Randomized Trial of Early Enhanced Parenteral Nutrition and Later Neurodevelopment in Preterm Infants

Erin E. Morris, Neely C. Miller, Nicholas A. Marka, Jennifer L. Super, Emily M. Nagel, Juan David Gonzalez, Ellen W. Demerath, Sara E. Ramel

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Retrospective studies indicate that the parenteral provision of calories, proteins, and lipids in the first week of life is associated with improved later neurodevelopment. We aimed to determine whether infants randomized to an enhanced parenteral nutrition protocol had improved developmental outcomes at 4, 12, or 24 months corrected age (CA). In total, 90 preterm infants (<32 weeks gestational age and <1500 g) were randomized to receive enhanced parenteral nutrition (PN) or standard PN during the first week of life. The enhanced group received a higher glucose infusion rate and intralipids. Neurodevelopmental outcomes included pattern-reversal visually evoked potentials (VEP) at 4 months CA (n = 33) and the Bayley Scales of Infant Development (BSID) at 12 (n = 46) and 24 (n = 29) months CA. P100 latency was longer in the intervention group, indicating slower processing speed (145 vs. 178 ms, p = 0.01). This association did not hold in multivariable analysis adjusting for potentially confounding variables. BSID scores were not associated with enhanced PN. Higher enteral energy and protein intake regardless of randomization group were associated with faster processing speed at 4 months CA (p ≤ 0.02 for both). Enhanced early PN was not associated with improved neurodevelopment; however, first-week enteral caloric and protein intake were associated with improved speed of processing.

Original languageEnglish (US)
Article number3890
JournalNutrients
Volume14
Issue number19
DOIs
StatePublished - Oct 2022

Bibliographical note

Funding Information:
This project was funded by the University of Minnesota Department of Pediatrics’ R Award. EMN was supported by NIH/NIDDK grant T32DK083250.

Publisher Copyright:
© 2022 by the authors.

Keywords

  • enhanced nutrition
  • enteral nutrition
  • neurodevelopment
  • parenteral nutrition
  • prematurity
  • Humans
  • Infant
  • Lipids
  • Glucose
  • Infant, Premature
  • Parenteral Nutrition/methods
  • Retrospective Studies
  • Child
  • Infant, Newborn

PubMed: MeSH publication types

  • Randomized Controlled Trial
  • Journal Article

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