Nutrition after preterm birth and adult neurocognitive outcomes
Sammallahti, Sara; Kajantie, Eero; Matinolli, Hanna-Maria; Pyhälä, Riikka; Lahti, Jari; Heinonen, Kati; Lahti, Marius; Pesonen, Anu-Katriina; Eriksson, Johan G.; Hovi, Petteri; Järvenpää, Anna-Liisa; Andersson, Sture; Räikkonen, Katri (2017-09-28)
Sammallahti S, Kajantie E, Matinolli H-M, Pyhälä R, Lahti J, Heinonen K, et al. (2017) Nutrition after preterm birth and adult neurocognitive outcomes. PLoS ONE12(9): e0185632. https://doi.org/10.1371/journal.pone.0185632
© 2017 Sammallahti et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Preterm birth (<37 gestational weeks) poses a risk of poorer neurocognitive functioning. Faster growth after preterm birth predicts better cognitive abilities and can be promoted through adequate nutrition, but it remains unknown whether variations in nutrient intakes translate into long-term benefits for neurodevelopment.
Methods: In 86 participants of the Helsinki Study of Very Low Birth Weight Adults (birthweight <1500g), we examined if higher intakes of energy, macronutrients, and human milk during the first nine weeks after preterm birth predict performance in tests of cognitive ability at 25.1 years of age (SD = 2.1).
Results: 10 kcal/kg/day higher total energy intake at 3 to 6 weeks of age was associated with 0.21 SD higher adult IQ (95% Confidence Interval [CI] 0.07–0.35). Higher carbohydrate and fat intake at 3–6 weeks, and higher energy intake from human milk at 3–6 and at 6–9 weeks were also associated with higher adult IQ: these effect sizes ranged from 0.09 SD (95% CI 0.01–0.18) to 0.34 SD (0.14–0.54) higher IQ, per one gram/kg/day more carbohydrate and fat, and per 10 kcal/kg/day more energy from human milk. Adjustment for neonatal complications attenuated the associations: intraventricular hemorrhage, in particular, was associated with both poorer nutrition and poorer IQ.
Conclusion: In preterm neonates with very low birth weight, higher energy and human milk intake predict better neurocognitive abilities in adulthood. To understand the determinants of these infants’ neurocognitive outcome, it seems important to take into account the role of postnatal nutrition, not just as an isolated exposure, but as a potential mediator between neonatal illness and long-term neurodevelopment.
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