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Premature small for gestational age infants fed an exclusive human milk-based diet achieve catch-up growth without metabolic consequences at 2 years of age.
Arch Dis Child Fetal Neonatal Ed. 2019 May; 104(3):F242-F247.AD

Abstract

OBJECTIVE

To compare postdischarge growth, adiposity and metabolic outcomes of appropriate for gestational age (AGA) versus small for gestational age (SGA) premature infants fed an exclusive human milk (HM)-based diet in the neonatal intensive care unit.

DESIGN

Premature infants (birth weight ≤1250 g) fed an exclusive HM-based diet were examined at 12-15 months corrected gestational age (CGA) (visit 1) for anthropometrics, serum glucose and non-fasting insulin, and at 18-22 months CGA (visit 2) for body composition by dual-energy X-ray absorptiometry.

RESULTS

Of 51 children, 33 were AGA and 18 were SGA at birth. The SGA group had weight gain (g/day) equal to AGA group during the follow-up period. SGA had a significantly greater body mass index (BMI) z-score gain from visit 1 to visit 2 (0.25±1.10 vs -0.21±0.84, p=0.02) reflecting catch-up growth. There were no significant differences in total fat mass (FM) and trunk FM between groups. SGA had significantly lower insulin level (5.0±3.7 vs 17.3±15.1 µU/mL, p=0.02) and homeostatic model of assessment-insulin resistance (1.1±0.9 vs 4.3±4.1, p=0.02). Although regional trunk FM correlated with insulin levels in SGA (r=0.893, p=0.04), they had lower insulin level compared with AGA and no difference in adiposity.

CONCLUSIONS

SGA premature infants who received an exclusive HM-based diet exhibited greater catch-up growth without increased adiposity or elevated insulin resistance compared with AGA at 2 years of age. An exclusive HM-based diet may improve long-term body composition and metabolic outcomes of premature infants with ≤1250 g birth weight, specifically SGA.

Authors+Show Affiliations

Section of Neonatology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA. USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA. Section of Nutrition, Department of Pediatrics, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand. Pediatric Nutrition STAR, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, Texas, USA.Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, Texas, USA.Section of Neonatology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.Section of Neonatology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30425116

Citation

Visuthranukul, Chonnikant, et al. "Premature Small for Gestational Age Infants Fed an Exclusive Human Milk-based Diet Achieve Catch-up Growth Without Metabolic Consequences at 2 Years of Age." Archives of Disease in Childhood. Fetal and Neonatal Edition, vol. 104, no. 3, 2019, pp. F242-F247.
Visuthranukul C, Abrams SA, Hawthorne KM, et al. Premature small for gestational age infants fed an exclusive human milk-based diet achieve catch-up growth without metabolic consequences at 2 years of age. Arch Dis Child Fetal Neonatal Ed. 2019;104(3):F242-F247.
Visuthranukul, C., Abrams, S. A., Hawthorne, K. M., Hagan, J. L., & Hair, A. B. (2019). Premature small for gestational age infants fed an exclusive human milk-based diet achieve catch-up growth without metabolic consequences at 2 years of age. Archives of Disease in Childhood. Fetal and Neonatal Edition, 104(3), F242-F247. https://doi.org/10.1136/archdischild-2017-314547
Visuthranukul C, et al. Premature Small for Gestational Age Infants Fed an Exclusive Human Milk-based Diet Achieve Catch-up Growth Without Metabolic Consequences at 2 Years of Age. Arch Dis Child Fetal Neonatal Ed. 2019;104(3):F242-F247. PubMed PMID: 30425116.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Premature small for gestational age infants fed an exclusive human milk-based diet achieve catch-up growth without metabolic consequences at 2 years of age. AU - Visuthranukul,Chonnikant, AU - Abrams,Steven A, AU - Hawthorne,Keli M, AU - Hagan,Joseph L, AU - Hair,Amy B, Y1 - 2018/11/13/ PY - 2017/11/24/received PY - 2018/07/10/revised PY - 2018/10/13/accepted PY - 2018/11/15/pubmed PY - 2019/5/7/medline PY - 2018/11/15/entrez KW - SGA infants KW - adiposity KW - human milk KW - metabolic outcomes KW - premature infants SP - F242 EP - F247 JF - Archives of disease in childhood. Fetal and neonatal edition JO - Arch. Dis. Child. Fetal Neonatal Ed. VL - 104 IS - 3 N2 - OBJECTIVE: To compare postdischarge growth, adiposity and metabolic outcomes of appropriate for gestational age (AGA) versus small for gestational age (SGA) premature infants fed an exclusive human milk (HM)-based diet in the neonatal intensive care unit. DESIGN: Premature infants (birth weight ≤1250 g) fed an exclusive HM-based diet were examined at 12-15 months corrected gestational age (CGA) (visit 1) for anthropometrics, serum glucose and non-fasting insulin, and at 18-22 months CGA (visit 2) for body composition by dual-energy X-ray absorptiometry. RESULTS: Of 51 children, 33 were AGA and 18 were SGA at birth. The SGA group had weight gain (g/day) equal to AGA group during the follow-up period. SGA had a significantly greater body mass index (BMI) z-score gain from visit 1 to visit 2 (0.25±1.10 vs -0.21±0.84, p=0.02) reflecting catch-up growth. There were no significant differences in total fat mass (FM) and trunk FM between groups. SGA had significantly lower insulin level (5.0±3.7 vs 17.3±15.1 µU/mL, p=0.02) and homeostatic model of assessment-insulin resistance (1.1±0.9 vs 4.3±4.1, p=0.02). Although regional trunk FM correlated with insulin levels in SGA (r=0.893, p=0.04), they had lower insulin level compared with AGA and no difference in adiposity. CONCLUSIONS: SGA premature infants who received an exclusive HM-based diet exhibited greater catch-up growth without increased adiposity or elevated insulin resistance compared with AGA at 2 years of age. An exclusive HM-based diet may improve long-term body composition and metabolic outcomes of premature infants with ≤1250 g birth weight, specifically SGA. SN - 1468-2052 UR - https://www.unboundmedicine.com/medline/citation/30425116/Premature_small_for_gestational_age_infants_fed_an_exclusive_human_milk_based_diet_achieve_catch_up_growth_without_metabolic_consequences_at_2_years_of_age_ L2 - http://fn.bmj.com/cgi/pmidlookup?view=long&pmid=30425116 DB - PRIME DP - Unbound Medicine ER -