The effect of early parenteral amino acids on growth and neurodevelopment of very low birth weight infants Original Article

Year 2010, Volume: 45 Issue: 2, 11 - 18, 01.06.2010

Fatma Karakuş Gülcan Türker Ayşe Sevim Gökalp

https://doi.org/10.4274/tpa.45.111

Abstract

Summary Aim: To assess the effect of early parenteral amino acids on growth and neurodevelopment of very low birth weight infants at 36 weeks rsquo; postmenstrual age and 18 months rsquo; corrected age nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; Material and Method: nbsp; Infants who received ge;3 gr kg per day of parenteral amino acids within the first 5 days of life were considered early group; infants who receive lt;3 gr kg per day of parenteral amino acids within the first 5 days of life were considered late group Infants rsquo; weight length and head circumference were measured et 36 weeks rsquo; of postmenstrual age and 18 months rsquo; of corrected age Nerodevelopmental index was evaluated by ldquo;Bayley Scales of Infant Development rdquo; Results: There were no statistically differences between the early and late amino acid groups in baseline characteristics; except birth weight At 36 weeks rsquo; postmenstrual age and 18 months rsquo; corrected age there were no statistically differences in weight length and head circumference between the two groups In the early group female babies had bigger head circumference than male babies at 36 weeks rsquo; postmenstrual age and 18 months rsquo; corrected age There were no other observed differences between boys or girls There were no differences between two groups for neurodevelopmental impairment by Bayley mental and psychomotor developmental index nbsp; Conclusions: On evaluation of head circumferences at 36 weeks rsquo; postmenstrual age and 18 months rsquo; corrected age it is shown that the low birth weight early group catch up with the late group and girls in the early group have bigger head circumference therefore it is suggested that early aminoacid supplementation may have positive effect on growth and neurodevelopmental impact Turk Arch Ped 2010; 45: 111 8 Key words: Premature infant early parenteral amino acid premature growth nbsp; neurodevelopment nbsp;

Keywords

-

Erken aminoasit desteğinin çok düşük doğum ağırlıklı bebeklerin büyüme ve nörolojik gelişimi üzerine etkisi Özgün Araştırma

Abstract

Özet Amaç: Erken aminoasit desteğinin 32 gebelik haftasının altında doğan bebeklerde postmenstrüel 36 hafta ve düzeltilmiş yaşa göre 18 aylarında nörolojik gelişim ve büyüme üzerine etkilerini değerlendirmektir nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; Gereç ve Yöntem: Hayatlarının ilk beş gününde ge;3 gr kg gün parenteral aminoasit alan bebekler erken grubu 3 gr kg gün rsquo;den daha az alanlar geç grubu oluşturdu Ağırlık boy baş çevresi ölçümleri postmenstruel 36 hafta ve düzeltilmiş yaş 18 ayda yapıldı Nörolojik değerlendirmede Bayley gelişim testi uygulandı nbsp; Bulgular: Erken ve geç gruplar arasında doğum ağırlığı arasında fark varken diğer temel belirgin özellikler açısından fark saptanmadı 36 gebelik haftasında ve düzeltilmiş yaşa göre 18 aylarında her iki grup arasında boy baş çevresi ve ağırlık açısından fark saptanmadı Erken grupta kızların 36 hafta ve 18 ayda baş çevre ölçümlerinin daha iyi olduğu görüldü Bayley mental ve psikomotor gelişim indeksi ile nörogelişimsel bozulma yönünden farklılık saptanmadı Çıkarımlar: Erken grupta doğum ağırlığının düşük olmasına rağmen 36 haftada ve 18 ayda geç grup seviyelerini yakalamış olması ve kızlarda daha iyi baş çevresinin elde edilmesinin erken aminoasit desteğinin büyüme ve nörogelişim üzerine olumlu etkisinin olduğunu düşündürmektedir Türk Ped Arş 2010; 45: 111 8 Anahtar sözcükler: Erken doğmuş bebek erken parenteral aminoasit erken doğmuş bebeğin büyümesi sinir sistemi gelişimi nbsp;

Keywords

Erken doğmuş bebek, erken parenteral aminoasit, erken doğmuş bebeğin büyümesi, sinir sistemi gelişimi

References

• Thureen P, Heird WC. Protein and energy requirments of the preterm/low birthweight (LBW) infant. Pediatr Res 2005; 57: 95-8. (PDF)
• Kashyap S, Schulze K, Forsyth M, Dell R, Ramakrishnan R, Heird WC. Growth, nutrient retention, and metabolic responce of low-birth-weight infants fed supplemented and unsupplemented preterm human milk. Am J Clin Nutr 1990; 52: 254-62. (Abstract) / (PDF)
• Kashyap S, Heird WC. Protein requirements of low birthweight, very low birthweight, and small for gestational age infants. Semin Fetal Neonatal Med 2001; 6: 377-82.
• Kashyap S, Schulze K, Forsyth M, et al. Growth, nutrient reten- tion, and metabolic responce in low birth weight infants fed vary- ing intakes of protein and energy. J Pediatr 1988; 113: 713-21. (Abstract) / (PDF)
• Battaglia FC, Lubchenco LO. A practical classification of new- born infants by weight and gestational age. J Pediatr 1967; 71: 159-63. (Abstract)
• Lubchenco LO, Hansman C, Boyd E. Intrauterine growth in lenght and head circumference as estimated from live births at gestational ages from 26 to 42 weeks. Pediatrics 1966; 37: 403-8. (Abstract) / (PDF)
• Fenton TR. A new growth chart for preterm babies: Babson and Benda's chart updated with recent data and a new format. BMC Pediatr 2003;16:3:13. (Abstract) / (Full Text) / (PDF)
• Neyzi O, Binyıldız H, Alp H. Türk çocuklarının persantil büyüme eğrileri. İst Tıp Fak Mecm1978; Suppl 41: 74.
• Vohr BR, Wright LL, Dusick AM, et al. Neurodevelopmental and functional outcomes of extremely low birth weight infants in the National Institute of Child Health and Human Development Neonatal Research Network, 1993-1994. Pediatrics 2000; 105: 1216-26. (Abstract) / (Full Text) / (PDF)
• Öner N. Gelişim Ölçekleri. Türkiye’de Kullanılan Psikolojik Testler, Boğaziçi Üniversitesi 1997; 157-75.
• Meulen Van Der BF, Ruiter SAJ, Lutjes-Spelberg HC, Smrkovsky M. Bayley scales of infant development II, BSID-II- NL. Swets & Zeitlinger Lisse, 2002.
• Sie LT, van der Knaap MS, van Wezel-Meijler G, Taets van Amerongen AH, Lafeber HN, Valk J. Early MR features of hypoxic-ischemic brain injury in neonates with periventricular densities on sonograms. Am J Neuroradiol 2000; 21: 852-61. (Abstract) / (Full Text) / (PDF)
• Heird WC, Hay W, Helms RA, Storm MC, Kashyap S, Dell RB. Pediatric parenteral amino acid mixture in low birth weight infants. Pediatrics 1988; 81: 41-50. (Abstract) / (PDF)
• Thureen PJ, Melara D, Fennessey PV, Hay WW Jr. Effect of low versus high intravenous amino acid intake on very low birth weight infants in the early neonatal period. Pediatr Res 2003; 53: 24-32. (Abstract) / (Full Text) / (PDF)
• Ridout E, Melara D, Rottinghaus S, Thureen PJ. Blood urea nitrogen concentration as a marker of amino-acid intolerance in neonates with birthweight less than 1 250 g. J Perinatol 2005; 25: 130-3. (Abstract) / (Full Text) / (PDF)
• Denne SC, Poindexter BB. Evidence supporting early nutrition- al support with parenteral amino acid infusion. Semin Perinatol 2007; 31: 56-60. (Abstract) / (Full Text) / (PDF)
• Berry MA, Abrahamowicz M, Usher RH. Factors associated with growth of extremely premature infants during initial hospi- talization. Pediatrics 1997; 100: 640-6. (Abstract) / (Full Text) / (PDF)
• Kashyap S. Is the early and aggressive administration of pro- tein to very low birth weight infants safe and efficacious? Curr Opin Pediatr 2008; 20: 132-6. (Abstract)
• Clark RH, Chace DH, Spitzer AR. The Pediatrix Amino Acid Study Group. The effects of two different doses of amino acid administration on growth and blood amino acids in premature neonates admitted to the NICU: a randomized controlled trial. Pediatrics 2007; 120: 1286-96. (Abstract) / (Full Text) / (PDF)
• Blanco CL, Falck A, Green BK, Cornell JE, Gong AK. Metabolic responses to early and high protein supplementation in a ran- domized trial evaluating the prevention of hyperkalemia in extremely low birth weight infants. J Pediatr 2008; 153: 535-40. (Abstract) / (Full Text) / (PDF)
• Kashyap S, Schulze KF, Ramakrishnan R, Dell RB, Heird WC. Evaluation of a mathematical model for predicting the relation- ship between protein and energy intakes of low birth weight infants and the rate and composition of weight gain. Pediatr Res 1994; 35: 704-12. (Abstract) / (PDF)
• Kotsopoulos K, Benadiba-Torch A, Cuddy A, et al. Safety and effi- cacy of early amino acids in preterm 28 weeks gestation: prospec- tive observational comparison. J Perinatol 2006; 26: 749-54. (Abstract) / (Full Text) / (PDF)
• Wilson DC, Cairns P, Halliday HL, Reid M, McClure G, Dodge JA. Randomised controlled trial of an aggressive nutritional regimen in sick very low birthweight infants. Arch Dis Child Fetal Neonatal Ed 1997; 77: 4-11. (Abstract) / (Full Text) / (PDF)
• Dinerstein A, Nieto RM, Solana CL, Perez GP, Otheguy LE, Larguia AM. Early and aggressive nutritional strategy (par- enteral and enteral) decreases postnatal growth failure in very low birth weight infants. J Perinatol 2006; 26: 436-42. (Abstract) / (Full Text) / (PDF)
• Tan MJ, Cooke RW. Improving head growth in very preterm infants - a randomised controlled trial 1; neonatal outcomes. Arch Dis Child Fetal Neonatal Ed 2008; 93: 337-41. (Abstract) / (Full Text) / (PDF)
• Georgieff MK, Hoffman JS, Pereira GR, Bernbaum J, Hoffman- Williamson M. Effect of neonatal caloric deprivation on head growth and 1-year developmental status in preterm infants. J Pediatr 1985; 107: 581-7. (Abstract) / (PDF)
• Vogt RA, Gargus RA, Tucker R, et al. Impact of early postnatal nutrition on growth in extreme low birth weight infants born small for gestational age. Pediatr Res 2004; 55: 444-5.
• Stephens BE, Walden RV, Gargus RA, et al. First-week protein and energy intakes are associated with 18-month develop- mental outcomes in extremely low birth weight infants. Pediatrics 2009; 123: 1337-43. (Abstract) / (Full Text) / (PDF)
• Tan M, Abernethy L, Cooke R. Improving head growth in preterm infants a randomised controlled trial II: MRI and devel- opmental outcomes in the first year. Arch Dis Child Fetal Neonatal Ed 2008; 93: 342-6. (Abstract) / (Full Text) / (PDF)
• Lucas A, Morley R, Cole TJ. Randomised trial of early diet in preterm babies and later intelligence quotient. BMJ 1998; 317: 1481-7. (Abstract) / (Full Text) / (PDF)
• Cooke RJ, Embleton ND, Griffin IJ, Wells JC, McCormick KP. Feeding preterm infants after hospital discharge: growth and development at 18 months of age. Pediatr Res 2001; 49: 719-22. (Abstract) / (PDF)
• Hack M, Breslau N, Weissman B, Aram D, Klein N, Borawski E. Effect of very low birth weight and subnormal head size on cognitive abilities at school age. N Engl J Med 1991; 325: 231-7. (Abstract)
• Yeşinel S, Kavuncuoğlu S. Çok düşük doğum ağırlıklı riskli pre- matürelerin somatik gelişimlerine etki eden faktörler. Uzmanlık tezi, İstanbul 2006.
• Kavuncuoğlu S, Hanedan S, Hatipoğlu N, Ayaz NA, Öztürk S, Öztürk H. Prematüre bebeklerin büyümeyi yakalama özellikleri ve değişik beslenme şekillerinin büyümeye etkileri. Türk Pediatri Arşivi 2001; 36: 26-31. (Abstract)