development in very low birth-weight preemies.

The volume of carbohydrates, proteins, lipids and calories
consumed by very vulnerable preemies significantly contributes to increased
brain volume and white matter development. However additional research is
needed to determine specific nutritional approaches that best support these
infants’ developing brains, according to research to be presented during the
Pediatric Academic Societies 2018 annual meeting currently being held in Toronto.

During the final weeks of pregnancy, the foetal brain
undergoes an unprecedented growth spurt, dramatically increasing in volume as
well as structural complexity as the foetus approaches full term.

Nutritional support in the neonatal intensive care unit
(NICU) helps to encourage optimal brain development among preterm infants.
However, their brain growth rates still lag behind those seen in full-term

“Few studies have investigated the impact of early
macronutrient and caloric intake on microstructural brain development in
vulnerable pre-term infants,” says Katherine Ottolini, lead author of the
Children’s-led study. “Advanced quantitative magnetic resonance imaging
(MRI) techniques may help to fill that data gap in order to better direct
targeted interventions to newborns who are most in need.”

The research team at Children’s National Health System
enrolled 69 infants who were born younger than 32 gestational weeks and weighed
less than 1500 grams. The infants’ mean birth weight was 970 grams and their
mean gestational age at birth was 27.6 weeks.

The newborns underwent MRI at their term-equivalent age, 40
weeks gestation. Parametric maps were generated for fractional anisotropy in
regions of the cerebrum and cerebellum for diffusion tensor imaging analyses,
which measures brain connectivity and white matter tract integrity. The
research team also tracked nutritional data: Grams per kilogram of
carbohydrates, proteins, lipids and overall caloric intake.

“We found a significantly negative association between
fractional anisotropy and cumulative macronutrient/caloric intake,” says
Catherine Limperopoulos, PhD, director of Children’s Developing Brain Research
Laboratory and senior author of the research. “Curiously, we also find
significantly negative association between macronutrient/caloric intake and
regional brain volume in the cortical and deep gray matter, cerebellum and

Because the nutritional support does contribute to cerebral
volumes and white matter microstructural development in very vulnerable
newborns, Limperopoulos says the significant negative associations seen in this
study may reflect the longer period of time these infants relied on nutritional
support in the NICU.