Two‐Year Follow‐up of a Randomized Controlled Nutrition Intervention Trial in Very Low‐Birth‐Weight Infants. Issue 1 (11th December 2017)

• Record Type: Journal Article
• Authors: Roelants, Jorine A.; Vlaardingerbroek, Hester; van den Akker, Chris H. P.; de Jonge, Rogier C. J.; van Goudoever, Johannes B.; Vermeulen, Marijn J.
• Is Part Of: JPEN, Journal of parenteral and enteral nutrition. Volume 42:Issue 1(2018)
• Page Start: 122
• Page End: 131
• Publication Date: 2017-12-11
• Subjects: life cycle -- lipids -- neonates -- parenteral nutrition -- proteins; Parenteral feeding -- Periodicals; Enteral feeding -- Periodicals; 615.85484
• DOI: 10.1177/0148607116678196
• Languages: English
• ISSNs: 0148-6071

Abstract

Abstract: Background : Very low‐birth‐weight (VLBW) infants are at risk for neurodevelopment impairment. This study assessed the effect of early aggressive parenteral nutrition (PN) on long‐term outcome in VLBW infants. Materials and Methods : Directly after birth, VLBW infants (birth weight <1500 g, n = 142) were randomized to 5 different PN regimes. Controls (n = 46) received glucose and standard‐dose amino acids (AAs; 2.4 g/[kg·d]) from birth onward and pure soybean oil fat emulsion (SOY) on the second day of life. Two intervention groups received glucose, standard‐dose AAs, and lipids from birth onward: SOY (n = 24) or mixed fat emulsion (MIX, n = 25). The 2 other intervention groups received glucose, high‐dose AAs (3.6 g/[kg·d]), and lipids from birth onward: SOY (n = 24) or MIX (n = 23). The primary outcome of this follow‐up study was the composite outcome of "death or major disability" at 2 years corrected age. Secondary outcomes were death, major disabilities, neurodevelopmental scores, and anthropometry. Results : Follow‐up rate was 92% (n = 134). Thirty‐five (26%) infants had died or had a major disability, with no differences between intervention groups and controls. Increased odds for death were observed in the standard‐dose AA‐MIX group (odds ratio, 5.4; 95% confidence interval [CI], 1.1–27.0). Neurodevelopmental scores and incidence of major disabilities did not differ between groups. Growth in the high‐dose AA‐MIX group was enhanced compared with growth in controls at 2 years corrected age (+0.51 [0.01–1.02] weight SDS). Conclusion : This randomized controlled hypothesis‐generating study demonstrated no beneficial effect of early high‐dose AA administration and mixed fat emulsions on survival and neurodevelopmental outcome in VLBW infants, although growth was enhanced.