Search

Current or recent low vitamin D status (or proxy measures such as dietary intake or ambient ultraviolet radiation) is linked to several chronic diseases, including osteoporosis, cancers, and cardiovascular and autoimmune diseases. Low prenatal vitamin D status may also increase susceptibility to such diseases in later life via specific target organ effects and/or through changes to the developing immune system. Maternal vitamin D supplementation during pregnancy could be an important public health measure to decrease risk of a range of chronic diseases, but further research is required to clarify beneficial and adverse effects of high prenatal vitamin D.

Objective. Many studies have shown that children born small for gestational age (SGA) are at a neurodevelopmental disadvantage. We have shown that nutrient enrichment of formula fed to term SGA infants improves their growth and hypothesized that it also would improve their neurodevelopmental outcome. Design. A randomized, controlled trial of standard term-infant (n = 147) or nutrient-enriched (n = 152) formula for the first 9 months. A reference group of 175 breastfed SGA infants was also recruited. Setting. Subjects were recruited in 5 maternity hospitals in Cambridge, Nottingham, and Leicester, all in the United Kingdom. Participants. Healthy, term infants (gestation: [greater than or equal to] 37 weeks) with birth weight Outcome Measures. Bayley mental and psychomotor scores at 18 months (primary) and developmental scores from Knobloch, Pasamanick, and Sherrard's developmental screening inventory at 9 months (secondary). Results. There was no significant intergroup difference in Bayley Mental Development Index (MDI) or Psychomotor Development Index (PDI) scores at 18 months. However, at 9 months, children fed the enriched formula had a significantly lower developmental quotient (99.5 vs 102.0; 95% confidence interval [CI] for difference: -4.6, -0.4). A significant disadvantage was seen in girls (-5.1; 95% CI: -7.8, -2.4) but not in boys (0.9; 95% CI: -2.4, 4.2). Breastfed infants had significantly higher MDI and PDI scores at 18 months than formula-fed infants. Confounding factors accounted for ~34% of the observed association between breastfeeding and MDI score and none of the association between breastfeeding and PDI score. Conclusions. The previously reported enhanced linear growth in SGA children fed enriched formula was not matched by a neurodevelopmental advantage. At 9 months, girls fed the enriched formula had a significant developmental disadvantage, although this was not seen at 18 months. Later follow-up will determine any long-term effects on health or development. Meanwhile, use of enriched formula for term SGA children should not be promoted. It seems that breastfeeding may be especially beneficial for neurodevelopment in children born SGA. Pediatrics 2004;113:515-521; term infant, small for gestational age, postnatal nutrition, neurodevelopment, randomized trial. ABBREVIATIONS. SGA, small for gestational age; MDI, Mental Development Index; PDI, Psychomotor Development Index; SD, standard deviation; IQ, intelligence quotient; CI, confidence interval., Many studies have shown that mean psychometric or academic test scores of children born small for gestational age (SGA) are lower than those of children with "appropriate" birth weight for [...]

Objectives. To determine whether blood pressure (BP) differed between very low birth weight (VLBW; birth weight [less than or equal to] 1500 g) subjects and normal birth weight (NBW; birth weight >2499 g) subjects in late adolescence, and to determine whether growth restriction in utero was related to BP in VLBW survivors at this age. Methods. This was a cohort study of 210 preterm survivors with birth weights Results. VLBW subjects had higher sphygmomanometer systolic and diastolic BPs than NBW subjects (mm Hg; mean difference [95% confidence interval]; systolic, 8.6 [3.4, 13.9]; diastolic, 4.3 [1.0, 7.6]). VLBW subjects also had significantly higher mean systolic ambulatory BPs (mm Hg; mean difference [95% confidence interval]) for the 24-hour period (4.7 [1.4, 8.0]), and for both the awake (5.0 [1.6, 8.5]) and asleep (3.6 [0.04, 7.1]) periods. There were no significant differences between the birth weight groups for any ambulatory diastolic BPs. Within the VLBW subjects, there was no significant relationship between birth weight standard deviation score and any measure of BP. Conclusions. BP was significantly higher in late adolescence in VLBW survivors than in NBW subjects. Growth restriction in utero was not significantly related to BP in VLBW survivors. Pediatrics 2003;111:252-257; very low birth weight, ambulatory blood pressure, hypertension, growth restriction in utero., ABBREVIATIONS. BP, blood pressure; VLBW, very low birth weight; NBW, normal birth weight; ABP, ambulatory blood pressure; SD, standard deviation; CI, confidence interval; IQR, interquartile range. Higher blood pressure (BP) [...]

Objective. We tested the hypothesis that balanced addition of long-chain polyunsaturated fatty acid (LCPUFA) to preterm formula during the first weeks of life would confer long-term neurodevelopmental advantage in a double-blind, randomized, controlled trial of preterm formula with and without preformed LCPUFA. Methods. The participants were 195 formula-fed preterm infants (birth weight Results. There were no significant differences in developmental scores between randomized groups, although infants who were fed LCPUFA-supplemented formula showed a nonsignificant 2.6-point (0.25 standard deviation) advantage in MDI and PDI at 18 months, with a greater (nonsignificant) advantage (MDI: 4.5 points; PDI: 5.8 points) in infants below 30 weeks' gestation. LCPUFA-supplemented infants were shorter than control infants at 18 months (difference in length standard deviation score: 0.44; 95% confidence interval: 0.08-0.8). No other significant short- or long-term differences in safety outcomes were observed. Breastfed infants had significantly higher developmental scores at 9 and 18 months than both formula groups and were significantly heavier and longer at 18 months than LCPUFA-supplemented but not control infants. Conclusions. With the dose, duration, and preparation of LCPUFA used, efficacy was not demonstrated, although an advantage in later neurodevelopment cannot be excluded by global tests of development up to 18 months, particularly in infants below 30 weeks' gestation. The surprising effect of LCPUFA-supplemented formula on growth 18 months beyond the intervention period needs to be confirmed in other studies using similar supplementation strategies. Additional follow-up of this cohort is critical at an age when more specific tests of cognitive function are possible. Pediatrics 2002;110:73-82; LCPUFA, preterm infant, randomized trial, efficacy, safety, neurodevelopment, growth., Two groups of long-chain polyunsaturated fatty acids (LCPUFA) have received increasing interest recently: homologues of linoleic acid of the n-6 series (dihomogammalinolenic acid, arachidonic acid [AA]) and of [alpha]-linolenic acid [...]

It may be best to give premature infants feeding solutions that are free of aluminum. Some intravenous feeding solutions contain aluminum but premature infants may not be able to excrete it properly. Researchers tested mental development in 182 premature infants who were randomly assigned to receive normal feeding solutions or solutions that had been depleted of aluminum. Those infants who received prolonged feeding with normal solutions had lower scores on a test of mental development compared to those who received aluminum-depleted solutions.