(P27-053-25) Early Nutritional Intake and Postnatal Brain Growth in Very Preterm Infants

Objectives: To identify early nutritional practices in the first two postnatal weeks associated with brain growth measurements on head ultrasound (HUS) at one month of age in very preterm infants.

Methods: We conducted a retrospective cohort study of infants born < 32 weeks gestational age (GA), excluding those with major congenital anomalies, grade 3 or 4 intraventricular hemorrhage, or mortality before one month of age. Daily caloric, protein, and lipid intake from day of life (DOL) 0 to 14 were collected. Brain structures were measured on HUS at one week and one month of age by two independent, blinded reviewers, and their mean values were used. Inter-rater reliability was 87%. Weight, length, and head circumference (HC) growth were calculated using difference in z-score at birth and one month of life. The relationship between nutritional intake and growth velocity of brain structures, as well as anthropometric measures, was analyzed using Pearson’s correlation coefficient. Multivariate regression adjusted for GA, sex, and small for gestational age (SGA) status.

Results: We included 57 patients, with mean GA 29.2 weeks (SD 2.1) and birthweight 1223g (SD 325). There was a positive correlation between enteral caloric intake and growth of biparietal diameter (BPD) (r = 0.155) and corpus callosum (CC) length (r = 0.200), with a contrasting negative correlation between parenteral caloric intake and BPD (r = -0.116) and CC length (r = -0.271, p < 0.05). Similarly, growth of BPD, CC length, and vermis height was positively correlated to enteral protein intake (r = 0.193, r = 0.155, r = 0.066, respectively) and negatively correlated to parenteral protein intake (r = -0.127, r = -0.178, r = -0.181). Growth of BPD, CC length, and vermis height was positively related to enteral lipid intake (r = 0.107, r = 0.253, r = 0.098) and negatively related to parenteral lipid intake (r = -0.081, r = -0.210, r = -0.144). Greater enteral nutrition was also associated with increased HC, length, and weight gain. Results were not significantly altered when adjusted for GA, sex, and SGA status.

Conclusions: In very preterm infants, greater early enteral caloric, protein, and lipid intake is related to brain growth. Conversely, higher macronutrient intake from parenteral nutrition may have an opposing impact, suggesting the preferential importance of early enteral nutrition on brain development.

Funding Sources: N/A