Higher growth, fat and fat‐free masses correlate with larger cerebellar volumes in preterm infants at term

Paviotti, Giulia; Cunto, Angela De; Zennaro, Floriana; Boz, Giulia; Cont, Gabriele; Bua, Jenny; Demarini, Sergio

doi:10.1111/apa.13829

Cited by 24 publications

(34 citation statements)

References 29 publications

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“…The positive association between lipid intake and brain volumes at 4 weeks of age seen in our study are consistent with the findings of Coviello et al, who demonstrated a significant positive association between cumulative lipid intake in the first 28 days of life and cerebellar, basal ganglia and thalamic volumes 15 . In contrast to these positive findings, studies of average macronutrient intake in preterm infants did not find a significant relationship between lipid intake and total or regional brain volumes at term‐equivalent age 39,40 . This discrepancy between average vs cumulative lipid intake in relation to brain growth warrants further investigation as we continue to explore the ideal lipid intake for optimal brain growth in the preterm population.…”

Section: Discussionsupporting

confidence: 91%

“…15 In contrast to these positive findings, studies of average macronutrient intake in preterm infants did not find a significant relationship between lipid intake and total or regional brain volumes at term-equivalent age. 39,40 This discrepancy between average vs cumulative lipid intake in relation to brain growth warrants further investigation as we continue to explore the ideal lipid intake for optimal brain growth in the preterm population. The positive relationship between lipid intake and cerebellar growth is of extreme interest, as the cerebellum is the most rapidly growing brain structure during the second half of pregnancy, with healthy fetuses experiencing a remarkable 34-fold increase in cerebellar volume that far exceeds the growth of the cerebrum during this time period.…”

Section: Discussionmentioning

confidence: 99%

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Early Lipid Intake Improves Cerebellar Growth in Very Low‐Birth‐Weight Preterm Infants

Ottolini

Andescavage

Kapse

et al. 2020

J Parenter Enteral Nutr

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Background Despite recent advances in nutrition practice in the neonatal intensive care unit, infants remain at high risk for growth restriction following preterm birth. Additionally, optimal values for macronutrient administration, especially lipid intake, have yet to be established for preterm infants in the extrauterine environment. Methods We studied preterm infants born at very low‐birth weight (VLBW, <1500 g) and ≤32 weeks’ gestation. Cumulative macronutrient (carbohydrate, lipid, protein, energy) intake in the first 2 and 4 weeks of life was compared with total and regional brain volumes on magnetic resonance imaging (MRI) obtained at term‐equivalent age. Preterm infants had no structural brain injury on conventional MRI. Results In a cohort of 67 VLBW infants, cumulative lipid intake in the first 2 weeks of life was positively associated with significantly greater cerebellar volume (β = 95.8; P = .01) after adjusting for weight gain, gestational age at birth, and postmenstrual age at MRI. Cumulative lipid (β = 36.1, P = .01) and energy (β = 3.1; P = .02) intake in the first 4 weeks of life were both significantly associated with greater cerebellar volume. No relationship was seen between carbohydrate or protein intake in the first month of life and cerebral volume at term‐equivalent age. Conclusion Early cumulative lipid intake in the first month of life is associated with significantly greater cerebellar volume by term‐equivalent age in very premature infants. Our findings emphasize the importance of early, aggressive nutrition interventions to optimize cerebellar development in VLBW infants.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Early Lipid Intake Improves Cerebellar Growth in Very Low‐Birth‐Weight Preterm Infants

Ottolini

Andescavage

Kapse

et al. 2020

J Parenter Enteral Nutr

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“…while Paviotti et al demonstrated that both fat mass and fat-free mass are related to cerebellar volume at term [7]. Further, consistent with the developmental origin of health and disease (DOHaD) concept, early life body composition is correlated with cardiovascular and metabolic diseases in adulthood [8,9].…”

Section: Introductionmentioning

confidence: 88%

Fat and Fat-Free Mass of Preterm and Term Infants from Birth to Six Months: A Review of Current Evidence

Hamatschek¹,

Yousuf

Möllers³

et al. 2020

Nutrients

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To optimize infant nutrition, the nature of weight gain must be analyzed. This study aims to review publications and develop growth charts for fat and fat-free mass for preterm and term infants. Body composition data measured by air displacement plethysmography (ADP) and dual energy X-ray absorptiometry (DXA) in preterm and term infants until six months corrected age were abstracted from publications (31 December 1990 to 30 April 2019). Age-specific percentiles were calculated. ADP measurements were used in 110 studies (2855 preterm and 22,410 term infants), and DXA was used in 28 studies (1147 preterm and 3542 term infants). At term age, preterm infants had higher percent-fat than term-born infants (16% vs. 11%, p < 0.001). At 52 weeks postmenstrual age (PMA), both reached similar percent-fat (24% vs. 25%). In contrast, at term age, preterm infants had less fat-free mass (2500 g vs. 2900 g) by 400 g. This difference decreased to 250 g by 52 weeks, and to 100 g at 60 weeks PMA (5000 g vs. 5100 g). DXA fat-free mass data were comparable with ADP. However, median percent-fat was up to 5% higher with DXA measurements compared with ADP with PMA > 50 weeks. There are methodological differences between ADP and DXA measures for infants with higher fat mass. The cause of higher fat mass in preterm infants at term age needs further investigation.

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“…The relationship illustrated in Figure of %fat mass and the deviation between predicted and target weight support the validity of the GVA. In contrast to the results achieved by the 2 other approaches, the GVA provides reasonable values of average %fat mass at the target weight, based on what has been shown in literature to correspond to appropriate neurodevelopment . Further, it was shown that the data points are centered and evenly distributed (similar proportion of infants with low and high %fat mass) around ΔW = 0.…”

Section: Discussionmentioning

confidence: 58%

Individualized Postnatal Growth Trajectories for Preterm Infants

Landau-Crangle

Rochow

Fenton

et al. 2018

J Parenter Enteral Nutr

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GVA provides an evidence-based approach for individualized growth trajectories. GVA is based on physiologic data and that healthy preterm infants adjust their postnatal trajectory below their birth percentile. GVA may reflect a biologic principle because it matches consistently with WHOGS at 42+0/7 weeks for all preterm infants from 24 to 34 weeks. This concept could become a bedside tool to aid clinicians in monitoring growth, guiding nutrition, and minimizing chronic adult disease risks as a consequence of unguided, inappropriate growth.

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Higher growth, fat and fat‐free masses correlate with larger cerebellar volumes in preterm infants at term

Abstract: Higher growth, higher fat mass and fat-free mass were associated with larger cerebellar volumes in VLBW infants at term.

Cited by 24 publications

References 29 publications

Early Lipid Intake Improves Cerebellar Growth in Very Low‐Birth‐Weight Preterm Infants

Early Lipid Intake Improves Cerebellar Growth in Very Low‐Birth‐Weight Preterm Infants

Fat and Fat-Free Mass of Preterm and Term Infants from Birth to Six Months: A Review of Current Evidence

Individualized Postnatal Growth Trajectories for Preterm Infants

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