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早产儿出生后脑区与处理速度相关的早期营养影响:一项随机试验的二次分析。

Early nutritional influences on brain regions related to processing speed in children born preterm: A secondary analysis of a randomized trial.

机构信息

Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.

Translational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.

出版信息

JPEN J Parenter Enteral Nutr. 2024 Oct;48(7):778-786. doi: 10.1002/jpen.2669. Epub 2024 Jul 15.

Abstract

BACKGROUND

Processing speed is a foundational skill supporting intelligence and executive function, areas often delayed in preterm-born children. The impact of early-life nutrition on gray matter facilitating processing speed for this vulnerable population is unknown.

METHODS

Magnetic resonance imaging and the Wechsler Preschool and Primary Scale of Intelligence-IV Processing Speed Index were acquired in forty 5-year-old children born preterm with very low birth weight. Macronutrient (grams per kilogram per day) and mother's milk (percentage of feeds) intakes were prospectively collected in the first postnatal month and associations between early-life nutrition and the primary outcome of brain regions supporting processing speed were investigated.

RESULTS

Children had a mean (SD) gestational age of 27.8 (1.8) weeks and 45% were male. Macronutrient intakes were unrelated, but mother's milk was positively related, to greater volumes in brain regions, including total cortical gray matter, cingulate gyri, and occipital gyri.

CONCLUSION

First postnatal month macronutrient intakes showed no association, but mother's milk was positively associated, with volumetric measures of total and regional cortical gray matter related to processing speed in preterm-born children. This exploratory analysis suggests early-life mother's milk supports processing speed by impacting structural underpinnings. Further research is needed on this potential strategy to improve preterm outcomes.

摘要

背景

处理速度是支持智力和执行功能的基础技能,而早产儿的这些方面往往发育迟缓。目前尚不清楚早期生活营养对促进这一脆弱人群处理速度的灰质的影响。

方法

对 40 名 5 岁早产儿极低出生体重的儿童进行磁共振成像和韦氏学前和小学智力量表第四版处理速度指数检查。在新生儿期第一个月前瞻性收集宏量营养素(每天每公斤克数)和母乳(喂养次数的百分比)摄入量,并研究早期生活营养与支持处理速度的大脑区域的主要结果之间的关系。

结果

儿童的平均(标准差)胎龄为 27.8(1.8)周,45%为男性。宏量营养素摄入量没有关联,但母乳与大脑区域的体积呈正相关,包括总皮质灰质、扣带回和枕叶。

结论

新生儿期第一个月的宏量营养素摄入量没有关联,但母乳与与处理速度相关的总皮质灰质和区域性皮质灰质的体积测量值呈正相关。这项探索性分析表明,早期生活中的母乳通过影响与处理速度相关的结构基础来支持处理速度。需要进一步研究这种潜在策略对改善早产儿结局的影响。

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