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Nutritional Requirements and Parenteral Nutrition in Preterm Infants

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Pediatric Nutrition".

Deadline for manuscript submissions: closed (25 October 2023) | Viewed by 2234

Special Issue Editors

Department of Neonatology, Liverpool Women’s Hospital, Liverpool L8 7SS, UK
Interests: neonatal nutrition and metabolism
Special Issues, Collections and Topics in MDPI journals
Director of the Liggins Institute and Professor of Neonatology, University of Auckland, Auckland 1142, New Zealand
Interests: neonatal nutrition and growth; fetal nutrition, growth and development; early-life influences on later non-communicable disease; maternal nutrition; fetal and newborn growth restriction

Special Issue Information

Dear Colleagues,

Neonatal parenteral nutrition has been in routine clinical use in preterm infants for more than 40 years and yet the field remains highly controversial. The initiation, targets and formulations for both macronutrients and micronutrients continue to provoke debate. This is reflected in variations in clinical practice which persist despite the move to more standardization and quality improvement in neonatal services. The PN-dependent period coincides with early postnatal metabolic and immune adaptation. The role of optimal parenteral immunonutrition while minimizing metabolic disturbance is a field of growing importance. Similarly, postoperative preterm parenteral nutrition after necrotizing enterocolitis provides even greater research complexity particularly in those infants facing the clinical challenge of long-term parenteral nutrition. Finally, there are the lifelong benefits and risks of preterm parenteral nutrition: brain growth and neurodevelopment versus adult cardiovascular and metabolic disease. This issue will tackle some of these research questions using the latest methodologies and clinical strategies.

Prof. Dr. Colin Morgan
Prof. Dr. Frank H. Bloomfield
Guest Editors

Manuscript Submission Information

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Keywords

  • preterm
  • parenteral nutrition
  • metabolism
  • amino acids
  • lipids
  • glucose
  • growth
  • necrotizing enterocolitis
  • neurodevelopment

Published Papers (2 papers)

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Research

14 pages, 977 KiB  
Article
Neurodevelopmental Outcome in Very Preterm Infants Randomised to Receive Two Different Standardised, Concentrated Parenteral Nutrition Regimens
by Colin Morgan, Samantha Parry, Julie Park and Maw Tan
Nutrients 2023, 15(22), 4741; https://doi.org/10.3390/nu15224741 - 10 Nov 2023
Viewed by 847
Abstract
We have previously shown that increasing parenteral protein (target: 3.8 versus 2.8 g/kg/d) and energy (12% versus 10% glucose; 3.8 versus 2.8 g/kg/d) intake using a Standardised, Concentrated with Added Macronutrients Parenteral (SCAMP) nutrition regimen ameliorates early head growth failure in very-preterm infants [...] Read more.
We have previously shown that increasing parenteral protein (target: 3.8 versus 2.8 g/kg/d) and energy (12% versus 10% glucose; 3.8 versus 2.8 g/kg/d) intake using a Standardised, Concentrated with Added Macronutrients Parenteral (SCAMP) nutrition regimen ameliorates early head growth failure in very-preterm infants (VPIs). We hypothesised that the SCAMP nutrition regimen would also improve neurodevelopmental outcome. The original double-blind randomised, controlled study (ISRCTN: 76597892) received ethical approval. VPIs were randomised to either start SCAMP or remain on the control regimen. The consent process included neurodevelopmental assessments (Bayley III), all of which were performed (blinded) at 2–3.5 years of corrected gestational age. Bayley III assessments were performed for 38/60 SCAMP survivors and 41/63 control survivors at means of (sd) 29.2 (3.7) and 20.0 (3.9) months, respectively. Motor, cognitive, language, and combined scores were all higher in the SCAMP intervention group, but none of the differences were statistically significant. Nutrient intake and biochemical monitoring data confirmed that protein/energy ratios were maintained in the SCAMP intervention group without increasing the incidence of hyperglycaemia, insulin treatment, or the derangement of plasma mineral/electrolyte levels. This study did not show a statistically significant improvement in neurodevelopmental outcome when administering higher parenteral protein/energy intakes despite optimal energy and mineral intakes. Full article
(This article belongs to the Special Issue Nutritional Requirements and Parenteral Nutrition in Preterm Infants)
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11 pages, 898 KiB  
Article
The Association of Human Milk Proportion with the Clinical Outcomes of Necrotizing Enterocolitis in Preterm Infants: A Retrospective Study
by Keqin Liu, Jinjin Guo, Jixin Yang and Yanwei Su
Nutrients 2023, 15(17), 3796; https://doi.org/10.3390/nu15173796 - 30 Aug 2023
Cited by 1 | Viewed by 1047
Abstract
Human milk (HM) has been associated with a lower risk of necrotizing enterocolitis (NEC). However, the association of precise HM proportion with the outcome of NEC remains unclear. A total of 77 cases and 154 matched controls were included in this study. The [...] Read more.
Human milk (HM) has been associated with a lower risk of necrotizing enterocolitis (NEC). However, the association of precise HM proportion with the outcome of NEC remains unclear. A total of 77 cases and 154 matched controls were included in this study. The samples were divided into three groups based on the HM proportion of the total enteral intake before NEC onset: ≥70% (HHM), <70% (LHM), and 0% (NHM). The study cohort did not show a significant association between different HM proportions and NEC risk. The adjusted odds ratio (OR) for the highest versus the lowest intake was 0.599. In the prognosis of NEC, different HM proportions significantly affected weight gain, the timing of NEC onset, diagnosis time, hospitalization cost, and the severity of NEC (p < 0.05). Our findings support the beneficial effects of HM on reducing NEC in preterm infants, particularly when a greater proportion of HM of the total enteral intake is included in their feeding. Additionally, the study indicates that preterm infants fed with lower proportions of HM of the total enteral feeding are more prone to experiencing severe cases of NEC. Full article
(This article belongs to the Special Issue Nutritional Requirements and Parenteral Nutrition in Preterm Infants)
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