The association between restricted intra-uterine growth and inadequate postnatal nutrition in very-low-birth-weight infants and their neurodevelopmental outcomes: a 50-month follow-up study

• Published in: British journal of nutrition 2022-02, Vol.127 (4), p.580-588
• Main Authors: Uberos, Jose, Jimenez-Montilla, Sara, Machado-Casas, Irene, Laynez-Rubio, Carolina, Fernández-Marin, Elizabeth, Campos-Martínez, Ana
• Format: Article
• Language: English
• Subjects: Birth Weight; Carbohydrates; Cerebral Palsy; Cognitive ability; Critical period; Energy; Enteral nutrition; Fetal Growth Retardation; Fetuses; Follow-Up Studies; Gestational age; Human and Clinical Nutrition; Humans; Infant; Infant, Newborn; Infant, Very Low Birth Weight; Infants; Intensive care; Lipids; Longitudinal Studies; Low birth weight; Lung diseases; Neonates; Neurodevelopment; Newborn babies; Nutrition; Paralysis; Parenteral nutrition; Proteins; Uterus
• ISSN: 0007-1145; 1475-2662
• DOI: 10.1017/S000711452100132X

Inadequate nutrition during a critical period of development – as is the case during gestation and the first days of life, especially in very-low-birth-weight (VLBW) infants, can impact on neurodevelopment and favour co-morbidities. In this study, we evaluate how neurodevelopment may be affected by intra-uterine growth (IUGR) restriction and by an inadequate intake of nutritional energy during the early neonatal period. A longitudinal cohort study was conducted to analyse the nutritional contributions received during the first week of life, among a population of 396 VLBW infants. Motor, cognitive, sensory and behavioural development was assessed at 14, 25, 33 and 50 months. The association between IUGR, postnatal energy restriction and neurodevelopment was examined using multivariate logistic regression techniques. Mild cognitive delay was observed in 35·6 % of neonates with IUGR and in 24 % of those with appropriate birth weight. IUGR is associated with behavioural disorder (OR 2·60; 95 % CI 1·25, 5·40) and delayed cognitive development (OR 2·64; 95 % CI 1·34, 5·20). Energy restriction during the first week of life is associated with visual deficiency (OR 2·96; 95 % CI 1·26, 6·84) and cerebral palsy (OR 3·05; CI 95 % 1·00, 9·54). In VLBW infants, IUGR is associated with behavioural disorder, while postnatal energy restriction is significantly associated with motor disorder, infantile cerebral palsy and sensory disorder.