Feeding preterm infants today for later metabolic and cardiovascular outcomes

Alexandre Lapillonne, Ian J. Griffin

Research output: Contribution to journalArticle

110 Scopus citations

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

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

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