Catch-up growth of head circumference of very low birth weight, small for gestational age preterm infants and mental development to adulthood

Brandt, Ingeborg; Sticker, Elisabeth; Lentze, Michael J.

doi:10.1067/mpd.2003.149

Cited by 189 publications

(127 citation statements)

References 32 publications

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“…Considering the important role that DHA plays in neural and retinal development, the finding of a lower formation of DHA in infants with IUGR may have important implications as it can be a contributing factor to the abnormalities in neurodevelopment described in infants with IUGR (25,26). Also, DHA supplementation may improve DHA status in infants with a demonstrated DHA deficiency, such as premature infants or those with Zellweger syndrome.…”

Section: Discussionmentioning

confidence: 99%

Infants with Intrauterine Growth Restriction Have Impaired Formation of Docosahexaenoic Acid in Early Neonatal Life: A Stable Isotope Study

Llanos¹,

Mena

et al. 2005

Pediatr Res

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This study evaluated the arachidonic acid (AA) and docosahexaenoic acid (DHA) formation from d5-labeled linoleic acid (d5-LA) and ␣-linolenic acid (d5-LNA) precursors in infants with intrauterine growth restriction (IUGR) compared with control groups matched by gestational age (GA) or birth weight. We compared DHA and AA formation from deuterated precursors d5-LA and d5-LNA in 11 infants with IUGR with 13 and 25 control subjects who were appropriate for GA and matched by GA and by birth weight, respectively. After an enteral administration of d5-LA and d5-LNA, we determined unlabeled and d5-labeled fatty acids at 24, 48, and 96 h in plasma. Absolute concentrations and area under the curve (AUC) over the 96-h study were used for analysis. Absolute concentration of d5-DHA and the product/precursor ratio of the d5-labeled AUCs indicated a less active DHA formation from LNA in infants with IUGR compared with their GAmatched (2-fold) and birth weight-matched (3-fold) control subjects. The ratios of eicosapentaenoic and n-3 docosapentaenoic acid to DHA were also affected. Similar evaluation for the n-6 series was not significant. DHA metabolism is affected in infants with IUGR; the restricted DPA to DHA conversion step seems to be principally responsible for this finding. Abbreviations AA, arachidonic acid AGA, appropriate for gestational age AUC, area under the curve DHA, docosahexaenoic acid d5-LA, deuterated linoleic acid d5-LNA, deuterated ␣-linolenic acid DPA, docosapentaenoic acid EFA, essential fatty acids EPA, eicosapentaenoic acid GA, gestational age IUGR, intrauterine growth restriction LA, linoleic acid LCP, long-chain polyunsaturated fatty acids LNA, ␣-linolenic acid PGC-1, peroxisome proliferator-activated receptor-␥ coactivator-1 PPAR, peroxisome proliferator-activated receptor SGA, small for gestational age Intrauterine growth restriction (IUGR) is the result of the failure of the placenta to provide the necessary nutrients required by the fetus to maintain adequate growth (1). During the last trimester of gestation, there is a significant accumulation of long-chain polyunsaturated fatty acids (LCPs) in the fetus and an increase in the relative content of both n-6 and n-3 LCPs in the human brain and retina. Fetal tissue content of LCPs is dependent on maternal intake and on an adequate placental transfer. Thus, a greater risk for restricted in utero LCPs supply may occur in pregnancies that are complicated with abnormal placental function affecting nutrient transfer. Data derived from IUGR animal models indicate that placental insufficiency is associated with abnormalities in fetal lipid metabolism of skeletal muscle and liver (2,3). Cetin et al. (4) reported that fetuses with IUGR have a lower proportion of long-chain n-6 and n-3 fatty acids, arachidonic acid (AA), and docosahexae-

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Section: Discussionmentioning

confidence: 99%

Infants with Intrauterine Growth Restriction Have Impaired Formation of Docosahexaenoic Acid in Early Neonatal Life: A Stable Isotope Study

Llanos¹,

Mena

et al. 2005

Pediatr Res

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“…9 Several authors warn of worse prognosis for development in cases of inadequate, or even exaggerated, growth in head circumference during the first months of life. 9,[24][25][26] Growth should not be assessed on the basis of a single evaluation since the anthropometric measurements taken at any given age only characterize the child s growth status. In particular with respect of premature children it is very important to monitor the growth rate over the first years of life by means of periodic anthropometric measurements assessed for progress along standard, age and sex specific, curves that are generally expressed in percentiles.…”

Section: Important Conceptsmentioning

confidence: 99%

Crescimento e desenvolvimento a longo prazo do prematuro extremo

Rugolo¹

2005

J. Pediatr. (Rio J.)

134

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“…14 Among small-for-gestational age preterm infants, higher mean postnatal energy intake/kg body weight per day in the first 2 weeks of life was associated with complete head circumference catch-up growth and better developmental and cognitive performance until the age of 6 years. 15 During early life, which is characterized by rapid development, the brain is particularly vulnerable to insufficient nutrients and other environmental insults. 1 Brain damage caused by malnutrition at an early age may be difficult to reverse, especially in impoverished settings where adequate stimulation in the home may be difficult to achieve.…”

Section: Introductionmentioning

confidence: 99%

Beneficial effects of zinc supplementation on head circumference of Nepalese infants and toddlers: a randomized controlled trial

et al. 2012

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BACKGROUND/OBJECTIVE: To assess the effects of micronutrient supplementation on head circumference of rural Nepali infants and children. SUBJECTS/METHODS: We used a randomized controlled trial to assess the effects of micronutrient supplementation on head circumference in 569 rural Nepali infants and children aged 4-17 months. Children were randomized to: (1) zinc, (2) iron-folic acid, (3) zinc plus iron-folic acid or (4) a placebo group. Data on head circumference were collected during five visits at B3 month intervals over the course of a year. We calculated change in head circumference in treatment groups receiving zinc and iron comparing the first and fifth visits as well as used generalized estimating equations (GEE) to take advantage of data from all points in time. Models were adjusted for covariates unbalanced in the randomization and for baseline head circumference. RESULTS: Estimating differences in head circumference between baseline and visit 5, children in the zinc treatment group showed smaller decreases in head circumference z-score compared with placebo (adjusted b ¼ 0.13, 95% confidence interval (CI): 0.03 to 0.23). Using GEE, zinc treatment was associated with 0.11 (95% CI: 0.05 to 0.17) decrease in the rate of decline in head circumference z-score across visits as compared with placebo. Iron-folic acid supplementation was not associated with head circumference z-scores when comparing visits 1 with 5 or including data across all visits in adjusted models. CONCLUSION: Our results suggest that zinc supplementation confers a beneficial effect on the rate of head growth in Nepali infants.

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Catch-up growth of head circumference of very low birth weight, small for gestational age preterm infants and mental development to adulthood

Cited by 189 publications

References 32 publications

Infants with Intrauterine Growth Restriction Have Impaired Formation of Docosahexaenoic Acid in Early Neonatal Life: A Stable Isotope Study

Infants with Intrauterine Growth Restriction Have Impaired Formation of Docosahexaenoic Acid in Early Neonatal Life: A Stable Isotope Study

Crescimento e desenvolvimento a longo prazo do prematuro extremo

Beneficial effects of zinc supplementation on head circumference of Nepalese infants and toddlers: a randomized controlled trial

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