The purpose of this study was to see if a novel nutrition strategy aimed to boost early protein intakes while decreasing fluid volume in extremely preterm infants was linked with altered neurodevelopment and growth later in life. A retrospective, observational cohort analysis of children born at 30 weeks’ gestation or 1500 g who were admitted to the newborn unit at the National Women’s Hospital in Auckland, New Zealand, before and after a change in feeding protocol. At 7 years, the primary outcome was neurodevelopmental disability. Using generalised linear regression, adjusted for sex and birth weight z score, outcomes were compared across groups and for the entire cohort. 128 of the 201 eligible youngsters were evaluated. In postnatal days 1 to 7, children who followed the new regimen received more protein, less calories, and less carbohydrate. At 7 years, neurodevelopmental impairment was comparable, as was the prevalence of cerebral palsy. Growth and body composition were likewise comparable between groups. A 1 g/kg increase in parenteral protein consumption from postnatal days 1 to 7 was related with a 27% higher risk of cerebral palsy.
At 7 years, higher early protein consumption has little effect on overall rates of neurodevelopmental impairment or growth. More study is required to establish the impact of increased early parenteral protein consumption on motor development.
