Body composition following necrotising enterocolitis in preterm infants
File(s)NEC+Binder.docx (129.26 KB)
Accepted version
Author(s)
Binder, C
Longford, N
Gale, CRK
Modi, N
Uthaya, S
Type
Journal Article
Abstract
Background: The optimal nutritional regimen for preterm infants, including those that develop necrotising enterocolitis (NEC), is unknown. Objective: The objective here was to evaluate body composition at term in infants following NEC, in comparison with healthy infants. The primary outcome measure was non-adipose tissue mass (non-ATM). Methods: We compared body composition assessed by magnetic resonance imaging at term in infants born <31 weeks of gestational age that participated in NEON, a trial comparing incremental versus immediate delivery of parenteral amino acids on non-ATM, and SMOF versus intralipid on intrahepatocellular lipid content. There were no differences in the primary outcomes. We compared infants that received surgery for NEC (NEC-surgical), infants with medically managed NEC (NEC-medical), and infants without NEC (reference). Results: A total of 133 infants were included (8 NEC-surgical; 15 NEC-medical; 110 reference). In comparison with the reference group, infants in the NEC-surgical and NEC-medical groups were significantly lighter [adjusted mean difference (95% CI) NEC-surgical: –630 g (–1,010, –210), p = 0.003; NEC-medical: –440 g (–760, –110), p = 0.009] and the total adipose tissue volume (ATV) was significantly lower [NEC-surgical: –360 cm3 (–516, –204), p < 0.001; NEC-medical: –127 cm3 (–251, –4); p = 0.043]. There were no significant differences in non-ATM [adjusted mean difference (95% CI) NEC-surgical: –46 g (–281, 189), p = 0.70; NEC-medical: –122 g (–308, 63), p = 0.20]. Conclusion: The lower weight at term in preterm infants following surgically and medically managed NEC, in comparison to preterm infants that did not develop the disease, was secondary to a reduction in ATV. This suggests that the nutritional regimen received was adequate to preserve non-ATM but not to support the normal third-trimester deposition of adipose tissue in preterm infants.
Date Issued
2018-01-23
Date Acceptance
2017-11-29
Citation
Neonatology, 2018, 113 (3), pp.242-248
ISSN
1661-7800
Publisher
Karger Publishers
Start Page
242
End Page
248
Journal / Book Title
Neonatology
Volume
113
Issue
3
Copyright Statement
Copyright © 2018, © 2018 S. Karger AG, Basel
Sponsor
National Institute for Health Research
Grant Number
08/99/04
Subjects
Body composition
Necrotising enterocolitis
Neonatal nutrition
Nutritional regimen
Parenteral nutrition
Preterm infants
1103 Clinical Sciences
1114 Paediatrics And Reproductive Medicine
Pediatrics
Publication Status
Published