Research

10 pages, 1434 KiB

Open AccessArticle

Growth Assessment in Preterm Children from Birth to Preschool Age

by Simone Ceratto, Francesco Savino, Silvia Vannelli, Luisa De Sanctis and Francesca Giuliani

Nutrients 2020, 12(7), 1941; https://doi.org/10.3390/nu12071941 - 30 Jun 2020

Cited by 6 | Viewed by 3051

Preterm infant growth is a major health indicator and needs to be monitored with an appropriate growth curve to achieve the best developmental and growth potential while avoiding excessive caloric intake that is linked to metabolic syndrome and hypertension later in life. New [...] Read more.

Preterm infant growth is a major health indicator and needs to be monitored with an appropriate growth curve to achieve the best developmental and growth potential while avoiding excessive caloric intake that is linked to metabolic syndrome and hypertension later in life. New international standards for size at birth and postnatal growth for preterm infants are available and need implementation in clinical practice. A prospective, single center observational study was conducted to evaluate the in-hospital and long-term growth of 80 preterm infants with a mean gestational age of 33.3 ± 2.2 weeks, 57% males. Size at birth and at discharge were assessed using the INTERGROWTH-21^ST standards, at preschool age with World Health Organization (WHO) child growth standards. The employment of INTERGROWTH-21^ST Preterm Postnatal longitudinal standards during the in-hospital follow-up significantly reduced the diagnosis of short term extrauterine growth restriction when compared to commonly used cross sectional neonatal charts, with significant lower loss of percentiles between birth and term corrected age (p < 0.0001). The implementation of a package of standards at birth, preterm postnatal growth standards and WHO child growth standards proved to be consistent, with correlation between centile at birth and at follow-up, and therefore effective in monitoring growth in a moderate and late preterm infant cohort without chronic or major morbidities. Infants identified as small for gestational age at birth showed significantly more frequently a need for auxological referral. Full article

(This article belongs to the Special Issue Postnatal Growth and Evaluation of the Nutritional Status of Very Preterm Infants: Implications for the Present and the Future)

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10 pages, 541 KiB

Open AccessArticle

Extrauterine Growth Restriction: Definitions and Predictability of Outcomes in a Cohort of Very Low Birth Weight Infants or Preterm Neonates

by Chiara Peila, Elena Spada, Francesca Giuliani, Giulia Maiocco, Melissa Raia, Francesco Cresi, Enrico Bertino and Alessandra Coscia

Nutrients 2020, 12(5), 1224; https://doi.org/10.3390/nu12051224 - 26 Apr 2020

Cited by 47 | Viewed by 4556

Abstract

Extrauterine Growth Restriction (EUGR) refers to inadequate growth during hospitalization. Current definitions for EUGR are varied and can be classified as cross-sectional (weight at a given t-time <10th centile) or longitudinal (weight loss between birth and a given t-time >1SD). Different t-times are [...] Read more.

Extrauterine Growth Restriction (EUGR) refers to inadequate growth during hospitalization. Current definitions for EUGR are varied and can be classified as cross-sectional (weight at a given t-time <10th centile) or longitudinal (weight loss between birth and a given t-time >1SD). Different t-times are also considered in literature, such as 36 weeks of gestational age (GA) or age at discharge. The aim of this study is to investigate whether EUGR could predict the auxological outcome at 24–30 months, and to evaluate the agreement between cross-sectional and longitudinal definitions. In total, 1589 infants with GA <30 weeks or birthweight ≤ 1500 g and without major congenital anomalies were included in this study. Cross-sectional and longitudinal EUGR were calculated at 36 and 40 weeks of GA, at discharge, and at 28 days. The concordance between the two definitions was estimated by Kappa coefficient. At 24–30 months, 803 infants were measured again. The agreement between the two definitions of EUGR was low. Both EUGR and not-EUGR groups were at lower centiles for weight, but at higher centiles for head circumference at 24–30 months than at birth. Longitudinal EUGR was associated with a poorer growth outcome for weight and height circumference than cross-sectional EUGR. No differences were observed for length. An agreed definition of EUGR is highly desirable in clinical practice to assess medical and nutritional interventions in preterm neonates. Based on the results of this study, we recommend the use of the longitudinal evaluation, that proved to better predict the auxological long-term outcome with respect to the cross-sectional one. Full article

(This article belongs to the Special Issue Postnatal Growth and Evaluation of the Nutritional Status of Very Preterm Infants: Implications for the Present and the Future)

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17 pages, 1349 KiB

Open AccessArticle

Plasma Metabolome Alterations Associated with Extrauterine Growth Restriction

by Danuta Dudzik, Isabel Iglesias Platas, Montserrat Izquierdo Renau, Carla Balcells Esponera, Beatriz del Rey Hurtado de Mendoza, Carles Lerin, Marta Ramón-Krauel and Coral Barbas

Nutrients 2020, 12(4), 1188; https://doi.org/10.3390/nu12041188 - 23 Apr 2020

Cited by 6 | Viewed by 3648

Abstract

Very preterm infants (VPI, born at or before 32 weeks of gestation) are at risk of adverse health outcomes, from which they might be partially protected with appropriate postnatal nutrition and growth. Metabolic processes or biochemical markers associated to extrauterine growth restriction (EUGR) [...] Read more.

Very preterm infants (VPI, born at or before 32 weeks of gestation) are at risk of adverse health outcomes, from which they might be partially protected with appropriate postnatal nutrition and growth. Metabolic processes or biochemical markers associated to extrauterine growth restriction (EUGR) have not been identified. We applied untargeted metabolomics to plasma samples of VPI with adequate weight for gestational age at birth and with different growth trajectories (29 well-grown, 22 EUGR) at the time of hospital discharge. A multivariate analysis showed significantly higher levels of amino-acids in well-grown patients. Other metabolites were also identified as statistically significant in the comparison between groups. Relevant differences (with corrections for multiple comparison) were found in levels of glycerophospholipids, sphingolipids and other lipids. Levels of many of the biochemical species decreased progressively as the level of growth restriction increased in severity. In conclusion, an untargeted metabolomic approach uncovered previously unknown differences in the levels of a range of plasma metabolites between well grown and EUGR infants at the time of discharge. Our findings open speculation about pathways involved in growth failure in preterm infants and the long-term relevance of this metabolic differences, as well as helping in the definition of potential biomarkers. Full article

(This article belongs to the Special Issue Postnatal Growth and Evaluation of the Nutritional Status of Very Preterm Infants: Implications for the Present and the Future)

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13 pages, 1370 KiB

Open AccessArticle

The Course Of IGF-1 Levels and Nutrient Intake in Extremely and Very Preterm Infants During Hospitalisation

by Dana F.J. Yumani, Alexandra K. Calor and Mirjam. M. van Weissenbruch

Nutrients 2020, 12(3), 675; https://doi.org/10.3390/nu12030675 - 02 Mar 2020

Cited by 13 | Viewed by 2820

Abstract

Background: Insulin-like growth factor 1 (IGF-1) plays an important role in the complex association between nutrition, growth, and maturation in extremely and very preterm infants. Nevertheless, in this population, research on associations between IGF-1 and nutrition is limited. Therefore this study aimed to [...] Read more.

Background: Insulin-like growth factor 1 (IGF-1) plays an important role in the complex association between nutrition, growth, and maturation in extremely and very preterm infants. Nevertheless, in this population, research on associations between IGF-1 and nutrition is limited. Therefore this study aimed to evaluate the possible associations between the course of IGF-1 levels and nutrient intake between preterm birth and 36 weeks postmenstrual age (PMA). Methods: 87 infants born between 24 and 32 weeks gestational age were followed up to 36 weeks PMA. Actual daily macronutrient intake was calculated, and growth was assessed weekly. IGF-1 was sampled from umbilical cord blood at birth and every other week thereafter. Results: There was an inverse relationship between the amount of parenteral nutrition in the second week of life and IGF-1. Total protein, fat, and carbohydrate intake, as well as total energy intake, primarily showed a positive association with IGF-1 levels, particularly between 30 and 33 weeks PMA. Gestational age, bronchopulmonary dysplasia (BPD), and weight were significant confounders in the association between nutrient intake and IGF-1 levels. Conclusion: Parenteral nutrition was found to be a negative predictor of IGF-1 levels, and there could potentially be a time frame in which macronutrient intake is unable to impact IGF-1 levels. Future research should aim to narrow down this time frame and to gain more insight into factors enhancing or decreasing the response of IGF-1 to nutrition, e.g., age and inflammatory state, to align nutritional interventions accordingly. Full article

(This article belongs to the Special Issue Postnatal Growth and Evaluation of the Nutritional Status of Very Preterm Infants: Implications for the Present and the Future)

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8 pages, 234 KiB

Open AccessArticle

Late Growth and Changes in Body Composition Influence Odds of Developing Retinopathy of Prematurity among Preterm Infants

by Ellen C. Ingolfsland, Jacob L. Haapala, Lauren A. Buckley, Ellen W. Demarath, Sixto F. Guiang and Sara E. Ramel

Nutrients 2020, 12(1), 78; https://doi.org/10.3390/nu12010078 - 27 Dec 2019

Cited by 11 | Viewed by 2251

Abstract

Background: While postnatal growth in the first month of life is known to impact retinopathy of prematurity (ROP) risk, the impact of growth later in hospitalization, during critical times of retinal vascularization, remains unknown. The purpose of this study was to assess if [...] Read more.

Background: While postnatal growth in the first month of life is known to impact retinopathy of prematurity (ROP) risk, the impact of growth later in hospitalization, during critical times of retinal vascularization, remains unknown. The purpose of this study was to assess if postnatal growth and body composition during the second half of neonatal intensive care unit hospitalization were associated with severity of retinopathy of prematurity in very low birth weight preterm infants. Methods: Prospective observational pilot study of 83 infants born <32 weeks gestation and <1500 g, conducted at a Level IV neonatal intensive care unit. Body composition was measured during the second half of hospitalization. Infants were evaluated for retinopathy of prematurity. Logistic regression was performed. Results: Greater gains in fat mass, fat-free mass, and percent body fat from 32 to 37 weeks postmenstrual age and higher % body fat at term postmenstrual age were associated with decreased odds of ≥stage 2 retinopathy of prematurity (p < 0.05). Conclusions: Improved growth later in neonatal intensive care unit hospitalization and increased adiposity at term may reduce odds of severe retinopathy of prematurity. Full article

(This article belongs to the Special Issue Postnatal Growth and Evaluation of the Nutritional Status of Very Preterm Infants: Implications for the Present and the Future)

13 pages, 327 KiB

Open AccessFeature PaperArticle

Applying Methods for Postnatal Growth Assessment in the Clinical Setting: Evaluation in a Longitudinal Cohort of Very Preterm Infants

by Montserrat Izquierdo Renau, Victoria Aldecoa-Bilbao, Carla Balcells Esponera, Beatriz del Rey Hurtado de Mendoza, Martin Iriondo Sanz and Isabel Iglesias-Platas

Nutrients 2019, 11(11), 2772; https://doi.org/10.3390/nu11112772 - 14 Nov 2019

Cited by 21 | Viewed by 3337

Abstract

Aim: To analyze different methods to assess postnatal growth in a cohort of very premature infants (VPI) in a clinical setting and identify potential early markers of growth failure. Methods: Study of growth determinants in VPI (≤32 weeks) during hospital stay. Nutritional intakes [...] Read more.

Aim: To analyze different methods to assess postnatal growth in a cohort of very premature infants (VPI) in a clinical setting and identify potential early markers of growth failure. Methods: Study of growth determinants in VPI (≤32 weeks) during hospital stay. Nutritional intakes and clinical evolution were recorded. Growth velocity (GV: g/kg/day), extrauterine growth restriction (%) (EUGR: weight < 10th centile, z-score < −1.28) and postnatal growth failure (PGF: fall in z-score > 1.34) at 36 weeks postmenstrual age (PMA) were calculated. Associations between growth and clinical or nutritional variables were explored (linear and logistic regression). Results: Sample: 197 VPI. GV in IUGR patients was higher than in non-IUGRs (28 days of life and discharge). At 36 weeks PMA 66.0% of VPIs, including all but one of the IUGR patients, were EUGR. Prevalence of PGF at the same time was 67.4% (IUGR patients: 48.1%; non-IUGRs: 70.5% (p = 0.022)). Variables related to PGF at 36 weeks PMA were initial weight loss (%), need for oxygen and lower parenteral lipids in the first week. Conclusions: The analysis of z-scores was better suited to identify postnatal growth faltering. PGF could be reduced by minimising initial weight loss and assuring adequate nutrition in patients at risk. Full article

(This article belongs to the Special Issue Postnatal Growth and Evaluation of the Nutritional Status of Very Preterm Infants: Implications for the Present and the Future)

Review

Jump to: Research, Other

42 pages, 865 KiB

Open AccessReview

Probiotic Supplementation during the Perinatal and Infant Period: Effects on gut Dysbiosis and Disease

by Elisabet Navarro-Tapia, Giorgia Sebastiani, Sebastian Sailer, Laura Almeida Toledano, Mariona Serra-Delgado, Óscar García-Algar and Vicente Andreu-Fernández

Nutrients 2020, 12(8), 2243; https://doi.org/10.3390/nu12082243 - 27 Jul 2020

Cited by 34 | Viewed by 7922

Abstract

The perinatal period is crucial to the establishment of lifelong gut microbiota. The abundance and composition of microbiota can be altered by several factors such as preterm delivery, formula feeding, infections, antibiotic treatment, and lifestyle during pregnancy. Gut dysbiosis affects the development of [...] Read more.

The perinatal period is crucial to the establishment of lifelong gut microbiota. The abundance and composition of microbiota can be altered by several factors such as preterm delivery, formula feeding, infections, antibiotic treatment, and lifestyle during pregnancy. Gut dysbiosis affects the development of innate and adaptive immune responses and resistance to pathogens, promoting atopic diseases, food sensitization, and infections such as necrotizing enterocolitis (NEC). Recent studies have indicated that the gut microbiota imbalance can be restored after a single or multi-strain probiotic supplementation, especially mixtures of Lactobacillus and Bifidobacterium strains. Following the systematic search methodology, the current review addresses the importance of probiotics as a preventive or therapeutic tool for dysbiosis produced during the perinatal and infant period. We also discuss the safety of the use of probiotics in pregnant women, preterm neonates, or infants for the treatment of atopic diseases and infections. Full article

(This article belongs to the Special Issue Postnatal Growth and Evaluation of the Nutritional Status of Very Preterm Infants: Implications for the Present and the Future)

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Other

Jump to: Research, Review

4 pages, 247 KiB

Open AccessReply

Reply: “It is Time for a Universal Nutrition Policy in Very Preterm Neonates during the Neonatal Period? Comment on: Applying Methods for Postnatal Growth Assessment in the Clinical Setting: Evaluation in a Longitudinal Cohort of Very Preterm Infants Nutrients 2019, 11, 2772”

by Montserrat Izquierdo Renau, Victoria Aldecoa-Bilbao, Carla Balcells Esponera, Beatriz del Rey Hurtado de Mendoza, Martin Iriondo Sanz and Isabel Iglesias-Platas

Nutrients 2020, 12(4), 983; https://doi.org/10.3390/nu12040983 - 02 Apr 2020

Viewed by 2173

Abstract

We would like to thank Gounaris et al [...] Full article

(This article belongs to the Special Issue Postnatal Growth and Evaluation of the Nutritional Status of Very Preterm Infants: Implications for the Present and the Future)

2 pages, 164 KiB

Open AccessComment

It is Time for a Universal Nutrition Policy in Very Preterm Neonates during the Neonatal Period? Comment on: “Applying Methods for Postnatal Growth Assessment in the Clinical Setting: Evaluation in a Longitudinal Cohort of Very Preterm Infants” Nutrients 2019, 11, 2772

by Antonios Gounaris, Rozeta Sokou, Polytimi Panagiotounakou and Ioanna N. Grivea

Nutrients 2020, 12(4), 980; https://doi.org/10.3390/nu12040980 - 02 Apr 2020

Cited by 2 | Viewed by 2081

Abstract

We have read the article entitled “Applying Methods for Postnatal Growth Assessment in the Clinical Setting: Evaluation in a Longitudinal Cohort of Very Preterm infants” by Montserrat Izquierdo Renau et al [...] Full article

(This article belongs to the Special Issue Postnatal Growth and Evaluation of the Nutritional Status of Very Preterm Infants: Implications for the Present and the Future)

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