Neuropediatrics 2014; 45(01): 022-029
DOI: 10.1055/s-0033-1349227
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Neurodevelopmental Outcome during the First Year of Life in Preterm Infants after Supplementation of a Prebiotic Mixture in the Neonatal Period: A Follow-Up Study

Natalie E. LeCouffe
1   Division of Neonatology, Department of Pediatrics, VU University Medical Center, Amsterdam, The Netherlands
,
Elisabeth A. M. Westerbeek
1   Division of Neonatology, Department of Pediatrics, VU University Medical Center, Amsterdam, The Netherlands
,
Petra E. M. van Schie
2   Department of Rehabilitation Medicine, (Pediatric) Physiotherapy, VU University Medical Center, Amsterdam, The Netherlands
,
Veronique A. M. Schaaf
2   Department of Rehabilitation Medicine, (Pediatric) Physiotherapy, VU University Medical Center, Amsterdam, The Netherlands
,
Harrie N. Lafeber
1   Division of Neonatology, Department of Pediatrics, VU University Medical Center, Amsterdam, The Netherlands
,
Ruurd M. van Elburg
1   Division of Neonatology, Department of Pediatrics, VU University Medical Center, Amsterdam, The Netherlands
3   Danone Research—Center for Specialized Nutrition, Wageningen, The Netherlands
› Author Affiliations
Further Information

Publication History

20 December 2012

08 May 2013

Publication Date:
25 July 2013 (online)

Abstract

Aim The study aimed to determine the effect of enteral supplementation of a prebiotic mixture (neutral and acidic oligosaccharides) in the neonatal period on neurodevelopmental outcome in preterm infants with a gestational age of less than 32 weeks and/or birth weight of less than 1,500 g in the first year of life.

Methods Neurodevelopmental outcome consisted of tone and motility according to Touwen, motor ability according to the Alberta Infant Motor Scale, as well as vision and hearing were evaluated at 0, 3, 6, and 12 months corrected age (CA). To adjust for potential confounders, data were analyzed by multinomial or logistic regression.

Results In total, 93 of 101 infants (92%) participated in the study (prebiotic mixture group [n = 48] and placebo group [n = 45]). Incidence of suspect and abnormal neurodevelopmental outcome and delayed motor ability was not different in the prebiotic mixture and placebo group at 0, 3, 6, and 12 months (CA). Infants with 1 or more neonatal infections or more had a higher incidence of abnormal neurodevelopmental outcome (OR: 20.73; 95% CI: 1.31–328.46; p = 0.03) at 6 months CA.

Conclusion Short-term enteral supplementation of a prebiotic mixture in the neonatal period had no effect on neurodevelopmental outcome in preterm infants in the first year of life. However, serious neonatal infections in preterm infants were associated with adverse neurodevelopmental outcome at 6 months, but not at 12 months.

 
  • References

  • 1 Srinivasjois R, Rao S, Patole S. Prebiotic supplementation of formula in preterm neonates: a systematic review and meta-analysis of randomised controlled trials. Clin Nutr 2009; 28 (3) 237-242
  • 2 Boehm G, Lidestri M, Casetta P , et al. Supplementation of a bovine milk formula with an oligosaccharide mixture increases counts of faecal bifidobacteria in preterm infants. Arch Dis Child Fetal Neonatal Ed 2002; 86 (3) F178-F181
  • 3 Berger I. Mind the gap: the unique neurodevelopment of extremely low birth weight infants. Isr Med Assoc J 2008; 10 (10) 718-721
  • 4 Soraisham AS, Amin HJ, Al-Hindi MY, Singhal N, Sauve RS. Does necrotising enterocolitis impact the neurodevelopmental and growth outcomes in preterm infants with birthweight < or =1250 g?. J Paediatr Child Health 2006; 42 (9) 499-504
  • 5 Rezaie P, Dean A. Periventricular leukomalacia, inflammation and white matter lesions within the developing nervous system. Neuropathology 2002; 22 (3) 106-132
  • 6 Costantine MM, How HY, Coppage K, Maxwell RA, Sibai BM. Does peripartum infection increase the incidence of cerebral palsy in extremely low birthweight infants?. Am J Obstet Gynecol 2007; 196 (5) e6-e8
  • 7 Stoll BJ, Hansen NI, Adams-Chapman I , et al; National Institute of Child Health and Human Development Neonatal Research Network. Neurodevelopmental and growth impairment among extremely low-birth-weight infants with neonatal infection. JAMA 2004; 292 (19) 2357-2365
  • 8 Murphy DJ, Hope PL, Johnson A. Neonatal risk factors for cerebral palsy in very preterm babies: case-control study. BMJ 1997; 314 (7078) 404-408
  • 9 Doctor BA, Newman N, Minich NM, Taylor HG, Fanaroff AA, Hack M. Clinical outcomes of neonatal meningitis in very-low birth-weight infants. Clin Pediatr (Phila) 2001; 40 (9) 473-480
  • 10 Westerbeek EA, van den Berg JP, Lafeber HN , et al. Neutral and acidic oligosaccharides in preterm infants: a randomized, double-blind, placebo-controlled trial. Am J Clin Nutr 91 (3) 679-686
  • 11 Wang CJ, McGlynn EA, Brook RH , et al. Quality-of-care indicators for the neurodevelopmental follow-up of very low birth weight children: results of an expert panel process. Pediatrics 2006; 117 (6) 2080-2092
  • 12 Spittle AJ, Doyle LW, Boyd RN. A systematic review of the clinimetric properties of neuromotor assessments for preterm infants during the first year of life. Dev Med Child Neurol 2008; 50 (4) 254-266
  • 13 Mikkola K, Ritari N, Tommiska V , et al. Neurodevelopmental outcome at 5 years of age of a national cohort of extremely low birth weight infants who were born in 1996-1997. Pediatrics 2005; 116 (6) 1391-1400
  • 14 Westerbeek EA, van Elburg RM, van den Berg A , et al. Design of a randomised controlled trial on immune effects of acidic and neutral oligosaccharides in the nutrition of preterm infants: carrot study. BMC Pediatr 2008; 8: 46
  • 15 Touwen BCL. Neurological development in infancy. Clinics in Developmental Medicine. London: 1976
  • 16 van Schie PE, Rep A, Ganzevoort W , et al; PETRA-Investigators. General movements in infants born from mothers with early-onset hypertensive disorders of pregnancy in relation to one year's neurodevelopmental outcome. Early Hum Dev 2008; 84 (9) 605-611
  • 17 van Schie PE, Becher JG, Dallmeijer AJ, Barkhof F, Weissenbruch MM, Vermeulen RJ. Motor outcome at the age of one after perinatal hypoxic-ischemic encephalopathy. Neuropediatrics 2007; 38 (2) 71-77
  • 18 Piper MC, Darrah J. Motor assessment of the developing infant. Philadelphia: WB Saunders; 1994
  • 19 Wood NS, Marlow N, Costeloe K, Gibson AT, Wilkinson AR. Neurologic and developmental disability after extremely preterm birth. EPICure Study Group. N Engl J Med 2000; 343 (6) 378-384
  • 20 Marlow N. Neurocognitive outcome after very preterm birth. Arch Dis Child Fetal Neonatal Ed 2004; 89 (3) F224-F228
  • 21 Brandt I, Sticker EJ, Höcky M, Lentze MJ. Transient abnormal neurologic signs (TANS) in a longitudinal study of very low birth weight preterm infants. Early Hum Dev 2000; 59 (2) 107-126
  • 22 Prechtl HFR, Beintema DJ. The Neurological Examination of the Full-Term Newborn Infant. Lavenham, Suffolk: The Lavenham Press; 1964
  • 23 Touwen BCL. Examination of the Child with Minor Neurological Dysfunction Clinics in Developmental Medicine with Spastics International Medical Publications. 2nd ed. Vol. 71, London, England: William Heinemann Medical Books; 1979
  • 24 Hadders-Algra M, Heineman KR, Bos AF, Middelburg KJ. The assessment of minor neurological dysfunction in infancy using the Touwen Infant Neurological Examination: strengths and limitations. Dev Med Child Neurol 2010; 52 (1) 87-92
  • 25 Yanowitz TD, Jordan JA, Gilmour CH , et al. Hemodynamic disturbances in premature infants born after chorioamnionitis: association with cord blood cytokine concentrations. Pediatr Res 2002; 51 (3) 310-316
  • 26 Chau V, Brant R, Poskitt KJ, Tam EW, Synnes A, Miller SP. Postnatal infection is associated with widespread abnormalities of brain development in premature newborns. Pediatr Res 2012; 71 (3) 274-279
  • 27 Harding D. Impact of common genetic variation on neonatal disease and outcome. Arch Dis Child Fetal Neonatal Ed 2007; 92 (5) F408-F413
  • 28 Anderson JW, Johnstone BM, Remley DT. Breast-feeding and cognitive development: a meta-analysis. Am J Clin Nutr 1999; 70 (4) 525-535
  • 29 de Graaf-Peters VB, Hadders-Algra M. Ontogeny of the human central nervous system: what is happening when?. Early Hum Dev 2006; 82 (4) 257-266
  • 30 van Haastert IC, de Vries LS, Helders PJ, Jongmans MJ. Early gross motor development of preterm infants according to the Alberta Infant Motor Scale. J Pediatr 2006; 149 (5) 617-622