Early protein intake predicts functional connectivity and neurocognition in preterm born children

Abstract

Nutritional intake can promote early neonatal brain development in very preterm born neonates (< 32 weeks’ gestation). In a group of 7-year-old very preterm born children followed since birth, we examined whether early nutrient intake in the first weeks of life would be associated with long-term brain function and neurocognitive skills at school age. Children underwent resting-state functional MRI (fMRI), intelligence testing (Wechsler Intelligence Scale for Children, 5th Ed) and visual-motor processing (Beery-Buktenica, 5th Ed) at 7 years. Relationships were assessed between neonatal macronutrient intakes, functional connectivity strength between thalamic and default mode networks (DMN), and neuro-cognitive function using multivariable regression. Greater functional connectivity strength between thalamic networks and DMN was associated with greater intake of protein in the first week (β = 0.17; 95% CI 0.11, 0.23, p < 0.001) but lower intakes of fat (β = − 0.06; 95% CI − 0.09, − 0.02, p = 0.001) and carbohydrates (β = − 0.03; 95% CI − 0.04, − 0.01, p = 0.003). Connectivity strength was also associated with protein intake during the first month (β = 0.22; 95% CI 0.06, 0.37, p = 0.006). Importantly, greater thalamic-DMN connectivity strength was associated with higher processing speed indices (β = 26.9; 95% CI 4.21, 49.49, p = 0.02) and visual processing scores (β = 9.03; 95% CI 2.27, 15.79, p = 0.009). Optimizing early protein intake may contribute to promoting long-term brain health in preterm-born children.

Optimizing Early Neonatal Nutrition and Dietary Pattern in Premature Infants

“…However, according to randomized controlled trials, its long-term benefit for metabolism and neurological development is still unclear [ 39 , 40 , 41 , 42 ]. Nevertheless, data on associations between higher nutrient intake and improved growth suggest that parenteral nutrition in the first postnatal weeks is likely to improve cognitive outcomes [ 5 , 42 , 43 ].…”

Premature Birth, Management, Complications

“…Bacterial products and/or profibrous cytokines acting on cervical cells of the uterus may cause a change of MMPs expression. High concentrations MMP-8 of amniotic fluid are associated with PB (before the 32nd week of pregnancy) so induction of uterine contractions (directly or by functional "withdrawal" of progesterone) [50][51][52][53][54][55][56][57][58][59][60].…”

“…The receptor antagonist of IL-1 inhibits the biological effects of IL-1, blocking its receptors. Consequently reduction of IL-1 production and induced from that of prostaglandin production by them endometrial tissue can prevent PB associated with infection Il-1β is found in chorionic villi, decidua, amniotic fluid and placental cultures [50][51][52][53][54][55][56][57][58][59][60]. Elevated levels of Il-6 are usually found in the amniotic fluid, with inflammation.…”

“…The finding of extremelly high levels of the specific cytokine in the amniotic fluid pregnant women who presented with some kind of inflammation and its very low concentration in cases of PB "idiopathic" etiology, make it one of the most sensitive and specific PB indicators On the contrary, they were found to be reduced in cases of premature birth. Il-10 is also elevated in amniotic fluid after amniocentesis during the second trimester in pregnancies with IUGR and chorioamnionitis [50][51][52][53][54][55][56][57][58][59][60]. Interleukin-10 (IL-10) is known to be major inhibitory cytokine in the process synthesis of cytokines by both T cells (interferon-γ and IL-2), as well as by monocytes macrophages (TNF-α, IL-6, IL-8, and IL-12) and as therefore plays an important role in achieving the outcome of the pregnancy by securing the maternity tolerance to the allogeneic fetus.…”

“…Interleukin-10 (IL-10) is known to be major inhibitory cytokine in the process synthesis of cytokines by both T cells (interferon-γ and IL-2), as well as by monocytes macrophages (TNF-α, IL-6, IL-8, and IL-12) and as therefore plays an important role in achieving the outcome of the pregnancy by securing the maternity tolerance to the allogeneic fetus. In most pregnancies IL-10 is detected in amniotic fluid Its high levels in amniotic fluid of pregnancies complicated with residual embryonic development as well as in cases of pregnant women with clinical symptoms chorioamnionitis associated with dysfunctional for immune activity in pregnancy and in PB [50][51][52][53][54][55][56][57][58][59][60].…”