Effect of optimization of parenteral nutritional strategy on early brain development in premature infants / 中国新生儿科杂志

ABSTRACT

Objective To study the influence of optimization of parenteral nutrition strategy on the head circumference and brain volume in very low birth weight infants.Method Very low birth weight infants admitted to NICU of University of Hong Kong-Shen Zhen Hospital from January 2014 to June 2016 were assigned to optimized group and conventional group according to early nutritional strategies.Early parenteral nutrition intakes were increased in infants assigned to optimizated group.Nutrition intakes and parenteral nutrition related complications within 28 days after birth were compared between groups.All participants underwent brain MRI at corrected gestational age (CGA) 36 weeks.Head circumference and brain volume measured by MRI were also compared between groups.Result A total of 40 preterm infants were recruited,with 20 infants in each group.There were no significant differences in the gestational age,birth weight,brain injury and intrauterine growth retardation rate between the two groups (P ＞ 0.05).The average daily total calories and protein intake of optimization group during the first 4 weeks were significantly higher than those of conventional group,respectively [(101.5 ± 3.1) kcal/ (kg · d) vs.(96.1 ± 3.2)kcal/(kg·d),(3.07±0.16) g/(kg·d) vs.(2.90±0.11) g/(kg· d),P＜ 0.05].Theaverage daily calorie intake and protein intake of optimization group was increased by 4.7％ and 5.5％,compared with those of conventional group.Compared with the conventional group,head circumference and total brain volume of optimized group at CGA 36 weeks was improved by 3.3％ and 4.1％,and the differences were both statistically significant (P ＜ 0.05).Cerebral cortex gray matter volume of optimized group was significantly higher than that of conventional group [(102.4 ± 4.9) ml vs.(96.4 ± 4.6) ml,P ＜ 0.05].There was no significant difference in brain white matter,deep gray matter and cerebrospinal fluid volume between the two groups (P ＞ 0.05).Conclusion The optimization of parenteral nutrition within the framework of active nutrition strategy of preterm infants can further improve the early nutritional intake of preterm infants,leading to the increase of the head circumference and the gray matter volume of the cerebral cortex.