Impact of early and high amino acid supplementation on ELBW infants at 2 years.
OBJECTIVE
The aim of the present study was to examine the effects of early and high intravenous (IV) amino acid (AA) supplementation on growth, health, and neurodevelopment of extremely-low-birth-weight (ELBW) infants throughout their first 2 years of life.


METHODS
Infants were prospectively randomized in a double-masked fashion and treated for 7 days with either IV AA starting at 0.5 g · kg (-1) · day(-1) and increased by 0.5 g · kg(-1) every day to 3 g · kg(-1)· day(-) or starting at 2 g · kg (-1) · day(-1) of IV AA and advanced by 1 g · kg(-1) every day to 4 g · kg (-1) · day(-1). Plasma AA concentrations were determined by reverse-phase high-performance liquid chromatography. Survivors were longitudinally assessed with Bayley II Scales of Infant Development and physical, social, and global health.


RESULTS
Forty-three of 51 survivors were studied. Mental Developmental Index (MDI) and Psychomotor Developmental Index were similar between groups; however, the early and high AA group had a lower MDI at 18 months. This difference disappeared at 2 years of age. The early and high AA group z score means for weight, length, and head circumferences were significantly lower than the standard AA group at most visits. Cumulative and single plasma AA concentrations correlated negatively with MDI and postnatal growth.


CONCLUSIONS
ELBW infants who received early and high IV AA during the first week of life were associated with poor overall growth at 2 years.
Department of Pediatrics, University of Texas Health Science Center San Antonio, San Antonio, TX 78229-3900, USA. blanco@uthscsa.edu
Cynthia L
CL
Blanco
Alice K
AK
Gong
John
J
Schoolfield
Belinda K
BK
Green
Wanda
W
Daniels
Edward A
EA
Liechty
Rajam
R
Ramamurthy
D000596:Amino Acids / Q000008:administration & dosage*; D002657:Child Development / Q000187:drug effects; D002675:Child, Preschool; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D052577:Infant, Extremely Low Birth Weight / Q000254:growth & development*; D007231:Infant, Newborn; D007275:Injections, Intravenous; D008297:Male; D011446:Prospective Studies
D000596:Amino Acids