Impact of early neonatal nutrition on neurodevelopment and the limbic system in very low birth weight infants

Abstract

The limbic system is a brain structure involved in emotional regulation. Since nutritional interventions in very low birth weight (VLBW) infants may be associated with measurable differences in brain structure and function, we designed this prospective study to evaluate the impact of early nutritional support in VLBW infants on the volume of the regions that comprise the limbic system, as well as on the emotional and neuropsychological development of these infants. This is a prospective observational study of a historical cohort of children with a history of prematurity. Seventy-four preterm infants, with a mean age of 11·1 (SD 2·9) years, underwent neuropsychological assessment using the Wechsler Intelligence Scale for Children and functional MRI (fMRI). We recorded the nutritional intake during the first week of the neonatal period, as well as data related to neonatal morbidity. The association between the results of the brain structural analysis, psychometrics variables and nutritional intake was determined using simple and multivariate linear regression adjusted for child age and BMI in the structural analysis of fMRI. Lipids intake was also associated with the volume of the left thalamus (b = 50·7; P = 0·014), the right thalamus (b = 47·4; P = 0·018) and the left nucleus accumbens (b = 5·02; P = 0·031). We conclude that lipids intake in the first week of life in VLBW newborns is associated with the volume of various structures of the limbic system, namely the thalamus and the nucleus accumbens.