Body composition following necrotising enterocolitis in preterm infants

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Title: Body composition following necrotising enterocolitis in preterm infants
Authors: Binder, C
Longford, N
Gale, CRK
Modi, N
Uthaya, S
Item 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.
Issue Date: 23-Jan-2018
Date of Acceptance: 29-Nov-2017
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/Funder: National Institute for Health Research
Funder's Grant Number: 08/99/04
Keywords: Body composition
Necrotising enterocolitis
Neonatal nutrition
Nutritional regimen
Parenteral nutrition
Preterm infants
1103 Clinical Sciences
1114 Paediatrics And Reproductive Medicine
Publication Status: Published
Appears in Collections:Department of Medicine
Faculty of Medicine

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