Optimal nutrient intake ensuring better neurodevelopment for very low birth weight (VLBW) infants remains unknown. The aim of this study was to assess the relationship between early (first 28 days) nutritional intake, first year growth, and neurodevelopment. In total, 120 VLBW infants were included into the study. A group of 95 infants completed follow-up to 12 months of corrected gestational age (CGA). Nutrient intake was assessed, and weight, length, and head circumference (HC) were measured weekly until discharge and at 3, 6, 9, and 12 months of CGA. Neurodevelopment was assessed at 12 months of CGA. Two groups—extremely preterm (EP) and very/moderately preterm (VP)—were compared. Growth before discharge was slower in the EP group than the VP group. At 12 months, there was no difference in anthropometric characteristics or neurodevelopmental scores between the groups. Higher carbohydrate intake during the first 28 days was the single significant predictor for better cognitive scores only in the EP group (βs = 0.60, p = 0.017). Other nutrients and growth before discharge were not significant for cognitive and motor scores in either group in multivariable models, whereas post-discharge HC growth was associated with both cognitive and motor scores in the VP group. Monitoring intake of all nutrients and both pre-discharge and post-discharge growth is essential for gaining knowledge about individualized nutrition for optimal neurodevelopment.

Background and Objectives: In very low birth weight (VLBW) newborns, parenteral nutrition (PN) is delivered via a peripheral venous catheter (PVC), a central venous catheter (CVC), or a peripherally inserted central venous catheter (PICC). Up to 45% of PICCs are accompanied by complications, the most common being sepsis. A PVC is an unstable PN delivery technique requiring frequent change. The growth and neurodevelopment of VLBW newborns may be disturbed because of catheters used for early PN delivery and complications thereof. The aim of the conducted study was to evaluate the effect of two PN delivery techniques (PICC and PVC) on anthropometric parameters and neurodevelopment of VLBW newborns. Materials and Methods: A prospective randomized clinical trial was conducted in VLBW (≥750–<1500 g) newborns that met the inclusion criteria and were randomized into two groups: PICC and PVC. We assessed short-term outcomes (i.e., anthropometric parameters from birth until corrected age (CA) 36 weeks) and long-term outcomes (i.e., anthropometric parameters from CA 3 months to 12 months as well as neurodevelopment at CA 12 months according to the Bayley II scale). Results: In total, 108 newborns (57 in the PICC group and 51 in the PVC group) were randomized. Short-term outcomes were assessed in 47 and 38 subjects, and long-term outcomes and neurodevelopment were assessed in 38 and 33 subjects of PICC and PVC groups, respectively. There were no differences observed in anthropometric parameters between the subjects of the two groups in the short- and long-term. Mental development index (MDI) < 85 was observed in 26.3% and 21.2% (p = 0.781), and psychomotor development index (PDI) < 85 was observed in 39.5% and 54.5% (p = 0.239) of PICC and PVC subjects, respectively. Conclusions: In the short- and long-term, no differences were observed in the anthropometric parameters of newborns in both groups. At CA 12 months, there was no difference in neurodevelopment in both groups.

Straipsnyje aprašomas VACTERL asociacijos klinikinis atvejis ir išsami literatūros apžvalga. VACTERL asociacija – tai daugybinių vaisiaus raidos ydų kompleksas, pasitaikantis atsitiktinai, kai nėra vienos aiškios minėtą patologiją lemiančios priežasties. VACTERL akronimas apima tam tikrų organų sistemų vystymosi defektus: stuburo, širdies ir kraujagyslių sistemos, virškinamojo trakto (analinės angos atrezija, stemplės atrezija), trachėjos ir stemplės fistulę, inkstų ir galūnių vystymosi ydas (ypač stipinkaulio). Diagnostikai svarbus išsamus ultragarsinis tyrimas nėštumo metu. Diagnozė yra klinikinė, apimanti bent tris minėtų organų sistemų vystymosi ydas. Prognozė priklauso nuo apsigimimų išraiškos sunkumo ir specializuotos pagalbos gimus naujagimiui.

Nuo 2 iki 4 proc. visų nėštumų yra susiję su įgimta vaisiaus patologija. Sužinojus apie vaisiaus patologiją, nėščioji ir jos artimieji patiria nerimą, baimę, liūdesį, susiduria su įvairiais psichologiniais sunkumais. Nustačius arba įtarus vaisiaus raidos ydą, svarbu suteikti pacientei ir jos artimiesiems visavertę pagalbą bei užtikrinti kuo geresnę priežiūrą ir gydymą būsimam naujagimiui. Tam labai svarbi daugiadalykė gydytojų komanda, kuri prižiūri nėščiąją ir vaisių nėštumo laikotarpiu, atlieka reikalingus tyrimus, stebi vaisiaus būklę, sprendžia dėl gydymo nėštumo laikotarpiu arba po gimimo bei gimdymo taktikos. Kartu dirbanti gydytojų specialistų komanda – tai saugumas ir visavertė pagalba šeimai ir jų naujagimiui.