scholarly journals Plasma Metabolome Alterations Associated with Extrauterine Growth Restriction

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 1188
Author(s):  
Danuta Dudzik ◽  
Isabel Iglesias Platas ◽  
Montserrat Izquierdo Renau ◽  
Carla Balcells Esponera ◽  
Beatriz del Rey Hurtado de Mendoza ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Growth Failure ◽  
Growth Restriction ◽  
Plasma Metabolites ◽  
Very Preterm Infants ◽  
Adverse Health Outcomes ◽  
Plasma Metabolome ◽  
Definition Of ◽  
Extrauterine Growth Restriction ◽  
Gestational Age At Birth

Very preterm infants (VPI, born at or before 32 weeks of gestation) are at risk of adverse health outcomes, from which they might be partially protected with appropriate postnatal nutrition and growth. Metabolic processes or biochemical markers associated to extrauterine growth restriction (EUGR) have not been identified. We applied untargeted metabolomics to plasma samples of VPI with adequate weight for gestational age at birth and with different growth trajectories (29 well-grown, 22 EUGR) at the time of hospital discharge. A multivariate analysis showed significantly higher levels of amino-acids in well-grown patients. Other metabolites were also identified as statistically significant in the comparison between groups. Relevant differences (with corrections for multiple comparison) were found in levels of glycerophospholipids, sphingolipids and other lipids. Levels of many of the biochemical species decreased progressively as the level of growth restriction increased in severity. In conclusion, an untargeted metabolomic approach uncovered previously unknown differences in the levels of a range of plasma metabolites between well grown and EUGR infants at the time of discharge. Our findings open speculation about pathways involved in growth failure in preterm infants and the long-term relevance of this metabolic differences, as well as helping in the definition of potential biomarkers.

“Extrauterine growth restriction” and “postnatal growth failure” are misnomers for preterm infants

2020 ◽  
Vol 40 (5) ◽  
pp. 704-714 ◽  
Author(s):  
Tanis R. Fenton ◽  
Barbara Cormack ◽  
Dena Goldberg ◽  
Roseann Nasser ◽  
Belal Alshaikh ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Growth Failure ◽  
Postnatal Growth ◽  
Growth Restriction ◽  
Extrauterine Growth Restriction ◽  
Postnatal Growth Failure

scholarly journals Nitrogen balance of very preterm infants with extrauterine growth restriction

2019 ◽  
Vol 61 (3) ◽  
pp. 352
Author(s):  
Rong Wu ◽  
Li-hua Li ◽  
Zhao-fang Tian ◽  
Wen-ying Xu ◽  
Jin-hui Hu ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Nitrogen Balance ◽  
Growth Restriction ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Extrauterine Growth Restriction

scholarly journals Digestive enzyme replacement relieves growth failure in preterm infants with poor exocrine pancreatic function: a retrospective case series

2021 ◽  
Author(s):  
Annette Münch ◽  
Christoph Bührer ◽  
Ann Carolin Longardt
Keyword(s):  
Weight Gain ◽  
Preterm Infants ◽  
Digestive Enzyme ◽  
Pancreatic Insufficiency ◽  
Growth Failure ◽  
Exocrine Pancreatic Function ◽  
Exocrine Pancreatic Insufficiency ◽  
Very Preterm Infants ◽  
Enzyme Replacement ◽  
Fecal Pancreatic Elastase

AbstractIn orally fed preterm infants, poor weight gain may be linked to low fecal pancreatic elastase-1 (FPE-1) activity, indicative of exocrine pancreatic insufficiency. The objective of this study was the retrospective assessment of the effect of exogenous digestive enzyme replacement by gavage in preterm infants with growth failure and low FPE-1 (<200 μg/g). We analyzed weight gain relative to baseline and caloric intake during 14-day periods before and after institution of digestive enzyme replacement containing 6000 U lipase and 240 U protease kg−1 d−1. Among 46 of 132 preterm infants < 1250g birth weight surviving to at least 14 days in whom FPE-1 was determined, 38 infants had low FPE-1 (< 200 μg/g), and 33 infants received exogenous digestive enzyme replacement. Average daily weight gain significantly increased from 14.4 [range 2.6–22.4] g kg−1 d−1 to 17.4 [8.4–29.0] g kg−1 d−1 (P = 0.001), as did weight gain per kcal, from 0.08 [0.02–0.13] g kcal−1 d−1 to 0.11 [0.05–0.18] g kcal−1 d−1.Conclusion: In preterm infants with signs and symptoms of exocrine pancreatic insufficiency, exogenous digestive enzyme replacement is associated with improved growth. What is Known:• Very preterm infants on full enteral nutrition may display growth failure linked to transient poor exocrine pancreatic function.• Porcine pancreatic enzymes covered with an acid-resistant coating are too large to pass the internal diameter of most gavage tubes used in very preterm infants.What is New:• Administration of a liquid formulation of acid-resistant microbial digestive enzymes in preterm infants with growth failure and low fecal pancreatic elastase-1 values was associated with improved weight gain.• Response to exogenous digestive enzyme replacement was associated with the prior extent of growth failure.

Aortic growth arrest after preterm birth: a lasting structural change of the vascular tree

2011 ◽  
Vol 2 (4) ◽  
pp. 218-225 ◽  
Author(s):  
U. Schubert ◽  
M. Müller ◽  
A.-K. Edstedt Bonamy ◽  
H. Abdul-Khaliq ◽  
M. Norman
Keyword(s):  
Preterm Birth ◽  
Carotid Artery ◽  
Preterm Infants ◽  
Growth Failure ◽  
Later Life ◽  
Postnatal Growth ◽  
Direct Result ◽  
Arterial Tree ◽  
Very Preterm Infants ◽  
Very Preterm

Young people who are born very preterm exhibit a narrower arterial tree as compared with people born at term. We hypothesized that such arterial narrowing occurs as a direct result of premature birth. The aim of this study was to compare aortic and carotid artery growth in infants born preterm and at term. Observational and longitudinal cohort study of 50 infants (21 born very preterm, all appropriate for gestational age, 29 controls born at term) was conducted. Diameters of the upper abdominal aorta and common carotid artery were measured with ultrasonography at three months before term, at term and three months after term-equivalent age. At the first assessment, the aortic end-diastolic diameter (aEDD) was slightly larger in very preterm infants as compared with fetal dimensions. Fetal aortic EDD increased by 2.6 mm during the third trimester, whereas very preterm infants exhibited 0.9 mm increase in aEDD during the same developmental period (P < 0.001 for group difference). During the following 3-month period, aortic growth continued unchanged (+0.9 mm) in very preterm infants, whereas postnatal growth in term controls slowed down to +1.3 mm (P < 0.001 v. fetal aortic growth). At the final examination, aEDD was 22% and carotid artery EDD was 14% narrower in infants born preterm compared with controls, also after adjusting for current weight (P < 0.01). Aortic and carotid artery growth is impaired after very preterm birth, resulting in arterial narrowing. Arterial growth failure may be a generalized vascular phenomenon after preterm birth, with implications for cardiovascular morbidity in later life.

scholarly journals Extrauterine Growth Restriction: Definitions and Predictability of Outcomes in a Cohort of Very Low Birth Weight Infants or Preterm Neonates

Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1224 ◽  
Author(s):  
Chiara Peila ◽  
Elena Spada ◽  
Francesca Giuliani ◽  
Giulia Maiocco ◽  
Melissa Raia ◽  
...  
Keyword(s):  
Very Low Birth Weight ◽  
Growth Restriction ◽  
Preterm Neonates ◽  
Low Birth Weight Infants ◽  
Term Outcome ◽  
Cross Sectional ◽  
Long Term Outcome ◽  
Nutritional Interventions ◽  
Definition Of ◽  
Extrauterine Growth Restriction

Extrauterine Growth Restriction (EUGR) refers to inadequate growth during hospitalization. Current definitions for EUGR are varied and can be classified as cross-sectional (weight at a given t-time <10th centile) or longitudinal (weight loss between birth and a given t-time >1SD). Different t-times are also considered in literature, such as 36 weeks of gestational age (GA) or age at discharge. The aim of this study is to investigate whether EUGR could predict the auxological outcome at 24–30 months, and to evaluate the agreement between cross-sectional and longitudinal definitions. In total, 1589 infants with GA <30 weeks or birthweight ≤ 1500 g and without major congenital anomalies were included in this study. Cross-sectional and longitudinal EUGR were calculated at 36 and 40 weeks of GA, at discharge, and at 28 days. The concordance between the two definitions was estimated by Kappa coefficient. At 24–30 months, 803 infants were measured again. The agreement between the two definitions of EUGR was low. Both EUGR and not-EUGR groups were at lower centiles for weight, but at higher centiles for head circumference at 24–30 months than at birth. Longitudinal EUGR was associated with a poorer growth outcome for weight and height circumference than cross-sectional EUGR. No differences were observed for length. An agreed definition of EUGR is highly desirable in clinical practice to assess medical and nutritional interventions in preterm neonates. Based on the results of this study, we recommend the use of the longitudinal evaluation, that proved to better predict the auxological long-term outcome with respect to the cross-sectional one.

scholarly journals The effect of smell and taste of milk during tube feeding of preterm infants (the Taste trial): a protocol for a randomised controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e027805 ◽  
Author(s):  
Friederike Beker ◽  
Judith Macey ◽  
Helen Liley ◽  
Ian Hughes ◽  
Peter G Davis ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Late Onset ◽  
Controlled Trial ◽  
Tube Feeding ◽  
Growth Failure ◽  
Neurodevelopmental Outcomes ◽  
Very Preterm Infants ◽  
Reference Number ◽  
Discharge From Hospital

IntroductionSmell and taste of milk are not generally considered when tube feeding preterm infants. Preterm infants have rapid growth, particularly of the brain, and high caloric needs. Enteral feeding is often poorly tolerated which may lead to growth failure and long-term neurodevelopmental impairment. Smell and taste are strong stimulators of digestion and metabolism. We hypothesise that regular smell and taste during tube feeding will improve weight z-scores of very preterm infants at discharge from hospital.Methods and analysisTaste is a randomised, unblinded two-centre trial. Infants born at <29 weeks’ gestation and/or <1250 g at birth and admitted to a participating neonatal intensive care unit are eligible. Randomisation occurs before infants receive two hourly feeds for 24 hours. Infants are randomised to either smell and taste of milk with each tube feed or tube feeding without the provision of smell and taste. The primary outcome is weight z-score at discharge. Secondary outcomes include: days to full enteral feeds, duration of parenteral nutrition, rate of late-onset sepsis, post menstrual age at removal of nasogastric tube and at discharge from hospital, anthropometric data and neurodevelopmental outcomes at 2 years of corrected age.Ethics and disseminationHuman Research Ethics Committees of Mater Misericordiae (trial reference number: HREC/16/MHS/112) and the Royal Women’s Hospital (trial reference number: 17/21) last approved the trial protocol (version 4.2; Date: 18 December 2018) and recruitment commenced in May 2017 and November 2017, respectively. The trial results will be published in a peer-reviewed journal and will be presented at national and international conferences.Trial registration numberACTRN12617000583347.

Extrauterine Growth Restriction in Low Birth Weight Infants

2019 ◽  
Vol 38 (1) ◽  
pp. 27-33 ◽  
Author(s):  
Kari Bonnar ◽  
Debbie Fraser
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Neurodevelopmental Outcome ◽  
Growth Failure ◽  
Postnatal Growth ◽  
Growth Restriction ◽  
Low Birth Weight Infants ◽  
Extrauterine Growth Restriction ◽  
Postnatal Growth Failure

Extrauterine growth restriction (EUGR) affects a significant number of very low birth weight (VLBW) infants and has the potential to impact neurodevelopmental outcome as well as other aspects of long-term health. More aggressive nutritional approaches have reduced the incidence of postnatal growth failure but many questions remain about the expected rate of growth for very preterm infants, the best ways to measure growth velocity, and the optimal approaches to supporting growth. This article examines some of the outstanding issues regarding postnatal growth failure and summarizes current practice recommendations.

Intrauterine Growth Restriction, Head Size at Birth, and Outcome in Very Preterm Infants

2015 ◽  
Vol 167 (5) ◽  
pp. 975-981.e2 ◽  
Author(s):  
Isabelle Guellec ◽  
Stephane Marret ◽  
Olivier Baud ◽  
Gilles Cambonie ◽  
Alexandre Lapillonne ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Intrauterine Growth Restriction ◽  
Growth Restriction ◽  
Head Size ◽  
Very Preterm Infants ◽  
Intrauterine Growth ◽  
Very Preterm ◽  
Size At Birth
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