Tesser Francesca, Meneghelli Marta, Martino Diletta, Pegoraro Luca, Pelosi Maria Sofia, Sebellin Sofia, Verlato Giovanna
Neonatal Intensive Care Unit, Department of Women's and Children's Health, University Hospital of Padova, 35128 Padova, Italy.
Paediatric Nutrition Service, Department of Women's and Children's Health, University Hospital of Padova, 35128 Padova, Italy.
Nutrients. 2025 Jan 9;17(2):232. doi: 10.3390/nu17020232.
Preterm infants (PIs) are more susceptible to neurodevelopmental impairment compared with term newborns. Adequate postnatal growth has been associated with improved neurocognitive outcomes; therefore, optimization of nutrition may positively impact the neurodevelopment of PIs.
This study focused on macronutrient parenteral nutrition (PN) intake during the Neonatal Intensive Care Unit stay and their associations with neurodevelopmental outcomes in PIs in the first two years of life.
The Embase, MEDLINE, and Cochrane Library databases were searched using the following subject headings and terms (MeSH): "premature infants", "parenteral nutrition", "growth", "brain", "neurodevelopment", and "central nervous system diseases". All relevant papers' reference lists were manually searched. PN and neurodevelopment studies concerning the first two years of life were collected and analyzed.
275 potential studies were retrieved, 64 were selected for full-text reading, and 22 were included (12 randomized controlled trials). While glucose intakes should be immediately provided and strictly monitored avoiding hyperglycemia, the long-term outcomes of aggressive PN caloric intakes are uncertain. Early amino acid (AA) supplementation is mandatory and improves short-term growth, though it is questionable whether increased AA and better neurodevelopment are directly related. Lipid infusion should be initiated right after birth, and further investigation will enable us to ascertain the potential impacts of lipid emulsions, particularly fish oil, on PI neurodevelopment.
An aggressive PN and its possible metabolic complication could not favor neurodevelopment; the way forward could be a customized approach, depending on the patient's clinical state and tolerance. Long-term follow-up studies and the search for specific markers of tolerance are warranted.
与足月儿相比，早产儿更容易出现神经发育障碍。出生后充足的生长与改善神经认知结局相关；因此，优化营养可能对早产儿的神经发育产生积极影响。
本研究聚焦于新生儿重症监护病房住院期间的肠外营养（PN）宏量营养素摄入量及其与早产儿出生后两年神经发育结局的关联。
使用以下主题词在Embase、MEDLINE和Cochrane图书馆数据库中进行检索：“早产儿”“肠外营养”“生长”“脑”“神经发育”和“中枢神经系统疾病”。对所有相关论文的参考文献列表进行手动检索。收集并分析有关出生后两年的PN和神经发育研究。
检索到275项潜在研究，64项被选作全文阅读，22项被纳入（12项随机对照试验）。虽然应立即提供葡萄糖摄入量并严格监测以避免高血糖，但积极的PN热量摄入的长期结局尚不确定。早期补充氨基酸（AA）是必要的，且可改善短期生长，不过AA增加与更好的神经发育是否直接相关仍存在疑问。出生后应立即开始输注脂肪乳，进一步的研究将使我们能够确定脂肪乳剂，尤其是鱼油，对早产儿神经发育的潜在影响。
积极的PN及其可能的代谢并发症可能不利于神经发育；未来的方向可能是根据患者的临床状态和耐受性采取定制化方法。有必要进行长期随访研究并寻找耐受性的特定标志物。
