Early Lipid Intake Improves Cerebellar Growth in Very Low Birth Weight Preterm Infants.

BACKGROUND: Despite recent advances in nutritional practice in the neonatal intensive care unit (NICU), infants remain at high risk for growth restriction following preterm birth. Additionally, optimal values for macronutrient administration, especially lipid intake, have yet to be established for preterm infants in the extrauterine environment. METHODS: We studied preterm infants born at very low birth weight (VLBW, <1500g) and ≤ 32 weeks gestation. Cumulative macronutrient (carbohydrate, lipid, protein, energy) intake in the first two and four weeks of life was compared to total and regional brain volumes on MRI obtained at term-equivalent age. Preterm infants had no structural brain injury on conventional MRI. RESULTS: In a cohort of 67 VLBW infants, cumulative lipid intake in the first two weeks of life was positively associated with significantly greater cerebellar volume (β = 95.8, p = 0.01) after adjusting for weight gain, gestational age at birth, and postmenstrual age at MRI. Cumulative lipid (β = 36.1, p = 0.01) and energy (β = 3.1, p = 0.02) intake in the first four weeks of life were both significantly associated with greater cerebellar volume. No relationship was seen between carbohydrate or protein intake in the first month of life and cerebral volume at term-equivalent age. CONCLUSION: Early cumulative lipid intake in the first month of life is associated with significantly greater cerebellar volume by term-equivalent age in very premature infants. Our findings emphasize the importance of early, aggressive nutritional interventions to optimize cerebellar development in VLBW infants. This article is protected by copyright. All rights reserved.