Parenteral Amino Acids in Preterm Infant and Impact on Bone Growth

Abstract

Early nutrition and adequate growth can influence future adult health. Nonetheless, recommended nutrient intakes, which can affect growth and bone health, are rarely achieved in preterm infants during the first weeks of life. Peak fetal accretion of bone mineralization occurs during the last trimester of gestation, and preterm infants are exposed to a higher risk of developing metabolic bone disease with an increased bone fragility, a higher fracture risk, and a long-term reduced linear growth and childhood height. When earlier and higher doses of intravenous amino acids were provided to preterm newborns, improved anabolism and short-and long-term somatic growth were observed. Nonetheless, higher amino acid intakes need to be accompanied by adequate energy, phosphate, and calcium intakes to meet the increased requirements for these minerals following enhanced cell anabolism. Further studies, including analysys of plasma amino acid concentrations and markers of amino acid tolerance, will give more details on the upper limit of amino acids to be provided to preterm infants and which are the possible long term influences of amino acids on later growth, body composition, and neurodevelopmental outcome.