title: Observational outcome results following a randomized controlled trial of early amino acid administration in preterm infants.
abstract: OBJECTIVE
  Several reports have investigated amino acid administration in premature infants during the early postnatal phase. Most of these previous studies, however, have only evaluated short-term in-hospital outcomes. Our aim was to describe long-term outcomes in premature infants previously subjected to different nutritional regimens in a randomized controlled trial. The primary outcome was survival without major disabilities, and the secondary outcomes included anthropometry and mental development.
  
  
  METHODS
  Infants born <32 weeks' gestation and <1500 g were randomized to receive glucose (n = 69) or glucose with 2.4 g · kg(-1) · day(-1 amino acids) (n = 63) from birth. From postnatal day 3 onward, the nutritional intake was similar. At 2 years of corrected age, the surviving infants were assessed for neurodevelopmental outcome and anthropometry.
  
  
  RESULTS
  Ninety-seven percent of the surviving infants were examined at follow-up, with no overall effect on survival without major disabilities. Boys, however, had a normal outcome significantly more often if amino acids were administered from birth onward (crude odds ratio 3.8, 95% confidence interval 1.3-11.4) and following adjustment for confounders (odds ratio 6.2, 95% confidence interval 1.0-38.0). The secondary outcomes exhibited no differences in anthropometric data. The mental developmental index was lower in the small number of girls who survived without major disabilities following the early administration of amino acids.
  
  
  CONCLUSIONS
  In this hypothesis-generating outcome study, premature boys, but not girls, benefited from amino acid administration directly following birth. The observed lower mental developmental index in a subgroup of girls, however, warrants further studies.
authors.affiliation: *Pediatrics-Neonatology, Erasmus MC-Sophia Children's Hospital, Rotterdam †Pediatrics, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Chris H P
authors.initials: CH
authors.lastname: van den Akker
authors.forename: Frans W J
authors.initials: FW
authors.lastname: te Braake
authors.forename: Nynke
authors.initials: N
authors.lastname: Weisglas-Kuperus
authors.forename: Johannes B
authors.initials: JB
authors.lastname: van Goudoever
mesh_terms: D000596:Amino Acids / Q000008:administration & dosage*; D000886:Anthropometry; D003071:Cognition; D005260:Female; D005865:Gestational Age; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development* / Q000502:physiology; D007235:Infant, Premature, Diseases / Q000517:prevention & control; D015931:Intensive Care, Neonatal / Q000379:methods*; D008297:Male; D010288:Parenteral Nutrition; D012737:Sex Factors; D016896:Treatment Outcome
chemical_list: D000596:Amino Acids