University of Oulu

Sammallahti S, Kajantie E, Matinolli H-M, Pyhälä R, Lahti J, Heinonen K, et al. (2017) Nutrition after preterm birth and adult neurocognitive outcomes. PLoS ONE12(9): e0185632. https://doi.org/10.1371/journal.pone.0185632

Nutrition after preterm birth and adult neurocognitive outcomes

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Author: Sammallahti, Sara1,2,3; Kajantie, Eero2,3,4; Matinolli, Hanna-Maria3;
Organizations: 1Department of Psychology and Logopedics, University of Helsinki
2Children’s Hospital, Helsinki University Hospital and University of Helsinki
3National Institute for Health and Welfare
4PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu
5Helsinki Collegium for Advanced Studies
6University BHF Centre for Cardiovascular Sciences, Queen’s Medical Research Institute, University of Edinburgh
7Folkhälsan Research Center
8Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital
9Vasa Central Hospital
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 3.3 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2017111450688
Language: English
Published: Public Library of Science, 2017
Publish Date: 2017-11-14
Description:

Abstract

Background: Preterm birth (<37 gestational weeks) poses a risk of poorer neurocognitive functioning. Faster growth after preterm birth predicts better cognitive abilities and can be promoted through adequate nutrition, but it remains unknown whether variations in nutrient intakes translate into long-term benefits for neurodevelopment.

Methods: In 86 participants of the Helsinki Study of Very Low Birth Weight Adults (birthweight <1500g), we examined if higher intakes of energy, macronutrients, and human milk during the first nine weeks after preterm birth predict performance in tests of cognitive ability at 25.1 years of age (SD = 2.1).

Results: 10 kcal/kg/day higher total energy intake at 3 to 6 weeks of age was associated with 0.21 SD higher adult IQ (95% Confidence Interval [CI] 0.07–0.35). Higher carbohydrate and fat intake at 3–6 weeks, and higher energy intake from human milk at 3–6 and at 6–9 weeks were also associated with higher adult IQ: these effect sizes ranged from 0.09 SD (95% CI 0.01–0.18) to 0.34 SD (0.14–0.54) higher IQ, per one gram/kg/day more carbohydrate and fat, and per 10 kcal/kg/day more energy from human milk. Adjustment for neonatal complications attenuated the associations: intraventricular hemorrhage, in particular, was associated with both poorer nutrition and poorer IQ.

Conclusion: In preterm neonates with very low birth weight, higher energy and human milk intake predict better neurocognitive abilities in adulthood. To understand the determinants of these infants' neurocognitive outcome, it seems important to take into account the role of postnatal nutrition, not just as an isolated exposure, but as a potential mediator between neonatal illness and long-term neurodevelopment.

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Series: PLoS one
ISSN: 1932-6203
ISSN-E: 1932-6203
ISSN-L: 1932-6203
Volume: 12
Issue: 9
Article number: e0185632
DOI: 10.1371/journal.pone.0185632
OADOI: https://oadoi.org/10.1371/journal.pone.0185632
Type of Publication: A1 Journal article – refereed
Field of Science: 3141 Health care science
515 Psychology
3123 Gynaecology and paediatrics
Subjects:
Funding: This study was part of the Helsinki Study of Very Low Birth Weight Adults funded by the Academy of Finland (http://www.aka.fi/), University of Helsinki Research Foundation (https://www.helsinki.fi/en/university/university-of-helsinki-research-foundation), the Finnish Medical Society Duodecim (http://www.duodecim.fi/english/), Finska Läkaresällskapet (http://www.fls.fi/), the Foundation for Pediatric Research in Finland (http://www.lastentautientutkimussaatio.fi/), the Finnish Special Governmental Subsidy for Health Sciences, the Jalmari and Rauha Ahokas Foundation (http://www.ahokkaansaatio.org/), the Juho Vainio Foundation (http://www.juhovainionsaatio.fi), the Emil Aaltonen Foundation (http://www.emilaaltonen.fi/), the Novo Nordisk Foundation (http://www.novonordisk.com/about-novo-nordisk/corporate-governance/foundation.html), the Päivikki and Sakari Sohlberg Foundation (http://www.pss-saatio.fi/), the Signe and Ane Gyllenberg Foundation (http://gyllenbergs.fi/), the Yrjö Jahnsson Foundation (http://www.yjs.fi/), the Orion-Pharma Foundation (http://www.orion.fi/tutkimus/orionin-tutkimussaatio/), the Sigrid Jusélius Foundation (http://sigridjuselius.fi/), the Finnish National Graduate School of Clinical Investigation (http://www.vktk.fi/), Hope and Optimism Initiative (http://hopeoptimism.com/), the Wilhelm and Else Stockmann Foundation, and the Pediatric Graduate School, University of Helsinki (http://www.kll.helsinki.fi/tutkimus/lnktko.html). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Dataset Reference: Supporting information:
  http://dx.doi.org/10.1371/journal.pone.0185632.s001
http://dx.doi.org/10.1371/journal.pone.0185632.s002
http://dx.doi.org/10.1371/journal.pone.0185632.s003
Copyright information: © 2017 Sammallahti et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
  https://creativecommons.org/licenses/by/4.0/