title: Two-Year Follow-up of a Randomized Controlled Nutrition Intervention Trial in Very Low-Birth-Weight Infants.
abstract: Very low-birth-weight (VLBW) infants are at risk for neurodevelopment impairment. This study assessed the effect of early aggressive parenteral nutrition (PN) on long-term outcome in VLBW infants.
  
  
  
  Directly after birth, VLBW infants (birth weight <1500 g, n = 142) were randomized to 5 different PN regimes. Controls (n = 46) received glucose and standard-dose amino acids (AAs; 2.4 g/[kg·d]) from birth onward and pure soybean oil fat emulsion (SOY) on the second day of life. Two intervention groups received glucose, standard-dose AAs, and lipids from birth onward: SOY (n = 24) or mixed fat emulsion (MIX, n = 25). The 2 other intervention groups received glucose, high-dose AAs (3.6 g/[kg·d]), and lipids from birth onward: SOY (n = 24) or MIX (n = 23). The primary outcome of this follow-up study was the composite outcome of "death or major disability" at 2 years corrected age. Secondary outcomes were death, major disabilities, neurodevelopmental scores, and anthropometry.
  
  
  
  Follow-up rate was 92% (n = 134). Thirty-five (26%) infants had died or had a major disability, with no differences between intervention groups and controls. Increased odds for death were observed in the standard-dose AA-MIX group (odds ratio, 5.4; 95% confidence interval [CI], 1.1-27.0). Neurodevelopmental scores and incidence of major disabilities did not differ between groups. Growth in the high-dose AA-MIX group was enhanced compared with growth in controls at 2 years corrected age (+0.51 [0.01-1.02] weight SDS).
  
  
  
  This randomized controlled hypothesis-generating study demonstrated no beneficial effect of early high-dose AA administration and mixed fat emulsions on survival and neurodevelopmental outcome in VLBW infants, although growth was enhanced.
authors.affiliation: Department of Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands.|Department of Gynecology and Obstetrics, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
authors.forename: Jorine A
authors.initials: JA
authors.lastname: Roelants
authors.affiliation: Department of Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands.|Department of Pediatrics, Emma Children's Hospital-Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Hester
authors.initials: H
authors.lastname: Vlaardingerbroek
authors.affiliation: Department of Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands.|Department of Pediatrics, Emma Children's Hospital-Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Chris H P
authors.initials: CHP
authors.lastname: van den Akker
authors.affiliation: Department of Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands.
authors.forename: Rogier C J
authors.initials: RCJ
authors.lastname: de Jonge
authors.affiliation: Department of Pediatrics, Emma Children's Hospital-Academic Medical Center, Amsterdam, the Netherlands.|Department of Pediatrics, VU University Medical Center, Amsterdam, the Netherlands.
authors.forename: Johannes B
authors.initials: JB
authors.lastname: van Goudoever
authors.affiliation: Department of Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands.
authors.forename: Marijn J
authors.initials: MJ
authors.lastname: Vermeulen
mesh_terms: D000596:Amino Acids / Q000627:therapeutic use; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005947:Glucose / Q000627:therapeutic use; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D008055:Lipids / Q000627:therapeutic use; D008297:Male; D010288:Parenteral Nutrition / Q000379:methods*; D013024:Soybean Oil / Q000627:therapeutic use; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000596:Amino Acids; D008055:Lipids; D013024:Soybean Oil; D005947:Glucose
keywords: life cycle; lipids; neonates; parenteral nutrition; proteins