Liggins Institute, University of Auckland, 1142 Auckland, New Zealand.
Newborn Services, Starship Child Health, Auckland City Hospital, 1142 Auckland, New Zealand.
Nutrients. 2020 Mar 13;12(3):760. doi: 10.3390/nu12030760.
A key modifiable factor for improving neurodevelopment in extremely low birthweight (ELBW) babies may be improving growth, especially head growth, by optimising nutrition in the early neonatal period. We aimed to investigate relationships between nutrient intakes in the 4 weeks after birth, and growth from birth to 36 weeks' corrected age (CA) in ELBW babies. We undertook a prospective cohort study of 434 participants enrolled in a randomised controlled trial (ProVIDe) in eight New Zealand and Australian neonatal intensive care units. Macronutrient intakes from birth to 4 weeks and weight, length and head circumference measurements from birth to 36 weeks' CA were collected. From birth to 36 weeks' CA, the median (IQR) z-score changes were: weight -0.48 (-1.09, 0.05); length -1.16 (-1.86, -0.43), and head circumference -0.82 (-1.51, -0.19). Changes in z-score to 4 weeks and 36 weeks' CA were correlated with protein intake. Each 1 g·Kg·d total protein intake in week 2 was associated with 0.26 z-score increase in head circumference at 36 weeks' CA. Both nutritional intake and change in z-scores to 36 weeks' CA differed widely amongst sites. Correlations between nutrition and growth, and differences in these amongst sites, indicate there may be potential to improve growth with enhanced nutrition practices.
改善极低出生体重（ELBW）婴儿神经发育的一个关键可改变因素可能是通过优化新生儿期的营养来改善生长，尤其是头围生长。我们旨在研究出生后 4 周内的营养素摄入量与 ELBW 婴儿从出生到 36 周校正年龄（CA）的生长之间的关系。我们对在新西兰和澳大利亚的 8 个新生儿重症监护单位进行的一项随机对照试验（ProVIDe）中的 434 名参与者进行了一项前瞻性队列研究。收集了从出生到 4 周的宏量营养素摄入量以及从出生到 36 周 CA 的体重、长度和头围测量值。从出生到 36 周 CA，中位数（IQR）z 评分变化为：体重-0.48（-1.09，0.05）；长度-1.16（-1.86，-0.43），头围-0.82（-1.51，-0.19）。4 周和 36 周 CA 的 z 评分变化与蛋白质摄入量相关。第 2 周每 1 g·Kg·d 的总蛋白摄入量与 36 周 CA 时头围的 0.26 z 评分增加有关。营养摄入量和 36 周 CA 的 z 评分变化在各中心之间差异很大。营养与生长之间的相关性以及各中心之间的这些差异表明，通过强化营养实践可能有潜力改善生长。
