and enteral intakes were positively associated with FA in the PLIC. Cumulative protein intake was positively associated with higher cognitive and motor scores (all P<0.05).ConclusionOur study demonstrated a positive association between nutrition, weight gain, and brain volumes. Moreover, we found a positive relationship between nutrition, white matter maturation at TEA, and neurodevelopment in infancy. These findings emphasize the importance of growth and nutrition with a balanced protein, fat, and caloric content for brain development.

摘要

背景

本研究旨在探讨出生后前 4 周的营养和生长状况对早产儿胎龄相当龄(TEA)时脑容量和白质成熟度以及 2 岁校正龄(CA)时神经发育结局的影响。

方法

研究纳入了 131 名胎龄(GA)<31 周的婴儿,他们在 TEA 时接受了磁共振成像(MRI)检查。计算了皮质灰质(CGM)体积、基底节和丘脑(BGT)体积、小脑体积和总脑体积(TBV)。获得了后内囊肢(PLIC)的各向异性分数(FA)。在 2 岁 CA 时评估认知和运动评分。

结果

累积脂肪和肠内摄入与较大的小脑和 BGT 体积呈正相关。体重增加与较大的小脑、BGT 和 CGM 体积有关。累积脂肪和热量摄入以及肠内摄入与 PLIC 中的 FA 呈正相关。累积蛋白质摄入与较高的认知和运动评分呈正相关(均 P<0.05)。

结论

我们的研究表明营养、体重增加与脑容量之间存在正相关。此外,我们还发现营养、TEA 时的白质成熟度与婴儿期的神经发育之间存在正相关。这些发现强调了生长和营养的重要性,对于大脑发育而言,蛋白质、脂肪和热量的均衡摄入是非常重要的。

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