Feeding preterm infants today for later metabolic and cardiovascular outcomes

Alexandre Lapillonne, Ian J. Griffin

Research output: Contribution to journalArticle

99 Citations (Scopus)

Abstract

Preterm birth continues to contribute disproportionately to neonatal morbidity and subsequent physical and neurodevelopmental disabilities. Epidemiologic studies have described additional long-term health consequences of preterm birth such as an increased risk of hypertension and insulin resistance in adult life. It is not known whether the influence of infant and childhood growth rates and early nutrition on long-term outcomes is the same or different among preterm infants and neonates with intrauterine growth restriction. Our goal is to review the effects of fetal growth, postnatal growth, and early nutrition on long-term cardiovascular and metabolic outcomes in preterm infants. Present evidence suggests that even brief periods of relative undernutrition during a sensitive period of development have significant adverse effects on later development. Our review suggests that growth between birth and expected term and 12-18 months post-term has no significant effect on later blood pressure and metabolic syndrome, whereas reduced growth during hospitalization significantly impacts later neurodevelopment. In contrast, growth during late infancy and childhood appears to be a major determinant of later metabolic and cardiovascular well being, which suggests that nutritional interventions during this period are worthy of more study. Our review also highlights the paucity of well-designed, controlled studies in preterm infants of the effects of nutrition during hospitalization and after discharge on development, the risk of developing hypertension, or insulin resistance.

Original languageEnglish (US)
JournalJournal of Pediatrics
Volume162
Issue number3 SUPPL.
DOIs
StatePublished - 2013

Fingerprint

Premature Infants
Growth
Premature Birth
Insulin Resistance
Hospitalization
Hypertension
Fetal Development
Malnutrition
Epidemiologic Studies
Parturition
Newborn Infant
Blood Pressure
Morbidity
Health

Keywords

  • AGA
  • Appropriate for gestational age
  • Blood pressure
  • BMI
  • Body mass index
  • BP
  • DBP
  • Diastolic blood pressure
  • ELBW
  • EUGR
  • Extrauterine growth restriction
  • Extremely low birth weight
  • HDL
  • High-density lipoprotein
  • HOMA-IR
  • Homeostasis Model of Assessment-Insulin Resistance
  • Intelligence quotient
  • Intrauterine growth restriction
  • IQ
  • IUGR
  • LBW
  • LCPUFA
  • Long-chain polyunsaturated fatty acid
  • Low birth weight
  • SBP
  • SGA
  • Small for gestational age
  • Systolic blood pressure
  • Very low birth weight
  • VLBW

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Feeding preterm infants today for later metabolic and cardiovascular outcomes. / Lapillonne, Alexandre; Griffin, Ian J.

In: Journal of Pediatrics, Vol. 162, No. 3 SUPPL., 2013.

Research output: Contribution to journalArticle

Lapillonne, Alexandre ; Griffin, Ian J. / Feeding preterm infants today for later metabolic and cardiovascular outcomes. In: Journal of Pediatrics. 2013 ; Vol. 162, No. 3 SUPPL.
@article{79fa1b32608d40bb89d891ce5abd10d5,
title = "Feeding preterm infants today for later metabolic and cardiovascular outcomes",
abstract = "Preterm birth continues to contribute disproportionately to neonatal morbidity and subsequent physical and neurodevelopmental disabilities. Epidemiologic studies have described additional long-term health consequences of preterm birth such as an increased risk of hypertension and insulin resistance in adult life. It is not known whether the influence of infant and childhood growth rates and early nutrition on long-term outcomes is the same or different among preterm infants and neonates with intrauterine growth restriction. Our goal is to review the effects of fetal growth, postnatal growth, and early nutrition on long-term cardiovascular and metabolic outcomes in preterm infants. Present evidence suggests that even brief periods of relative undernutrition during a sensitive period of development have significant adverse effects on later development. Our review suggests that growth between birth and expected term and 12-18 months post-term has no significant effect on later blood pressure and metabolic syndrome, whereas reduced growth during hospitalization significantly impacts later neurodevelopment. In contrast, growth during late infancy and childhood appears to be a major determinant of later metabolic and cardiovascular well being, which suggests that nutritional interventions during this period are worthy of more study. Our review also highlights the paucity of well-designed, controlled studies in preterm infants of the effects of nutrition during hospitalization and after discharge on development, the risk of developing hypertension, or insulin resistance.",
keywords = "AGA, Appropriate for gestational age, Blood pressure, BMI, Body mass index, BP, DBP, Diastolic blood pressure, ELBW, EUGR, Extrauterine growth restriction, Extremely low birth weight, HDL, High-density lipoprotein, HOMA-IR, Homeostasis Model of Assessment-Insulin Resistance, Intelligence quotient, Intrauterine growth restriction, IQ, IUGR, LBW, LCPUFA, Long-chain polyunsaturated fatty acid, Low birth weight, SBP, SGA, Small for gestational age, Systolic blood pressure, Very low birth weight, VLBW",
author = "Alexandre Lapillonne and Griffin, {Ian J.}",
year = "2013",
doi = "10.1016/j.jpeds.2012.11.048",
language = "English (US)",
volume = "162",
journal = "Journal of Pediatrics",
issn = "0022-3476",
publisher = "Mosby Inc.",
number = "3 SUPPL.",

}

TY - JOUR

T1 - Feeding preterm infants today for later metabolic and cardiovascular outcomes

AU - Lapillonne, Alexandre

AU - Griffin, Ian J.

PY - 2013

Y1 - 2013

N2 - Preterm birth continues to contribute disproportionately to neonatal morbidity and subsequent physical and neurodevelopmental disabilities. Epidemiologic studies have described additional long-term health consequences of preterm birth such as an increased risk of hypertension and insulin resistance in adult life. It is not known whether the influence of infant and childhood growth rates and early nutrition on long-term outcomes is the same or different among preterm infants and neonates with intrauterine growth restriction. Our goal is to review the effects of fetal growth, postnatal growth, and early nutrition on long-term cardiovascular and metabolic outcomes in preterm infants. Present evidence suggests that even brief periods of relative undernutrition during a sensitive period of development have significant adverse effects on later development. Our review suggests that growth between birth and expected term and 12-18 months post-term has no significant effect on later blood pressure and metabolic syndrome, whereas reduced growth during hospitalization significantly impacts later neurodevelopment. In contrast, growth during late infancy and childhood appears to be a major determinant of later metabolic and cardiovascular well being, which suggests that nutritional interventions during this period are worthy of more study. Our review also highlights the paucity of well-designed, controlled studies in preterm infants of the effects of nutrition during hospitalization and after discharge on development, the risk of developing hypertension, or insulin resistance.

AB - Preterm birth continues to contribute disproportionately to neonatal morbidity and subsequent physical and neurodevelopmental disabilities. Epidemiologic studies have described additional long-term health consequences of preterm birth such as an increased risk of hypertension and insulin resistance in adult life. It is not known whether the influence of infant and childhood growth rates and early nutrition on long-term outcomes is the same or different among preterm infants and neonates with intrauterine growth restriction. Our goal is to review the effects of fetal growth, postnatal growth, and early nutrition on long-term cardiovascular and metabolic outcomes in preterm infants. Present evidence suggests that even brief periods of relative undernutrition during a sensitive period of development have significant adverse effects on later development. Our review suggests that growth between birth and expected term and 12-18 months post-term has no significant effect on later blood pressure and metabolic syndrome, whereas reduced growth during hospitalization significantly impacts later neurodevelopment. In contrast, growth during late infancy and childhood appears to be a major determinant of later metabolic and cardiovascular well being, which suggests that nutritional interventions during this period are worthy of more study. Our review also highlights the paucity of well-designed, controlled studies in preterm infants of the effects of nutrition during hospitalization and after discharge on development, the risk of developing hypertension, or insulin resistance.

KW - AGA

KW - Appropriate for gestational age

KW - Blood pressure

KW - BMI

KW - Body mass index

KW - BP

KW - DBP

KW - Diastolic blood pressure

KW - ELBW

KW - EUGR

KW - Extrauterine growth restriction

KW - Extremely low birth weight

KW - HDL

KW - High-density lipoprotein

KW - HOMA-IR

KW - Homeostasis Model of Assessment-Insulin Resistance

KW - Intelligence quotient

KW - Intrauterine growth restriction

KW - IQ

KW - IUGR

KW - LBW

KW - LCPUFA

KW - Long-chain polyunsaturated fatty acid

KW - Low birth weight

KW - SBP

KW - SGA

KW - Small for gestational age

KW - Systolic blood pressure

KW - Very low birth weight

KW - VLBW

UR - http://www.scopus.com/inward/record.url?scp=84875411793&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84875411793&partnerID=8YFLogxK

U2 - 10.1016/j.jpeds.2012.11.048

DO - 10.1016/j.jpeds.2012.11.048

M3 - Article

VL - 162

JO - Journal of Pediatrics

JF - Journal of Pediatrics

SN - 0022-3476

IS - 3 SUPPL.

ER -