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Impact of early protein and energy intakes on neurodevelopment at 2 years of corrected age in very low birth weight infants: A single-center observational study

INTRODUCTION: Aggressive nutritional strategy, particularly enhancing early provision of energy and protein, has appeared to reduce postnatal growth failure and improve later developmental outcomes. But the amount of macronutrients required remains unclear. The aim of this study was to investigate t...

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Autores principales: Barreault, Simon, Bellanger, Amandine, Berneau, Pauline, de La Pintière, Armelle, Lallemant, Carine, Beuchée, Alain
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6590817/
https://www.ncbi.nlm.nih.gov/pubmed/31233553
http://dx.doi.org/10.1371/journal.pone.0218887
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author Barreault, Simon
Bellanger, Amandine
Berneau, Pauline
de La Pintière, Armelle
Lallemant, Carine
Beuchée, Alain
author_facet Barreault, Simon
Bellanger, Amandine
Berneau, Pauline
de La Pintière, Armelle
Lallemant, Carine
Beuchée, Alain
author_sort Barreault, Simon
collection PubMed
description INTRODUCTION: Aggressive nutritional strategy, particularly enhancing early provision of energy and protein, has appeared to reduce postnatal growth failure and improve later developmental outcomes. But the amount of macronutrients required remains unclear. The aim of this study was to investigate the impact of protein and energy intakes during the first two weeks after birth on neurodevelopmental outcomes. METHODS: This retrospective cohort study of very low birth weight infants born between January 2012 and December 2015 was conducted at one tertiary neonatal intensive care unit. The primary outcome was a neurodevelopmental impairment (NDI) at 2 years corrected age defined by a cerebral palsy or a 24 month Ages and Stages Questionnaires score on any of the five domains lower than 2 standard deviation below the mean score. Multivariable logistic regression analysis was used to adjust for perinatal and postnatal confounders. RESULTS: Among 245 (73%) infants discharged home alive, 159 (65%) had follow-up at 2 years. Infants with NDI (55/159, 35%) were more likely male gender (67.3% versus 46.2%, P = 0.02) and experienced more patent ductus arteriosus (PDA) ligation (20% versus 5.8%, P = 0.01) than control. After adjusting for confounders, first-week protein intake (OR: 2.27 [CI: 1.07–5.14]; P < 0.05), second-week non-protein energy intake (OR: 1.03 [CI: 1.01–1.05]; P < 0.01) and PDA ligation (OR: 6.81 [1.80–28.46]; P < 0.01) had significant independent association with higher likelihood of NDI at 2 years. CONCLUSION: Providing nutrition above the optimal level may not be beneficial and may even be harmful. These results confirm the recent recommendation to decrease amino acid intakes published in the latest ESPGHAN guidelines.
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spelling pubmed-65908172019-07-05 Impact of early protein and energy intakes on neurodevelopment at 2 years of corrected age in very low birth weight infants: A single-center observational study Barreault, Simon Bellanger, Amandine Berneau, Pauline de La Pintière, Armelle Lallemant, Carine Beuchée, Alain PLoS One Research Article INTRODUCTION: Aggressive nutritional strategy, particularly enhancing early provision of energy and protein, has appeared to reduce postnatal growth failure and improve later developmental outcomes. But the amount of macronutrients required remains unclear. The aim of this study was to investigate the impact of protein and energy intakes during the first two weeks after birth on neurodevelopmental outcomes. METHODS: This retrospective cohort study of very low birth weight infants born between January 2012 and December 2015 was conducted at one tertiary neonatal intensive care unit. The primary outcome was a neurodevelopmental impairment (NDI) at 2 years corrected age defined by a cerebral palsy or a 24 month Ages and Stages Questionnaires score on any of the five domains lower than 2 standard deviation below the mean score. Multivariable logistic regression analysis was used to adjust for perinatal and postnatal confounders. RESULTS: Among 245 (73%) infants discharged home alive, 159 (65%) had follow-up at 2 years. Infants with NDI (55/159, 35%) were more likely male gender (67.3% versus 46.2%, P = 0.02) and experienced more patent ductus arteriosus (PDA) ligation (20% versus 5.8%, P = 0.01) than control. After adjusting for confounders, first-week protein intake (OR: 2.27 [CI: 1.07–5.14]; P < 0.05), second-week non-protein energy intake (OR: 1.03 [CI: 1.01–1.05]; P < 0.01) and PDA ligation (OR: 6.81 [1.80–28.46]; P < 0.01) had significant independent association with higher likelihood of NDI at 2 years. CONCLUSION: Providing nutrition above the optimal level may not be beneficial and may even be harmful. These results confirm the recent recommendation to decrease amino acid intakes published in the latest ESPGHAN guidelines. Public Library of Science 2019-06-24 /pmc/articles/PMC6590817/ /pubmed/31233553 http://dx.doi.org/10.1371/journal.pone.0218887 Text en © 2019 Barreault et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Barreault, Simon
Bellanger, Amandine
Berneau, Pauline
de La Pintière, Armelle
Lallemant, Carine
Beuchée, Alain
Impact of early protein and energy intakes on neurodevelopment at 2 years of corrected age in very low birth weight infants: A single-center observational study
title Impact of early protein and energy intakes on neurodevelopment at 2 years of corrected age in very low birth weight infants: A single-center observational study
title_full Impact of early protein and energy intakes on neurodevelopment at 2 years of corrected age in very low birth weight infants: A single-center observational study
title_fullStr Impact of early protein and energy intakes on neurodevelopment at 2 years of corrected age in very low birth weight infants: A single-center observational study
title_full_unstemmed Impact of early protein and energy intakes on neurodevelopment at 2 years of corrected age in very low birth weight infants: A single-center observational study
title_short Impact of early protein and energy intakes on neurodevelopment at 2 years of corrected age in very low birth weight infants: A single-center observational study
title_sort impact of early protein and energy intakes on neurodevelopment at 2 years of corrected age in very low birth weight infants: a single-center observational study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6590817/
https://www.ncbi.nlm.nih.gov/pubmed/31233553
http://dx.doi.org/10.1371/journal.pone.0218887
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