Inadequate nutrition leads to poor neurodevelopmental outcomes in very low-birth weight infants (VLBWIs). This study aimed to investigate the beneficial effects of early amino acid intake on the neurodevelopmental outcomes in VLBWIs at 20 months of correct age and school age.
The information of VLBWIs that received amino acid intake were retrospectively analyzed in this study. The cases in early group (EAA) received amino acid within 24 h, but the cases in standard group (SAA) after 48 h post-natal. The body weight, height, and Bayley score of the infants at correct age of 20 months were compared between groups. And the cognitive outcomes at school age were evaluated using Wechsler Intelligence Scale and Das-Naglieri cognitive assessment system.
There were no differences at baseline characteristics of the VLBWIs between EAA and SAA groups. Compared with the SAA group, the infants in EAA group had shorter time to regain birth weight (P < 0.05). The head circumference, MDI, and PDI in EAA group at 20 months of correct age were significantly higher than that in SAA group (both P < 0.05). According to the Wechsler scale and Das-Naglieri scores, the infants in EAA group had markedly improved cognitive outcomes compared with those in SAA group (all P < 0.05).
The results of this study revealed that early amino acid intake within 24 h could significantly improve the neurodevelopmental and cognitive outcomes in VLBWIs at 20 months of correct age and school age.
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Ditzenberger G (2014) Nutritional support for premature infants in the neonatal intensive care unit. Crit Care Nurs Clin North Am 26(2):181–198. https://doi.org/10.1016/j.ccell.2014.02.003
Lee JY, Lee JH, Yeon GM, Jung YJ (2019) Parental anxiety regarding premature infants and factors affecting parental concern. J Spec Pediatr Nurs 24(4):e12266. https://doi.org/10.1111/jspn.12266
Huang XC, Qiu XQ, Zeng XY et al (2019) Associations of parental thalassemia with preterm birth and low birth weight. Zhonghua Liu Xing Bing Xue Za Zhi 40(5):596–600. https://doi.org/10.3760/cma.j.issn.0254-6450.2019.05.020
Rogers EE, Hintz SR (2016) Early neurodevelopmental outcomes of extremely preterm infants. Semin Perinatol 40(8):497–509. https://doi.org/10.1053/j.semperi.2016.09.002
Meyers JM, Tan S, Bell EF et al (2019) Neurodevelopmental outcomes among extremely premature infants with linear growth restriction. J Perinatol 39(2):193–202. https://doi.org/10.1038/s41372-018-0259-8
Teo CM, Poon WB, Ho SK et al (2018) Long-term neurodevelopmental outcomes of premature infants in Singapore. Ann Acad Med Singap 47(2):63–70
Chien HC, Chen CH, Wang TM et al (2018) Neurodevelopmental outcomes of infants with very low birth weights are associated with the severity of their extra-uterine growth retardation. Pediatr Neonatol 59(2):168–175. https://doi.org/10.1016/j.pedneo.2017.08.003
Yang P, Cheng CP, Chang CL et al (2013) Wechsler Intelligence Scale for Children 4th edition-Chinese version index scores in Taiwanese children with attention-deficit/hyperactivity disorder. Psychiatry Clin Neurosci 67(2):83–91. https://doi.org/10.1111/pcn.12014
Deng CP, Liu M, Wei W et al (2011) Latent factor structure of the Das-Naglieri Cognitive Assessment System: a confirmatory factor analysis in a Chinese setting. Res Dev Disabil 32(5):1988–1997. https://doi.org/10.1016/j.ridd.2011.04.005
Oommen SP, Santhanam S, John H et al (2019) Neurodevelopmental outcomes of very low birth weight infants at 18–24 months, corrected gestational age in a tertiary health centre: a prospective cohort study. J Trop Pediatr 65(6):552–560. https://doi.org/10.1093/tropej/fmz006
Hsu CT, Chen CH, Lin MC et al (2018) Post-discharge body weight and neurodevelopmental outcomes among very low birth weight infants in Taiwan: a nationwide cohort study. PLoS ONE 13(2):e0192574. https://doi.org/10.1371/journal.pone.0192574
Wang L, Liu D, Shen H et al (2020) Analysis of amino acid patterns with nutrition regimens in preterm infants with extrauterine growth retardation. Front Pediatr 8:184. https://doi.org/10.3389/fped.2020.00184
Jadcherla SR, Khot T, Moore R et al (2017) Feeding methods at discharge predict long-term feeding and neurodevelopmental outcomes in preterm infants referred for gastrostomy evaluation. J Pediatr 181(125–130):e121. https://doi.org/10.1016/j.jpeds.2016.10.065
Leenders E, de Waard M, van Goudoever JB et al (2018) Low- versus high-dose and early versus late parenteral amino-acid administration in very-low-birth-weight infants: a systematic review and meta-analysis. Neonatology 113(3):187–205. https://doi.org/10.1159/000481192
Barreault S, Bellanger A, Berneau P et al (2019) 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. PLoS ONE 14(6):e0218887. https://doi.org/10.1371/journal.pone.0218887
Lee BS (2015) Nutritional strategy of early amino acid administration in very low birth weight infants. Korean J Pediatr 58(3):77–83. https://doi.org/10.3345/kjp.2015.58.3.77
Chung SH, Bae CW (2017) Improvement in the survival rates of very low birth weight infants after the establishment of the Korean Neonatal Network: comparison between the 2000s and 2010s. J Korean Med Sci 32(8):1228–1234. https://doi.org/10.3346/jkms.2017.32.8.1228
Asbury MR, Unger S, Kiss A et al (2019) Optimizing the growth of very-low-birth-weight infants requires targeting both nutritional and nonnutritional modifiable factors specific to stage of hospitalization. Am J Clin Nutr 110(6):1384–1394. https://doi.org/10.1093/ajcn/nqz227
Falciglia GH, Murthy K, Holl JL et al (2018) Energy and protein intake during the transition from parenteral to enteral nutrition in infants of very low birth weight. J Pediatr 202(38–43):e31. https://doi.org/10.1016/j.jpeds.2018.07.010
Embleton ND, van den Akker CHP (2019) Protein intakes to optimize outcomes for preterm infants. Semin Perinatol 43(7):151154. https://doi.org/10.1053/j.semperi.2019.06.002
Lafeber HN, van de Lagemaat M, Rotteveel J, van Weissenbruch M (2013) Timing of nutritional interventions in very-low-birth-weight infants: optimal neurodevelopment compared with the onset of the metabolic syndrome. Am J Clin Nutr 98(2):556S-560S. https://doi.org/10.3945/ajcn.112.045039
Belfort MB, Ehrenkranz RA (2017) Neurodevelopmental outcomes and nutritional strategies in very low birth weight infants. Semin Fetal Neonatal Med 22(1):42–48. https://doi.org/10.1016/j.siny.2016.09.001
Denne SC, Poindexter BB (2007) Evidence supporting early nutritional support with parenteral amino acid infusion. Semin Perinatol 31(2):56–60. https://doi.org/10.1053/j.semperi.2007.02.005
Stephens BE, Walden RV, Gargus RA et al (2009) First-week protein and energy intakes are associated with 18-month developmental outcomes in extremely low birth weight infants. Pediatrics 123(5):1337–1343. https://doi.org/10.1542/peds.2008-0211
Ranjitkar S, Kvestad I, Strand TA et al (2018) Acceptability and reliability of the Bayley Scales of Infant and Toddler Development-III Among Children in Bhaktapur. Nepal Front Psychol 9:1265. https://doi.org/10.3389/fpsyg.2018.01265
Picciolini O, Squarza C, Fontana C et al (2015) Neurodevelopmental outcome of extremely low birth weight infants at 24 months corrected age: a comparison between Griffiths and Bayley Scales. BMC Pediatr 15:139. https://doi.org/10.1186/s12887-015-0457-x
Del Rosario C, Slevin M, Molloy EJ et al (2020) How to use the Bayley Scales of Infant and Toddler Development. Arch Dis Child Educ Pract Ed. https://doi.org/10.1136/archdischild-2020-319063
Suppiej A, Vedovelli L, Boschiero D et al (2020) Abnormal heart rate variability at school age in survivors of neonatal hypoxic-ischemic encephalopathy managed with therapeutic hypothermia. Eur J Paediatr Neurol. https://doi.org/10.1016/j.ejpn.2020.08.004
Sasaki T, Hashimoto K, Tachibana M et al (2014) Tipepidine in children with attention deficit/hyperactivity disorder: a 4-week, open-label, preliminary study. Neuropsychiatr Dis Treat 10:147–151. https://doi.org/10.2147/NDT.S58480
A Project of the Comprehensive Treatment of Very Low Birth Weight Infants (2017wsjs099).
Ethics approval and consent to participate
A signed written informed consent was obtained from each patient and the experimental procedures were all in accordance with the guideline of the Ethics Committee of Weifang People’s Hospital.
Consent for publication
Written informed consent for publication was obtained from each participant.
The authors declare that they have no competing interests.
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Zhao, W., Yin, Y., Qin, F. et al. Effects of early intake of amino acid on the neurodevelopmental outcomes in very low birth weight infants at correct age of 20 months and school age. Ir J Med Sci (2021). https://doi.org/10.1007/s11845-021-02526-1
- Amino acid intake
- Breast feeding
- Cognitive outcomes
- Very low-birth weight infants