The Influence of Early Nutrition on Neurodevelopmental Outcomes in Preterm Infants
Abstract
1. Introduction
2. Data Sources
3. Amino Acids
4. Glucose
5. Lipids
6. Human Milk Oligosaccharides (HMOs)
7. Micronutrients
8. Vitamins
9. Intestinal Microbiota and the Gut-Brain Axis
10. Human Milk
11. Conclusions
Funding
Conflicts of Interest
References
- Ramel, S.E.; Georfieff, M.K. Preterm nutrition and the brain. In Nutritional Care of Preterm Infants; Koletzko, B., Poindexter, B., Uauy, R., Eds.; Karger: Basel, Switzerland, 2014; pp. 190–200. [Google Scholar]
- Morris, E.E.; Miller, N.C.; Marka, N.A.; Super, J.L.; Nagel, E.M.; Gonzalez, J.D.; Demerath, E.W.; Ramel, S.E. Randomized Trial of Early Enhanced Parenteral Nutrition and Later Neurodevelopment in Preterm Infants. Nutrients 2022, 14, 3890. [Google Scholar] [CrossRef] [PubMed]
- Kumar, R.K.; Singhal, A.; Vaidya, U.; Banerjee, S.; Anwar, F.; Rao, S. Optimizing Nutrition in Preterm Low Birth Weight Infants—Consensus Summary. Front. Nutr. 2017, 4, 20. [Google Scholar] [CrossRef] [PubMed]
- Johnson, M.J.; Wootton, S.A.; Leaf, A.A.; Jackson, A.A. Preterm birth and body composition at term equivalent age: A systematic review and meta-analysis. Pediatrics 2012, 130, e640–e649. [Google Scholar] [CrossRef] [PubMed]
- De Nardo, M.C.; Di Mario, C.; Laccetta, G.; Boscarino, G.; Terrin, G. Enteral and parenteral energy intake and neurodevelopment in preterm infants: A systematic review. Nutrition 2022, 97, 111572. [Google Scholar] [CrossRef] [PubMed]
- Samara, J.; Moossavi, S.; Alshaikh, B.; Ortega, V.A.; Pettersen, V.K.; Ferdous, T.; Hoops, S.L.; Soraisham, A.; Vayalumkal, J.; Dersch-Mills, D.; et al. Supplementation with a probiotic mixture accelerates gut microbiome maturation and reduces intestinal inflammation in extremely preterm infants. Cell Host Microbe 2022, 30, 696–711.e5. [Google Scholar] [CrossRef]
- Buffet-Bataillon, S.; Bellanger, A.; Boudry, G.; Gangneux, J.-P.; Yverneau, M.; Beuchée, A.; Blat, S.; Le Huërou-Luron, I. New Insights Into Microbiota Modulation-Based Nutritional Interventions for Neurodevelopmental Outcomes in Preterm Infants. Front. Microbiol. 2021, 12, 676622. [Google Scholar] [CrossRef]
- Beghetti, I.; Barone, M.; Turroni, S.; Biagi, E.; Sansavini, A.; Brigidi, P.; Corvaglia, L.; Aceti, A. Early-life gut microbiota and neurodevelopment in preterm infants: Any role for Bifidobacterium? Eur. J. Pediatr. 2022, 181, 1773–1777. [Google Scholar] [CrossRef] [PubMed]
- Cooke, R.W. Preterm mortality and morbidity over 25 years. Arch. Dis. Child Fetal Neonatal Ed. 2006, 91, F293–F294. [Google Scholar] [CrossRef]
- Sandström, O.; Lönnerdal, B.; Graverholt, G.; Hernell, O. Effects of alpha-lactalbumin-enriched formula containing different concentrations of glycomacropeptide on infant nutrition. Am. J. Clin. Nutr. 2008, 87, 921–928. [Google Scholar] [CrossRef]
- Ehrenkranz, R.A. Early, Aggressive nutritional management for very low birth weight infants: What is the evidence? Semin. Perinatol. 2007, 31, 48–55. [Google Scholar] [CrossRef]
- Morgan, C.; McGowan, P.; Herwitker, S.; Hart, A.E.; Turner, M.A. Postnatal head growth in preterm infants: A randomized controlled parenteral nutrition study. Pediatrics 2014, 133, e120–e128. [Google Scholar] [CrossRef]
- Leppänen, M.; Lapinleimu, H.; Lind, A.; Matomäki, J.; Lehtonen, L.; Haataja, L.; Rautava, P.; on Behalf of the PIPARI Study Group. Antenatal and postnatal growth and 5-year cognitive outcome in very preterm infants. Pediatrics 2014, 133, 63–70. [Google Scholar] [CrossRef]
- Cormack, B.E.; Bloomfield, F.H.; Dezoete, A.; Kuschel, C.A. Does more protein in the first week of life change outcomes for very low birthweight babies? J. Paediatr. Child Health 2011, 47, 898–903. [Google Scholar] [CrossRef] [PubMed]
- Keunen, K.; van Elburg, R.M.; van Bel, F.; Benders, M.J.N.L. Impact of nutrition on brain development and its neuroprotective implications following preterm birth. Pediatr. Res. 2015, 77, 148–155. [Google Scholar] [CrossRef] [PubMed]
- Schneider, N.; Garcia-Rodenas, C.L. Early Nutritional Interventions for Brain and Cognitive Development in Preterm Infants: A Review of the Literature. Nutrients 2017, 9, 187. [Google Scholar] [CrossRef]
- Roberts, D.; Brown, J.; Medley, N.; Dalziel, S.R. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst. Rev. 2017, 3, CD004454. [Google Scholar] [CrossRef] [PubMed]
- Robinson, D.T.; Calkins, K.L.; Chen, Y.; Cober, M.P.; Falciglia, G.H.; Church, D.D.; Mey, J.; McKeever, L.; Sentongo, T. Guidelines for parenteral nutrition in preterm infants: The American Society for Parenteral and Enteral Nutrition. J. Parenter. Enter. Nutr. 2023, 47, 830–858. [Google Scholar] [CrossRef]
- Fenton, T.R.; Al-Wassia, H.; Premji, S.S.; Sauve, R.S. Higher versus lower protein intake in formula-fed low birth weight infants. Cochrane Database Syst. Rev. 2020, 6, CD003959. [Google Scholar] [CrossRef]
- Gao, C.; Miller, J.; Collins, C.T.; Rumbold, A.R. Comparison of different protein concentrations of human milk fortifier for promoting growth and neurological development in preterm infants. Cochrane Database Syst. Rev. 2020, 11, CD007090. [Google Scholar] [CrossRef]
- Embleton, N.D.; Akker, C.H.v.D. Protein intakes to optimize outcomes for preterm infants. Semin. Perinatol. 2019, 43, 151154. [Google Scholar] [CrossRef]
- Wharton, B.A.; Morley, R.; Isaacs, E.B.; Cole, T.J.; Lucas, A. Low plasma taurine and later neurodevelopment. Arch. Dis. Child.-Fetal Neonatal Ed. 2004, 89, F497–F498. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Volpe, J.J. Volpe’s Neurology of the Newborn; Elsevier: Amsterdam, The Netherlands, 2017; pp. 100–177. [Google Scholar]
- Cormack, B.E.; Harding, J.E.; Miller, S.P.; Bloomfield, F.H. The Influence of Early Nutrition on Brain Growth and Neurodevelopment in Extremely Preterm Babies: A Narrative Review. Nutrients 2019, 11, 2029. [Google Scholar] [CrossRef] [PubMed]
- Isaacs, E.B.; Morley, R.; Lucas, A. Early diet and general cognitive outcome at adolescence in children born at or below 30 weeks gestation. J. Pediatr. 2009, 155, 229–234. [Google Scholar] [CrossRef] [PubMed]
- Villamizar, J.D.G.; Haapala, J.L.; Scheurer, J.M.; Rao, R.; Ramel, S.E. Relationships between Early Nutrition, Illness, and Later Outcomes among Infants Born Preterm with Hyperglycemia. J. Pediatr. 2020, 223, 29–33.e2. [Google Scholar] [CrossRef] [PubMed]
- Georgieff, M.K. Nutrition and the developing brain: Nutrient priorities and measurement. Am. J. Clin. Nutr. 2007, 85, 614S–620S. [Google Scholar]
- Skinner, A.M.; Narchi, H. Preterm nutrition and neurodevelopmental outcomes. World J. Methodol. 2021, 11, 278–293. [Google Scholar] [CrossRef]
- Shulkin, M.; Pimpin, L.; Bellinger, D.; Kranz, S.; Fawzi, W.; Duggan, C.; Mozaffarian, D. n–3 Fatty Acid Supplementation in Mothers, Preterm Infants, and Term Infants and Childhood Psychomotor and Visual Development: A Systematic Review and Meta-Analysis. J. Nutr. 2018, 148, 409–418. [Google Scholar] [CrossRef]
- Wang, Q.; Cui, Q.; Yan, C. The Effect of Supplementation of Long-Chain Polyunsaturated Fatty Acids During Lactation on Neurodevelopmental Outcomes of Preterm Infant From Infancy to School Age: A Systematic Review and Meta-analysis. Pediatr. Neurol. 2016, 59, 54–61.e1. [Google Scholar] [CrossRef]
- Alshweki, A.; Muñuzuri, A.P.; Baña, A.M.; de Castro, M.J.; Andrade, F.; Aldamiz-Echevarría, L.; de Pipaón, M.S.; Fraga, J.M.; Couce, M.L. Effects of different arachidonic acid supplementation on psychomotor development in very preterm infants; a randomized controlled trial. Nutr. J. 2015, 14, 101. [Google Scholar] [CrossRef]
- Moon, K.; Rao, S.C.; Schulzke, S.M.; Patole, S.K.; Simmer, K. Long chain polyunsaturated fatty acid supplementation in preterm infants. Cochrane Database Syst. Rev. 2016, 12, CD000375. [Google Scholar]
- Koletzko, B.; Bergmann, K.; Brenna, J.T.; Calder, P.C.; Campoy, C.; Clandinin, M.T.; Colombo, J.; Daly, M.; Decsi, T.; Demmelmair, H.; et al. Should formula for infants provide arachidonic acid along with DHA? Am. J. Clin. Nutr. 2020, 111, 10–16. [Google Scholar] [CrossRef] [PubMed]
- Lapillonne, A.; Groh-Wargo, S.; Gonzalez, C.H.L.; Uauy, R. Lipid Needs of Preterm Infants: Updated Recommendations. J. Pediatr. 2013, 162 (Suppl. 3), S37–S47. [Google Scholar] [CrossRef]
- Tam, E.W.Y.; Chau, V.; Barkovich, A.J.; Ferriero, D.M.; Miller, S.P.; Rogers, E.E.; Grunau, R.E.; Synnes, A.R.; Xu, D.; Foong, J.; et al. Early postnatal docosahexaenoic acid levels and improved preterm brain development. Pediatr. Res. 2016, 79, 723–730. [Google Scholar] [CrossRef] [PubMed]
- Ottolini, K.M.; Andescavage, N.; Keller, S.; Limperopoulos, C. Nutrition and the developing brain: The road to optimizing early neurodevelopment: A systematic review. Pediatr. Res. 2020, 87, 194–201. [Google Scholar] [CrossRef] [PubMed]
- Berger, P.K.; Ong, M.L.; Bode, L.; Belfort, M.B. Human Milk Oligosaccharides and Infant Neurodevelopment: A Narrative Review. Nutrients 2023, 15, 719. [Google Scholar] [CrossRef]
- Bode, L.; Jantscher-Krenn, E. Structure-function relationships of human milk oligosaccharides. Adv. Nutr. Int. Rev. J. 2012, 3, 383S–391S. [Google Scholar] [CrossRef]
- Azad, M.B.; Robertson, B.; Atakora, F.; Becker, A.B.; Subbarao, P.; Moraes, T.J.; Mandhane, P.J.; Turvey, S.E.; Lefebvre, D.L.; Sears, M.R.; et al. Human Milk Oligosaccharide Concentrations Are Associated with Multiple Fixed and Modifiable Maternal Characteristics, Environmental Factors, and Feeding Practices. J. Nutr. 2018, 148, 1733–1742. [Google Scholar] [CrossRef]
- Oliveros, E.; Vázquez, E.; Barranco, A.; Ramírez, M.; Gruart, A.; Delgado-García, J.M.; Buck, R.; Rueda, R.; Martín, M.J. Sialic Acid and Sialylated Oligosaccharide Supplementation during Lactation Improves Learning and Memory in Rats. Nutrients 2018, 10, 1519. [Google Scholar] [CrossRef] [PubMed]
- Fan, Y.; McMath, A.L.; Donovan, S.M. Review on the Impact of Milk Oligosaccharides on the Brain and Neurocognitive Development in Early Life. Nutrients 2023, 15, 3743. [Google Scholar] [CrossRef]
- Georgieff, M.K.; Ramel, S.E.; Cusick, S.E. Nutritional influences on brain development. Acta Paediatr. 2018, 107, 1310–1321. [Google Scholar] [CrossRef]
- Berglund, S.K.; Westrup, B.; Hägglöf, B.; Hernell, O.; Domellöf, M. Effects of iron supplementation of LBW infants on cognition and behavior at 3 years. Pediatrics 2013, 131, 47–55. [Google Scholar] [CrossRef] [PubMed]
- Berglund, S.K.; Chmielewska, A.; Starnberg, J.; Westrup, B.; Hägglöf, B.; Norman, M.; Domellöf, M. Effects of iron supplementation of low-birth-weight infants on cognition and behavior at 7 years: A randomized controlled trial. Pediatr. Res. 2017, 83, 111–118. [Google Scholar] [CrossRef]
- Volpe, J.J. Iron and zinc: Nutrients with potential for neurorestoration in premature infants with cerebral white matter injury. J. Neonatal-Perinatal Med. 2020, 12, 365–368. [Google Scholar] [CrossRef]
- Rao, R.; Bora, R. Timing of umbilical cord clamping and infant brain development. J. Pediatr. 2018, 203, 8–10. [Google Scholar] [CrossRef] [PubMed]
- Brion, L.P.; Heyne, R.; Lair, C.S. Role of zinc in neonatal growth and brain growth: Review and scoping review. Pediatr. Res. 2021, 89, 1627–1640. [Google Scholar] [CrossRef] [PubMed]
- Castillo-Durán, C.; Weisstaub, G. Zinc Supplementation and growth of the fetus and low birth weight infant. J. Nutr. 2003, 133, 1494S–1497S. [Google Scholar] [CrossRef]
- Griffin, I.J.; Domellöf, M.; Bhatia, J.; Anderson, D.M.; Kler, N. Zinc and copper requirements in preterm infants: An examination of the current literature. Early Hum. Dev. 2013, 89, S29–S34. [Google Scholar] [CrossRef] [PubMed]
- Koletzko, B.; Cheah, F.C.; Domellöf, M.; Poindexter, B.B.; Vain, N.; van Goudoever, J.B. Nutritional Care of Preterm Infants. Scientific Basis and Practical Guidelines. World Rev. Nutr. Diet. 2021, 122, 46–59. [Google Scholar] [CrossRef]
- Kumar, M.; Shaikh, S.; Sinha, B.; Upadhyay, R.P.; Choudhary, T.S.; Chandola, T.R.; Mazumder, S.; Taneja, S.; Bhandari, N.; Chowdhury, R. Enteral Vitamin D Supplementation in Preterm or Low Birth Weight Infants: A Systematic Review and Meta-analysis. Pediatrics 2022, 150, 150–160. [Google Scholar] [CrossRef] [PubMed]
- Lockyer, F.; McCann, S.; Moore, S.E. Breast Milk Micronutrients and Infant Neurodevelopmental Outcomes: A Systematic Review. Nutrients 2021, 13, 3848. [Google Scholar] [CrossRef] [PubMed]
- Isaacs, E.B.; Gadian, D.G.; Sabatini, S.; Chong, W.K.; Quinn, B.T.; Fischl, B.R.; Lucas, A. The effect of early human diet on caudate volumes and IQ. Pediatr. Res. 2008, 63, 308–314. [Google Scholar] [CrossRef] [PubMed]
- Lu, J.; Claud, E.C. Connection between gut microbiome and brain development in preterm infants. Dev. Psychobiol. 2019, 61, 739–751. [Google Scholar] [CrossRef]
- Arboleya, S.; Sánchez, B.; Milani, C.; Duranti, S.; Solís, G.; Fernández, N.; de Los Reyes-Gavilan, C.G.; Ventura, M.; Margolles, A.; Gueimonde, M. Intestinal microbiota development in preterm neonates and effect of perinatal antibiotics. J. Pediatr. 2015, 166, 538–544. [Google Scholar] [CrossRef] [PubMed]
- Panchal, H.; Athalye-Jape, G.; Rao, S.; Patole, S. Growth and neuro-developmental outcomes of probiotic supplemented preterm infants—A systematic review and meta-analysis. Eur. J. Clin. Nutr. 2023, 77, 855–871. [Google Scholar] [CrossRef] [PubMed]
- Belfort, M.B.; Anderson, P.J.; Nowak, V.A.; Lee, K.J.; Molesworth, C.; Thompson, D.K.; Doyle, L.W.; Inder, T.E. Breast Milk Feeding, Brain Development, and Neurocognitive Outcomes: A 7-Year Longitudinal Study in Infants Born at Less Than 30 Weeks’ Gestation. J. Pediatr. 2016, 177, 133–139.e1. [Google Scholar] [CrossRef] [PubMed]
- Deoni, S.; Dean, D.; Joelson, S.; O’Regan, J.; Schneider, N. Early nutrition influences developmental myelination and cognition in infants and young children. NeuroImage 2017, 178, 649–659. [Google Scholar] [CrossRef] [PubMed]
- Ou, X.; Andres, A.; Pivik, R.; Cleves, M.; Snow, J.; Ding, Z.; Badger, T. Voxel-Based Morphometry and fMRI Revealed Differences in Brain Gray Matter in Breastfed and Milk Formula–Fed Children. Am. J. Neuroradiol. 2016, 37, 713–719. [Google Scholar] [CrossRef]
- Boscarino, G.; Di Chiara, M.; Cellitti, R.; De Nardo, M.C.; Conti, M.G.; Parisi, P.; Spalice, A.; Di Mario, C.; Ronchi, B.; Russo, A.; et al. Effects of early energy intake on neonatal cerebral growth of preterm newborn: An observational study. Sci. Rep. 2021, 11, 18457. [Google Scholar] [CrossRef]
Nutrient | Impact | Brain Structure |
---|---|---|
Energy and protein | Cell multiplication and differentiation, synaptogenesis, growth factors | Cortex, hippocampus, global brain |
Iron | Myelin, monoamine synthesis, glial metabolism | White matter and hippocampus |
Zinc | DNA synthesis, neurotransmitters | Autonomous nervous system, hippocampus, cerebellum |
Copper | Neurotransmitters, glial metabolism, antioxidation | Cerebellum |
LC-PUFAS | Synaptogenesis | Retina, cortex |
TAURINE/HILL | Neurotransmitters, DNA methylination, myelin | Global region, hippocampus and cerebral white matter |
Immediate Effects and Short Term | Long Term |
---|---|
Significant improvement in white matter microstructure | Better cognitive, behavioral, and academic performance |
Larger deep nuclear gray matter and hippocampus volume at term-equivalent age | Improved working memory |
Significantly greater brain volume and white matter volume | Significantly improved verbal IQ, especially in boys (25% increase in IQ) |
Better receptive language at age 3 | Better verbal and nonverbal IQ at age 7 * |
Improved mental and psychomotor development scores at Bayley Scales | Significantly higher IQ in later years, even after adjustment for maternal IQ |
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Silveira, R.C.; Corso, A.L.; Procianoy, R.S. The Influence of Early Nutrition on Neurodevelopmental Outcomes in Preterm Infants. Nutrients 2023, 15, 4644. https://doi.org/10.3390/nu15214644
Silveira RC, Corso AL, Procianoy RS. The Influence of Early Nutrition on Neurodevelopmental Outcomes in Preterm Infants. Nutrients. 2023; 15(21):4644. https://doi.org/10.3390/nu15214644
Chicago/Turabian StyleSilveira, Rita C., Andrea L. Corso, and Renato S. Procianoy. 2023. "The Influence of Early Nutrition on Neurodevelopmental Outcomes in Preterm Infants" Nutrients 15, no. 21: 4644. https://doi.org/10.3390/nu15214644
APA StyleSilveira, R. C., Corso, A. L., & Procianoy, R. S. (2023). The Influence of Early Nutrition on Neurodevelopmental Outcomes in Preterm Infants. Nutrients, 15(21), 4644. https://doi.org/10.3390/nu15214644