Optimizing Growth and Neurocognitive Development While Minimalizing Metabolic Risk in Preterm Infants

Abstract

Early aggressive nutrition is associated with improved neurodevelopmental outcomes, and is increasingly becoming the standard of care for preterm infants. Additionally, more rapid growth while in the NICU has been linked to lower risk of abnormal motor and cognitive development. However, as increasing reports of the metabolic consequences of rapid growth in other populations (i.e. appropriately grown and growth-restricted term infants) become available, we must consider the possibility that these negative long-term health outcomes may also affect preterm infants. This becomes especially concerning as studies revealing the prevalence of disproportionate growth and increased adiposity upon discharge from the NICU are published. This article will review the available literature on the impact of nutrition, illness and growth during several different epochs (i.e. first weeks of life, later inpatient weeks and post-discharge) on both neurodevelopmental and metabolic outcomes in preterm infants.