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. 2025 Aug;98(2):593-598.
doi: 10.1038/s41390-025-03964-8. Epub 2025 Mar 4.

Impact of early nutrition on brain development and neurocognitive outcomes in very preterm infants

Nima Naseh  1 , Tânia F Vaz  2 , Hugo Ferreira  2 , Nuno Canto Moreira  3 , Lena Hellström-Westas  4 , Fredrik Ahlsson  4 , Johan Ågren  4
Affiliations

Impact of early nutrition on brain development and neurocognitive outcomes in very preterm infants

Nima Naseh et al. Pediatr Res. 2025 Aug.

Abstract

Background: Malnutrition of preterm infants may negatively affect brain growth and later neurocognitive function. We aimed to investigate the association between very preterm infants' macronutrient intakes, and brain MRI at term and neurodevelopment at 2 years.

Methods: Single-center, retrospective cohort including extremely (22-27w) and very (28-31w) preterm infants born 2011-2014. The intakes of fluid, protein, carbohydrate, fat, and total calories during days 0-28 together with body weights were assessed in relation to brain MRI (morphology, volumetry, diffusion-weighted imaging) at term, and cognition (BSID-III) at 2 years, using adjusted multivariable regression analyses.

Results: Seventy-two infants were included. A lower (p < 0.001) caloric intake in extremely preterm (n = 26) than in very preterm (n = 46) infants did not translate to any differences in brain volumes. While bivariate correlations (p < 0.01) were found between the enteral intakes of all macronutrients, and white matter volume and apparent diffusion coefficients, none of the correlations remained significant after adjusting for covariates in the multivariable analysis. Similarly, no associations between nutrient intakes and cognitive development remained after covariate adjustment.

Conclusion: In a cohort of preterm infants receiving macronutrient intakes meeting current recommendations, individual variations in nutrition did not influence brain growth or neurodevelopment.

Impact: Early postnatal macronutrient intake was not associated with brain volumes at term or neurocognitive outcomes at 2 years in very preterm infants All infants received nutritional intakes meeting current recommendations Adequate macronutrient intake based on a standardized protocol may eliminate the need for further minor adjustments in the pursuit of supporting brain growth and neurodevelopment in preterm infants.

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Conflict of interest statement

Competing interests: The authors declare no competing interests. Ethics approval: The investigation was approved 2014 of by the Swedish Ethical Review Authority (2014/236), and data were included after parental consent.

Figures

Fig. 1
Fig. 1
STROBE flowchart of the study cohort.
See this image and copyright information in PMC

References

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