Body composition and neuromotor development in the year after NICU discharge in premature infants

Girolami, Gay L.; Kepes, Brenda; Stehli, Annamarie; Lucas, Candice Taylor; Haddad, Fadia; Zalidvar, Frank; Dror, Nitzan; Ahmad, Irfan; Soliman, Antoine; Radom‐Aizik, Shlomit

doi:10.1038/s41390-020-0756-2

Cited by 6 publications

(8 citation statements)

References 37 publications

(42 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We identified 120 studies that were entered into Cochrane CENTRAL 2017 to 2021 and met our inclusion criteria (eFigure 1 in Supplement 1). There was a range in the articles’ availability via electronic publication (2016-2021) and publication year (2017-2023).…”

Section: Resultsmentioning

confidence: 99%

“…Figure 1 shows that the distribution of reporting vs not reporting race and ethnicity data in NICU clinical studies over the 5 years evaluated. We assessed reporting by NIH funding: of the 52 studies funded by the NIH, 35 studies (67%) included race and ethnicity data. Among 68 studies not funded by the NIH, 40 studies (58%) reported race and ethnicity data; the difference between NIH-funded and non-NIH–funded studies was not statistically significant by Pearson χ 2 .…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Race and Ethnicity of Infants Enrolled in Neonatal Clinical Trials

Lyle,

Shaikh,

Oslin

et al. 2023

JAMA Netw Open

View full text Add to dashboard Cite

ImportanceRepresentativeness of populations within neonatal clinical trials is crucial to moving the field forward. Although racial and ethnic disparities in research inclusion are well documented in other fields, they are poorly described within neonatology.ObjectiveTo describe the race and ethnicity of infants included in a sample of recent US neonatal clinical trials and the variability in this reporting.Evidence ReviewA systematic search of US neonatal clinical trials entered into Cochrane CENTRAL 2017 to 2021 was conducted. Two individuals performed inclusion determination, data extraction, and quality assessment independently with discrepancies adjudicated by consensus.FindingsOf 120 studies with 14 479 participants that met the inclusion criteria, 75 (62.5%) included any participant race or ethnicity data. In the studies that reported race and ethnicity, the median (IQR) percentage of participants of each background were 0% (0%-1%) Asian, 26% (9%-42%) Black, 3% (0%-12%) Hispanic, 0% (0%-0%) Indigenous (eg, Alaska Native, American Indian, and Native Hawaiian), 0% (0%-0%) multiple races, 57% (30%-68%) White, and 7% (1%-21%) other race or ethnicity. Asian, Black, Hispanic, and Indigenous participants were underrepresented, while White participants were overrepresented compared with a reference sample of the US clinical neonatal intensive care unit (NICU) population from the Vermont Oxford Network. Many participants were labeled as other race or ethnicity without adequate description. There was substantial variability in terms and methods of reporting race and ethnicity data. Geographic representation was heavily skewed toward the Northeast, with nearly one-quarter of states unrepresented.Conclusions and RelevanceThese findings suggest that neonatal research may perpetuate inequities by underrepresenting Asian, Black, Hispanic, and Indigenous neonates in clinical trials. Studies varied in documentation of race and ethnicity, and there was regional variation in the sites included. Based on these findings, funders and clinical trialists are advised to consider a 3-point targeted approach to address these issues: prioritize identifying ways to increase diversity in neonatal clinical trial participation, agree on a standardized method to report race and ethnicity among neonatal clinical trial participants, and prioritize the inclusion of participants from all regions of the US in neonatal clinical trials.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Race and Ethnicity of Infants Enrolled in Neonatal Clinical Trials

Lyle,

Shaikh,

Oslin

et al. 2023

JAMA Netw Open

View full text Add to dashboard Cite

show abstract

“…However, in relation to later measurements of body composition, others did find IGF-I to relate to body composition. For example, Cooper et al reported a higher increase in IGF-I between hospital discharge and 1 year corrected age to be associated with a concurrent higher increase in fat free mass in infants born prematurely [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, the relationship between IGF-I and body composition has been reported to vary, depending on the timing of IGF-I and body composition measurement. Based on previous studies, it could be speculated that high IGF-I levels between preterm birth and term equivalent age increase fat free mass, while from term age onwards higher IGF-I could be associated with more fat mass [ 9-11 ]. Nevertheless, only a few studies report on IGF-I in relation to body composition in preterm infants.…”

mentioning

confidence: 99%

IGF-I, Growth, and Body Composition in Preterm Infants up to Term Equivalent Age

Yumani

Lafeber

Weissenbruch

2021

Journal of the Endocrine Society

View full text Add to dashboard Cite

Context There are concerns that a higher fat mass in the early life of preterm infants is associated with adverse cardiometabolic outcomes in young adulthood. Objective To investigate the role of IGF-I and growth in determining body composition of preterm infants at term equivalent age. Methods An observational study was conducted from August 2015 to August 2018. From birth to term equivalent age, IGF-I levels were measured bi-weekly and growth was assessed weekly. At term equivalent age, body composition was assessed through air displacement plethysmography; 65 infants with a gestational age of 24 to 32 weeks were assessed at term equivalent age, of whom 58 completed body composition measurement. The main outcome measures were fat (free) mass (g) and fat (free) mass percentage at term equivalent age. Results In the first month of life, each 0.1 nmol/L per week increase in IGF-I was associated with a 465 g (SE 125 g) increase in fat free mass. A greater increase in weight SDS in the first month of life was associated with a higher fat free mass percentage (B 200.9; 95% CI, 12.1-389.6). A higher head circumference SDS was associated with more fat free mass (r = 0.46; 95% CI, 0.21-0.65). However, a greater increase in weight SDS up to term equivalent age was associated with a lower fat free mass percentage (B −55.7, SE 9.4). Conclusion These findings suggest that impaired growth in the first month of life is associated with a less favorable body composition at term equivalent age.

show abstract

“…While it has not been fully elucidated what early life nutrition interventions promote the best body composition outcomes in preterm infants, the goal of body composition development is becoming clearer. Increased lean body mass in preterm infants is increasingly associated with improved neurodevelopmental outcomes at 4 months ( 27), 1 year (28,29), and 4 years of life (30). The potential to improve growth and body composition development in preterm infants is driving the incorporation of HMA into standard NICU care.…”

Section: Adapted Protein Supplementationmentioning

confidence: 99%

Exploring Innovations in Human Milk Analysis in the Neonatal Intensive Care Unit: A Survey of the United States

et al. 2021

View full text Add to dashboard Cite

Introduction: Human milk (HM) is the ideal enteral feeding for nearly all infants and offers unique benefits to the very low birthweight (VLBW) infant population. It is a challenge to meet the high nutrient requirements of VLBW infants due to the known variability of HM composition. Human milk analysis (HMA) assesses the composition of HM and allows for individualized fortification. Due to recent U.S. Food and Drug Administration (FDA) approval, it has relatively recent availability for clinical use in the US.Aim: To identify current practices of HMA and individualized fortification in neonatal intensive care units (NICUs) across the United States (US) and to inform future translational research efforts implementing this nutrition management method.Methods: An institutional review board (IRB) approved survey was created and collected data on the following subjects such as NICU demographics, feeding practices, HM usage, HM fortification practices, and HMA practices. It was distributed from 10/30–12/21/2020 via online pediatric nutrition groups and listservs selected to reach the intended audience of NICU dietitians and other clinical staff. Each response was assessed prior to inclusion, and descriptive analysis was performed.Results: About 225 survey responses were recorded during the survey period with 119 entries included in the analysis. This represented 36 states and Washington D.C., primarily from level III and IV NICUs. HMA was reported in 11.8% of responding NICUs. The most commonly owned technology for HMA is the Creamatocrit Plus TM (EKF Diagnostics), followed by the HM Analyzer by Miris (Uppsala, Sweden). In NICUs practicing HMA, 84.6% are doing so clinically.Discussion: Feeding guidelines and fortification of HM remain standard of care, and interest in HMA was common in this survey. Despite the interest, very few NICUs are performing HMA and individualized fortification. Barriers identified include determining who should receive individualized fortification and how often, collecting a representative sample, and the cost and personnel required.Conclusions: Human milk analysis and individualized fortification are emerging practices within NICUs in the US. Few are using it in the clinical setting with large variation in execution among respondents and many logistical concerns regarding implementation. Future research may be beneficial to evaluate how practices change as HMA and individualized fortification gain popularity and become more commonly used in the clinical setting.

show abstract

Body composition and neuromotor development in the year after NICU discharge in premature infants

Cited by 6 publications

References 37 publications

Race and Ethnicity of Infants Enrolled in Neonatal Clinical Trials

Race and Ethnicity of Infants Enrolled in Neonatal Clinical Trials

IGF-I, Growth, and Body Composition in Preterm Infants up to Term Equivalent Age

Exploring Innovations in Human Milk Analysis in the Neonatal Intensive Care Unit: A Survey of the United States

Contact Info

Product

Resources

About