Dataset Information

Preterm Infants on Early Solid Foods and Vitamin D Status in the First Year of Life-A Secondary Outcome Analysis of a Randomized Controlled Trial.

ABSTRACT: Preterm birth places infants at high risk for mineral and micronutrient deficiencies important for bone health. The aim of this study was to examine whether two timepoints for the introduction of solid foods in preterm infants have an impact on vitamin D status in the first year of life. This is a secondary outcome analysis of a prospective, randomized trial on very low birth weight (VLBW) infants, randomized to an early (10-12th week corrected age) or a late (16-18th week corrected age) complementary-feeding group. Vitamin D status was assessed by blood samples taken at 6 weeks, 6, and 12 months corrected age. In total, 177 infants were randomized (early group: n = 89, late group: n = 88). There was a tendency toward lower levels of serum 25-OH-vitamin D in the early group throughout the first year of life (p = not significant (n.s.)); no differences were detected in the other parameters. At 6 months corrected age, infants of the early group had a significantly higher incidence of vitamin D deficiency. The timepoint of the introduction of solid foods had no impact on the serum 25-OH-vitamin D levels and other parameters important for bone health but showed a tendency toward lower levels in the early-feeding group.

SUBMITTER: Thanhaeuser M

PROVIDER: S-EPMC9370713 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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Preterm Infants on Early Solid Foods and Vitamin D Status in the First Year of Life-A Secondary Outcome Analysis of a Randomized Controlled Trial.

Thanhaeuser Margarita M Eibensteiner Fabian F Kornsteiner-Krenn Margit M Gsoellpointner Melanie M Brandstetter Sophia S Koeller Ursula U Huf Wolfgang W Huber-Dangl Mercedes M Binder Christoph C Thajer Alexandra A Jilma Bernd B Berger Angelika A Haiden Nadja N

Nutrients 20220728 15

Preterm birth places infants at high risk for mineral and micronutrient deficiencies important for bone health. The aim of this study was to examine whether two timepoints for the introduction of solid foods in preterm infants have an impact on vitamin D status in the first year of life. This is a secondary outcome analysis of a prospective, randomized trial on very low birth weight (VLBW) infants, randomized to an early (10-12th week corrected age) or a late (16-18th week corrected age) complem ...[more]

PMID: 35956281

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Project description:ImportanceThere is a beneficial association between human breast milk exposure in the neonatal period and cardiac mechanics in adults who were born preterm. It is unknown whether this benefit is apparent in infants in the first year of age.ObjectiveTo test the hypothesis that higher consumption of mother's own milk in preterm infants is associated with enhanced cardiac performance during the first year of age.Design, setting, and participantsThis cross-sectional study of cardiac and nutritional data at an academic medical center included 80 individuals born preterm and 100 individuals in the control group born full-term. All births were between 2011 and 2013. Two-dimensional echocardiograms were performed at 32 weeks' and 36 weeks' postmenstrual age and at 1 year's corrected age in individuals born preterm and at 1 month and 1 year of age in individuals born full-term. Statistical analysis was performed from January to May 2021.ExposuresConsumption of mother's own milk.Main outcomes and measuresMain study outcomes included echocardiography measures of right and left ventricle longitudinal strain (function), left ventricle mass index and right ventricular areas (morphology), and pulmonary vascular resistance (pulmonary hemodynamics) at age 1 year.ResultsOf 180 infants included in the study, 97 (54%) were Black infants and 89 (49%) were female infants. Among the 80 infants born in the preterm cohort, 43 (54%) were female infants and 43 (54%) were Black infants. The median gestational age at birth of the preterm infants was 27.0 weeks (interquartile range, 26.0-28.0 weeks) and the median birth weight was 960 g (interquartile range, 800-1138). For each week of exposure to mother's own milk, preterm infants had greater magnitudes of right ventricular strain (eg, right longitudinal strain: β, 0.021; 95% CI, 0.002-0.041; P < .001) and left ventricular strain (eg, left longitudinal strain: β, 0.065; 95% CI, 0.049-0.080; P = .01), larger right ventricle areas (eg, systolic area: β, 0.026; 95% CI, 0.011-0.042; P = .009), larger left ventricle mass index (β, 0.045; 95% CI, 0.024-0.073; P = .003), and decreased pulmonary vascular resistance (eg, pulmonary artery acceleration time: β, 0.041; 95% CI, 0.018-0.063; P < .001) at 1 year's corrected age, even after accounting for gestational age and common neonatal morbidities. Cardiac values approached those seen in controls born full-term with increased mother's own milk exposure. There were no differences in any of the cardiac indices at 32 weeks' postmenstrual age, but with each week of exposure, right ventricle function (eg, right longitudinal strain: β, 0.016; 95% CI, 0.002-0.031; P < .001) was greater and pulmonary pressured (eg, pulmonary artery acceleration time: β, 0.0032; 95% CI, 0.0013-0.0062; P < .001).Conclusions and relevanceThis study found that preterm infants with higher consumption of mother's own milk had enhanced cardiac performance at age 1 year, suggesting that mother's own milk consumption may play a dynamic modulator role on cardiac mechanics in preterm-born infants and help in normalization of the preterm cardiac phenotype.

Project description:Iron deficiency (ID) and iron deficiency anemia (IDA) typically occur in developing countries. Notably, ID and IDA can affect an infant's emotion, cognition, and development. Breast milk is considered the best food for infants. However, recent studies have indicated that breastfeeding for more than six months increases the risk of ID. This study investigated the prevalence of ID and IDA, as well as the association between feeding type and iron nutritional status in northern Taiwan. A cross-sectional study was conducted on infants who returned to the well-baby clinic for routine examination from October 2012 to January 2014. Overall, 509 infants aged 1-12 months completed the iron nutritional status analysis, anthropometric measurement, and dietary intake assessment, including milk and complementary foods. The results revealed that 49 (10%) and 21 (4%) infants in their first year of life had ID and IDA, respectively, based on the World Health Organization criteria. Breastfed infants had a higher prevalence rate of ID and IDA than mixed-fed and formula-fed infants (p < 0.001). Regarding biomarkers of iron status, plasma hemoglobin (Hb), ferritin, and transferrin saturation (%) levels were significantly lower in ID and IDA groups. The prevalence of ID and IDA were 3.7% and 2.7%, respectively, in infants under six months of age, but increased to 20.4% and 6.6%, respectively, in infants above six months of age. The healthy group had a higher total iron intake than ID and IDA groups, mainly derived from infant formula. The total dietary iron intake was positively correlated with infants' Hb levels. Compared with formula-fed infants, the logistic regression revealed that the odds ratio for ID was 2.157 (95% confidence interval [CI]: 1.369-3.399) and that for IDA was 4.196 (95% CI: 1.780-9.887) among breastfed infants (p < 0.001) after adjusted for all confounding factors (including gestational week, birthweight, sex, body weight percentile, body length percentile, age of infants, mothers' BMI, gestational weight gain, education level, and hemoglobin level before delivery). In conclusion, our results determined that breastfeeding was associated with an increased the prevalence of ID and/or IDA, especially in infants above six months. This suggests that mothers who prolonged breastfeed after six months could provide high-quality iron-rich foods to reduce the prevalence of ID and IDA.

Dataset Information

Preterm Infants on Early Solid Foods and Vitamin D Status in the First Year of Life-A Secondary Outcome Analysis of a Randomized Controlled Trial.

Publications

Preterm Infants on Early Solid Foods and Vitamin D Status in the First Year of Life-A Secondary Outcome Analysis of a Randomized Controlled Trial.

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