Metabolic outcomes in very low birthweight and preterm infants in later life
Journal Title: Jornal de Pediatria - Year 2019, Vol 95, Issue 3
Abstract
Survival for very low birthweight (VLBW) infants has improved dramatically over the last 2 decades. This has shifted the aim of neonatal care from one that focuses purely on short term survival to one that considers the life-long impacts of preterm birth.1 Neonatologists must, of course, continue to strengthen their efforts to reduce key neonatal morbidities such as necrotizing enterocolitis, sepsis and chronic lung disease, but must now consider the impact of nutrition and other interventions over the life course. There are strong data to show that improved neuro-cognitive outcomes are associated with higher early nutrient intakes. However, the emerging discipline of ‘Developmental Origins of Health and Disease’ (DOHaD) has increased awareness of the associations between higher nutrient intakes and more rapid growth in early life and worse long-term metabolic outcomes such as cardio-vascular disease and type 2 diabetes.2,3 This risk seems especially high in those who are born in utero growth-restricted (IUGR), but the independent impact of prematurity has not been well studied.4 The paper by Heidemann et al.5 is important because it highlights the issue that adverse metabolic effects may be apparent in early infancy in those born preterm, and asks clinicians to consider what practical steps can be taken to reduce their later life consequences.
Authors and Affiliations
Nicholas Embleton
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