Body composition after implementation of an enhanced parenteral nutrition protocol in the neonatal intensive care unit: a randomised pilot trial

Abstract

Background

Very low birthweight (VLBW) infants are at risk for growth failure and poor neurodevelopment. Optimised parenteral nutrition may help promote optimal growth and development, but concerns that provision of enhanced nutrition may contribute to increased early adiposity and later metabolic disease remain.

Aim

To determine associations between provision of an early enhanced parenteral nutrition protocol or standard parenteral nutrition protocol and growth and body composition for VLBW preterm infants in the neonatal intensive care unit.

Subjects

This is a secondary analysis of data from a clinical trial aimed at assessing the feasibility and safety of randomising VLBW preterm infants to Standard (n = 45) or Intervention (n = 42) parenteral nutrition groups between August 2017 and June 2019.

Methods

We evaluated associations between weekly infant growth and body composition measurements from n = 55 infants (Standard = 29, Intervention = 26) that were clinically stable enough to have body composition measurements taken before discharge using mixed effects linear regression models.

Result

No statistically significant associations between nutrition group and infant growth or body composition measures were observed (p >.05).

Conclusion

In this pilot trial, enhanced parenteral nutrition in the first week of life was not associated with significant differences in infant growth or body composition during hospitalisation.

Keywords:

• Prematurity
• enhanced nutrition
• parenteral nutrition

Acknowledgements

We thank Juan David Gonzalez V, Jensina Ericksen, Jenna Wassenaar, and Neely Miller for their assistance with this study. We are also grateful to the participants and their parents for taking part in this study.

Disclosure statement

The authors have no relevant conflicts of interest to disclose. This article was submitted to the Human Growth & Development section of Annals of Human Biology (AHB) for which one of the authors is the Section Editor. This Section Editor reclused themselves from handling this article and it was assigned to another AHB Editor for independent and anonymous peer-review. In no way was this author involved in the editorial process for this article.

Data availability statement

Deidentified data used in this manuscript are available upon request.

Additional information

Funding

This project was supported by the University of Minnesota Department of Paediatrics “R Award” and Grant Number UL1TR002494 from the National Institutes of Health’s National Centre for Advancing Translational Sciences. EMN was supported by NIH/NIDDK grant T32DK083250 and NIH/NICHD grant K99HD108276. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This work was supported by Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institute of Diabetes and Digestive and Kidney Diseases.