Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep 23;14(19):3957.
doi: 10.3390/nu14193957.

A Scoping Review: Urinary Markers of Metabolic Maturation in Preterm Infants and Future Interventions to Improve Growth

Luise V Marino  1   2   3 , Simone Paulson  1 , James J Ashton  3   4   5 , Charlotte Weeks  1 , Aneurin Young  3   5   6 , John V Pappachan  1   7 , Jonathan Swann  8 , Mark J Johnson  3   6   7 , Robert Mark Beattie  3   4   5
Affiliations

A Scoping Review: Urinary Markers of Metabolic Maturation in Preterm Infants and Future Interventions to Improve Growth

Luise V Marino et al. Nutrients. .

Abstract

Background: Growth failure in infants born preterm is a significant issue, increasing the risk of poorer neurodevelopmental outcomes and metabolic syndrome later in life. During the first 1000 days of life biological systems mature rapidly involving developmental programming, cellular senescence, and metabolic maturation, regulating normal growth and development. However, little is known about metabolic maturation in infants born preterm and the relationship with growth. Objective: To examine the available evidence on urinary markers of metabolic maturation and their relationship with growth in infants born preterm. Eligibility criteria: Studies including in this scoping review using qualitative or quantitative methods to describe urinary markers of metabolic maturation and the relationship with growth in infants born preterm. Results: After a screening process 15 titles were included in this review, from 1998-2021 drawing from China (n = 1), Italy (n = 3), Germany (n = 3), Greece (n = 1), Japan (n = 2), Norway (n = 1), Portugal (n = 1), Spain (n = 2) and USA (n = 1). The included studies examined urinary metabolites in 1131 infants. A content analysis identified 4 overarching themes relating to; (i) metabolic maturation relative to gestational age, (ii) metabolic signature and changes in urinary metabolites over time, (iii) nutrition and (iv) growth. Conclusion: The results of this scoping review suggest there are considerable gaps in our knowledge relating to factors associated with metabolic instability, what constitutes normal maturation of preterm infants, and how the development of reference phenome age z scores for metabolites of interest could improve nutritional and growth outcomes.

Keywords: growth; infants; metabolic maturation; preterm; urinary metabolites.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Prisma flow chart of studies included in the scoping review.
Figure 2
Figure 2
Graphical representation of the narrative synthesis and content analysis.
Figure 3
Figure 3
Relationships with changes in metabolites over time and growth in preterm infants compared to healthy term infants. Abbreviations: ADP: adenosine triphosphate, 4-DTA: 4-deoxythreonic acid, 4-DTA: 4-deoxythreonic acid, 3-HBA: 3-hydroxybutyrate; IS: indoxyl sulfate; 3-Me-His: 3-methylhistidine; 1-Me-His: 1-methylhistidine.
See this image and copyright information in PMC

References

    1. Preterm Birth. [(accessed on 24 April 2022)]. Available online: http://www.who.int/news-room/fact-sheets/detail/preterm-birth.
    1. Demerath E.W., Johnson W., Davern B.A., Anderson C.G., Shenberger J.S., Misra S., Ramel S.E. New body composition reference charts for preterm infants. Am. J. Clin. Nutr. 2016;105:70–77. doi: 10.3945/ajcn.116.138248. - DOI - PubMed
    1. Ashton J., Johnson M.J., Pond J., Crowley P., Dimitrov B.D., Pearson F., Beattie R.M. Assessing the growth of preterm infants using detailed anthropometry. Acta Paediatr. 2017;106:889–896. doi: 10.1111/apa.13804. - DOI - PubMed
    1. Agostoni C., Buonocore G., Carnielli V.P., De Curtis M., Darmaun D., Decsi T., Domellöf M., Embleton N.D., Fusch C., Genzel-Boroviczeny O., et al. Enteral Nutrient Supply for Preterm Infants: Commentary From the European Society of Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. J. Pediatr. Gastroenterol. Nutr. 2010;50:85–91. doi: 10.1097/MPG.0b013e3181adaee0. - DOI - PubMed
    1. Young A., Beattie R.M., Johnson M.J. Optimising growth in very preterm infants: Reviewing the evidence. Arch. Dis. Child. Fetal Neonatal Ed. 2022 doi: 10.1136/archdischild-2021-322892. Published online First: 28 February. - DOI - PubMed

Publication types