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Effect of early nutritional intake on long-term growth and bone mineralization of former very low birth weight infants.

Authors
  • Christmann, V1
  • van der Putten, M E2
  • Rodwell, L3
  • Steiner, K4
  • Gotthardt, M5
  • van Goudoever, J B6
  • van Heijst, A F J4
  • 1 Department of Pediatrics, Subdivision of Neonatology, Radboudumc Amalia Children's Hospital, Nijmegen, The Netherlands. Electronic address: [email protected] , (Mali)
  • 2 Department of Pediatrics, Subdivision of Neonatology, Radboudumc Amalia Children's Hospital, Nijmegen, The Netherlands; Department of Pediatrics, Subdivision of Neonatology, Maastricht University Medical Centre, Maastricht, The Netherlands. , (Mali)
  • 3 Department for Health Evidence, Radboud Institute for Health Science, Subdivision of Biostatistics, Radboud University Medical Center, Nijmegen, The Netherlands. , (Netherlands)
  • 4 Department of Pediatrics, Subdivision of Neonatology, Radboudumc Amalia Children's Hospital, Nijmegen, The Netherlands. , (Mali)
  • 5 Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. , (Netherlands)
  • 6 Department of Pediatrics, VU University Medical Center Amsterdam, Amsterdam, The Netherlands; Department of Pediatrics, Emma Children's Hospital - AMC Amsterdam, Amsterdam, The Netherlands. , (Netherlands)
Type
Published Article
Journal
Bone
Publication Date
Mar 01, 2018
Volume
108
Pages
89–97
Identifiers
DOI: 10.1016/j.bone.2017.12.022
PMID: 29289790
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Preterm infants are at risk for impaired bone mineralization and growth in length later in life due to inadequate nutritional intake in the early postnatal period. To investigate whether increased nutritional supplementation of calcium, phosphate and protein in Very Low Birth Weight (VLBW) infants during the first 14days after birth was associated with improvement in length and bone development until 9-10years of age. Observational follow-up study of VLBW infants (birth weight<1500g or gestational age<32weeks) born in two consecutive years (eligible infants: 2004 n: 63 and 2005: n: 66). Cohort 2005 received higher intake of calcium, phosphate and protein with parenteral nutrition compared to Cohort 2004. Anthropometric data were collected during standard follow-up visits until five years, and additionally at 9-10years of age including measurements of bone mineral content, bone mineral density of the whole body and lumbar spine determined by dual-energy X-ray absorptiometry. Long-term growth trajectories of both cohorts were evaluated separately for participants born appropriate (AGA) and small for gestational age (SGA), stratified by gender. Multivariate linear regression was used to examine the effect of nutritional intake and clinical covariates on length and bone mineralization. Both cohorts achieved a catch-up in length to SDS within the normal range by 6months (length SDS: estimated mean (95% confidence interval (CI): 6months: Cohort 2004: -0.7 (-1.1, -0.3) Cohort 2005: -0.5 (-0.8, -0.2)). Bone mineral content and density were within the normal range and not different between the cohorts. SGA children achieved a catch-up in length at 5years with bone mineralization comparable to AGA children. Only for girls birth weight was significantly associated with length SDS (per gram: β 0.001; 95% CI (0.000, 0.003); p=0.03) There was no evidence of an association between early nutritional intake and bone mineralization. Children born as appropriate or small for gestational age preterm infants are able to catch up in length after the postnatal period, and achieve a normal length and bone mineralization at age nine-ten years. An improvement of calcium and phosphate intake during the first 14days after birth was not associated with improvement in length and bone development. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

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