Naseh Nima, Vaz Tânia F, Ferreira Hugo, Moreira Nuno Canto, Hellström-Westas Lena, Ahlsson Fredrik, Ågren Johan
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Institute of Biophysics and Biomedical Engineering, Faculty of Sciences, University of Lisbon, Lisbon, Portugal.
Pediatr Res. 2025 Mar 4. doi: 10.1038/s41390-025-03964-8.
Malnutrition of preterm infants may negatively affect brain growth and later neurocognitive function. We aimed to investigate the association between very preterm infants' macronutrient intakes, and brain MRI at term and neurodevelopment at 2 years.
Single-center, retrospective cohort including extremely (22-27w) and very (28-31w) preterm infants born 2011-2014. The intakes of fluid, protein, carbohydrate, fat, and total calories during days 0-28 together with body weights were assessed in relation to brain MRI (morphology, volumetry, diffusion-weighted imaging) at term, and cognition (BSID-III) at 2 years, using adjusted multivariable regression analyses.
Seventy-two infants were included. A lower (p < 0.001) caloric intake in extremely preterm (n = 26) than in very preterm (n = 46) infants did not translate to any differences in brain volumes. While bivariate correlations (p < 0.01) were found between the enteral intakes of all macronutrients, and white matter volume and apparent diffusion coefficients, none of the correlations remained significant after adjusting for covariates in the multivariable analysis. Similarly, no associations between nutrient intakes and cognitive development remained after covariate adjustment.
In a cohort of preterm infants receiving macronutrient intakes meeting current recommendations, individual variations in nutrition did not influence brain growth or neurodevelopment.
Early postnatal macronutrient intake was not associated with brain volumes at term or neurocognitive outcomes at 2 years in very preterm infants All infants received nutritional intakes meeting current recommendations Adequate macronutrient intake based on a standardized protocol may eliminate the need for further minor adjustments in the pursuit of supporting brain growth and neurodevelopment in preterm infants.
早产儿营养不良可能对大脑发育及后期神经认知功能产生负面影响。我们旨在研究极早早产儿的常量营养素摄入量与足月时脑磁共振成像（MRI）及2岁时神经发育之间的关联。
单中心回顾性队列研究，纳入2011年至2014年出生的极早早产儿（22 - 27周）和早早产儿（28 - 31周）。评估出生后0至28天期间的液体、蛋白质、碳水化合物、脂肪和总热量摄入量以及体重，并通过校正多变量回归分析，将其与足月时的脑MRI（形态学、容积测量、弥散加权成像）以及2岁时的认知能力（贝利婴幼儿发展量表第三版）进行关联分析。
共纳入72例婴儿。极早早产儿（n = 26）的热量摄入量低于早早产儿（n = 46）（p < 0.001），但这并未导致脑容量出现差异。虽然所有常量营养素的肠内摄入量与白质体积和表观扩散系数之间存在双变量相关性（p < 0.01），但在多变量分析中校正协变量后，这些相关性均不再显著。同样，校正协变量后，营养素摄入量与认知发育之间也不存在关联。
在一组常量营养素摄入量符合当前推荐标准的早产儿队列中，个体营养差异并未影响大脑发育或神经发育。
极早早产儿出生后早期的常量营养素摄入量与足月时的脑容量或2岁时的神经认知结局无关。所有婴儿的营养摄入量均符合当前推荐标准。基于标准化方案的充足常量营养素摄入可能无需进一步微调即可支持早产儿的大脑发育和神经发育。
