Arginine supplementation prevents necrotizing enterocolitis in the premature infant.
OBJECTIVE
To determine whether supplementation with L -arginine reduces the incidence of all stages of necrotizing enterocolitis (NEC) in premature infants with birth weight < or =1250 g and gestational age < or =32 weeks.


METHODS
In a randomized, double-blind, placebo-controlled study, 152 premature infants were prospectively, randomly assigned to receive either supplemental L -arginine (1.5 mmol/kg per day; n =75 [group A]) or placebo (control group; n = 77 [group B]) with oral feeds/parenteral nutrition during the first 28 days of life. Nutrient intake, plasma ammonia, arginine, and amino acid concentrations were measured in all infants at days 3, 14, and 28 and at the time of diagnosis of NEC.


RESULTS
NEC developed in 5 infants in group A compared with 21 infants in group B (P <.001). Arginine intake and plasma arginine concentrations were similar in both groups at study entry and (as expected) increased in group A at days 14 and 28. Plasma arginine concentrations were lower in both groups at time of diagnosis of NEC. No significant differences in maternal and neonatal demographics, nutrient intake, plasma ammonia and total and essential amino acid concentrations were present between the two groups.


CONCLUSIONS
Arginine supplementation (1.5 mmol/kg per day) in premature infants reduces the incidence of all stages of NEC.
Amin
Harish J
HJ
Division of Neonatology, Department of Pediatrics, The University of Calgary, Calgary, Alberta, Canada.
Zamora
Samuel A
SA
McMillan
Douglas D
DD
Fick
Gordon H
GH
Butzner
J Decker
JD
Parsons
Howard G
HG
Scott
R Brent
RB
D001120:Arginine / Q000097:blood / Q000627:therapeutic use*; D002170:Canada / Q000453:epidemiology; D019587:Dietary Supplements; D004311:Double-Blind Method; D020345:Enterocolitis, Necrotizing / Q000097:blood / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D005865:Gestational Age; D005973:Glutamine / Q000097:blood; D006801:Humans; D015994:Incidence; D007229:Infant Welfare; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D008297:Male; D012720:Severity of Illness Index; D016896:Treatment Outcome
D005973:Glutamine; D001120:Arginine