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中度和晚期早产儿的神经发育及其与早期营养的关联。

Neurodevelopment and the association with early life nutrition in moderate and late preterm infants.

作者信息

Lafeber Anne H, Bosch Mark, de Roos Sophie F, Aarnoudse-Moens Cornelieke S H, van Veenendaal Nicole R, van Goudoever Johannes B, de Groof Femke

机构信息

Department of Pediatrics and Neonatology, North West Clinics, Alkmaar, the Netherlands.

Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.

出版信息

J Pediatr Gastroenterol Nutr. 2025 Jul;81(1):95-103. doi: 10.1002/jpn3.70056. Epub 2025 May 5.

Abstract

OBJECTIVES

Long-term neurodevelopment of moderate and late preterm infants (MLPTI; gestational age [GA] 32 0/7 weeks to 36 6/7 weeks) is at a lower level than that of those at term age. Increased protein and energy intakes in the first week of life have been associated with better neurodevelopment early in life, in very preterm infants. This study aimed to evaluate the neurodevelopmental outcome of MLPTI at 2 years corrected age (CA) for prematurity (i.e., after term equivalent age) and its association with nutritional intake in the first week of life.

METHODS

We prospectively collected nutritional data during the first week of life from 100 MLPTI (GA 32 0/7 weeks to 35 6/7 weeks). At 2 years CA, children underwent a neurodevelopmental assessment using the Bayley Scales of Infant and Toddler Development, Third edition, Dutch version (BSID-III-NL).

RESULTS

The mean BSID-III-NL (mean ± standard deviation [SD]) score was 103.1 (10.9) on the cognitive composite, 101.1 (SD ± 15.0) on the language composite, and 100.8 (SD ± 9.6) on the motor composite. Boys scored significantly lower than girls on both cognitive and language composite scores. We found no significant associations between nutritional intake in the first week of life and neurodevelopment at 2 years CA.

CONCLUSION

Neurodevelopment at 2 years CA was within normal limits, while boys scored lower than girls. First week nutritional intakes do not seem to be associated with neurodevelopmental outcomes at 2 years CA. This study emphasizes the need for more long-term follow-up and research concerning neurodevelopment in MLPTI, especially in boys.

摘要

目的

中度和晚期早产儿(胎龄[GA]32⁰/₇周 至 36⁶/₇周)的长期神经发育水平低于足月儿。出生后第一周蛋白质和能量摄入量增加与极早产儿生命早期更好的神经发育有关。本研究旨在评估中度和晚期早产儿在矫正年龄2岁(即足月等效年龄后)时的神经发育结局及其与出生后第一周营养摄入的关系。

方法

我们前瞻性收集了100例中度和晚期早产儿(胎龄32⁰/₇周 至 35⁶/₇周)出生后第一周的营养数据。在矫正年龄2岁时,使用贝利婴幼儿发展量表第三版荷兰语版(BSID-III-NL)对儿童进行神经发育评估。

结果

认知综合量表的平均BSID-III-NL(均值±标准差[SD])得分为103.1(10.9),语言综合量表得分为101.1(标准差±15.0),运动综合量表得分为100.8(标准差±9.6)。男孩在认知和语言综合量表得分上显著低于女孩。我们发现出生后第一周的营养摄入与矫正年龄2岁时的神经发育之间无显著关联。

结论

矫正年龄2岁时的神经发育在正常范围内,但男孩得分低于女孩。出生后第一周的营养摄入似乎与矫正年龄2岁时的神经发育结局无关。本研究强调需要对中度和晚期早产儿,尤其是男孩的神经发育进行更多长期随访和研究。

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