Jain Shipra, Alshaikh Belal N, Elmrayed Seham, Fenton Tanis R
The Perinatal Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnett Avenue, Cincinnati 45229, Ohio, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Community Health Sciences, O'Brien Institute of Public Health, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada; Neonatal Nutrition and Gastroenterology Program, Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada.
Semin Fetal Neonatal Med. 2025 Jul;30(2):101636. doi: 10.1016/j.siny.2025.101636. Epub 2025 Apr 9.
Preterm infants typically experience faster growth rates than term-born infants, often doubling their weight in six to eight weeks. However, many face challenges leading to growth faltering and suboptimal neurodevelopment. To achieve optimal growth, these infants often require fortified breastmilk or high-nutrient formula. While meeting nutrition and growth targets are essential, concerns arise about rapid postnatal growth during their catch-up phase, particularly regarding increased body fat at term-corrected age, possibly increasing their risk for obesity and chronic health conditions later. However, evidence suggests that although preterm infants may have higher body fat at term-corrected age, this difference diminishes by three months corrected age, aligning more closely with term-born infants. Systematic reviews of more than 20,000 individuals observed that small for gestational age preterm infants do not have higher adiposity in childhood and adulthood; rather, they exhibit lower body mass indexes, waist circumferences, similar body and visceral fat and blood pressure compared to their appropriate for gestational age preterm-born peers. Therefore, it is reassuring that promoting early growth in preterm infants does not necessitate a trade-off when it comes to supporting long-term metabolic outcomes versus neurodevelopment. Healthcare providers should encourage a responsive feeding approach, even in preterm infants, guided by infants' physiological needs, hunger and satiety once they exhibit feeding cues. This approach respects the child's developmental needs and encourages healthy eating habits, fostering positive parent-child feeding relationships, and ultimately allowing the child to grow and develop to their full potential without compromising their long-term health outcomes.
早产儿通常比足月儿生长速度更快，往往在六到八周内体重翻倍。然而，许多早产儿面临生长发育迟缓以及神经发育不理想的挑战。为了实现最佳生长，这些婴儿通常需要强化母乳或高营养配方奶。虽然达到营养和生长目标至关重要，但人们担心他们在追赶期的出生后快速生长，特别是在矫正月龄时体脂增加，这可能会增加他们日后患肥胖症和慢性健康问题的风险。然而，有证据表明，尽管早产儿在矫正月龄时可能有更高的体脂，但这种差异在矫正年龄三个月时会减小，与足月儿更为接近。对两万多人的系统评价观察到，小于胎龄的早产儿在儿童期和成年期并没有更高的肥胖率；相反，与适于胎龄的早产同龄人相比，他们的体重指数、腰围更低，身体脂肪、内脏脂肪和血压相似。因此，令人欣慰的是，在支持长期代谢结果与神经发育方面，促进早产儿的早期生长并不需要权衡取舍。医疗保健提供者应鼓励采取顺应性喂养方法，即使是对早产儿，一旦他们表现出进食信号，就应以婴儿的生理需求、饥饿和饱腹感为指导。这种方法尊重儿童的发育需求，鼓励健康的饮食习惯，培养积极的亲子喂养关系，并最终让儿童充分成长和发展，而不会损害他们的长期健康结果。
