Effect of early nutritional intake on long-term growth and bone mineralization of former very low birth weight infants

V. Christmann, M. E. van der Putten, L. Rodwell, K. Steiner, M. Gotthardt, J. B. van Goudoever, A. F. J. van Heijst

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background Preterm infants are at risk for impaired bone mineralization and growth in length later in life due to inadequate nutritional intake in the early postnatal period. Objective To investigate whether increased nutritional supplementation of calcium, phosphate and protein in Very Low Birth Weight (VLBW) infants during the first 14 days after birth was associated with improvement in length and bone development until 9–10 years of age. Design Observational follow-up study of VLBW infants (birth weight < 1500 g or gestational age < 32 weeks) born in two consecutive years (eligible infants: 2004 n: 63 and 2005: n: 66). Cohort 2005 received higher intake of calcium, phosphate and protein with parenteral nutrition compared to Cohort 2004. Anthropometric data were collected during standard follow-up visits until five years, and additionally at 9–10 years of age including measurements of bone mineral content, bone mineral density of the whole body and lumbar spine determined by dual-energy X-ray absorptiometry. Long-term growth trajectories of both cohorts were evaluated separately for participants born appropriate (AGA) and small for gestational age (SGA), stratified by gender. Multivariate linear regression was used to examine the effect of nutritional intake and clinical covariates on length and bone mineralization. Results Both cohorts achieved a catch-up in length to SDS within the normal range by 6 months (length SDS: estimated mean (95% confidence interval (CI): 6 months: Cohort 2004: − 0.7 (− 1.1, − 0.3) Cohort 2005: − 0.5 (− 0.8, − 0.2)). Bone mineral content and density were within the normal range and not different between the cohorts. SGA children achieved a catch-up in length at 5 years with bone mineralization comparable to AGA children. Only for girls birth weight was significantly associated with length SDS (per gram: β 0.001; 95% CI (0.000, 0.003); p = 0.03) There was no evidence of an association between early nutritional intake and bone mineralization. Conclusion Children born as appropriate or small for gestational age preterm infants are able to catch up in length after the postnatal period, and achieve a normal length and bone mineralization at age nine–ten years. An improvement of calcium and phosphate intake during the first 14 days after birth was not associated with improvement in length and bone development.
Original languageEnglish
Pages (from-to)89-97
JournalBone
Volume108
DOIs
Publication statusPublished - 2018

Cite this

Christmann, V., van der Putten, M. E., Rodwell, L., Steiner, K., Gotthardt, M., van Goudoever, J. B., & van Heijst, A. F. J. (2018). Effect of early nutritional intake on long-term growth and bone mineralization of former very low birth weight infants. Bone, 108, 89-97. https://doi.org/10.1016/j.bone.2017.12.022
Christmann, V. ; van der Putten, M. E. ; Rodwell, L. ; Steiner, K. ; Gotthardt, M. ; van Goudoever, J. B. ; van Heijst, A. F. J. / Effect of early nutritional intake on long-term growth and bone mineralization of former very low birth weight infants. In: Bone. 2018 ; Vol. 108. pp. 89-97.
@article{c5c60f9ef2a142aaa5eef89372efdd36,
title = "Effect of early nutritional intake on long-term growth and bone mineralization of former very low birth weight infants",
abstract = "Background Preterm infants are at risk for impaired bone mineralization and growth in length later in life due to inadequate nutritional intake in the early postnatal period. Objective To investigate whether increased nutritional supplementation of calcium, phosphate and protein in Very Low Birth Weight (VLBW) infants during the first 14 days after birth was associated with improvement in length and bone development until 9–10 years of age. Design Observational follow-up study of VLBW infants (birth weight < 1500 g or gestational age < 32 weeks) born in two consecutive years (eligible infants: 2004 n: 63 and 2005: n: 66). Cohort 2005 received higher intake of calcium, phosphate and protein with parenteral nutrition compared to Cohort 2004. Anthropometric data were collected during standard follow-up visits until five years, and additionally at 9–10 years of age including measurements of bone mineral content, bone mineral density of the whole body and lumbar spine determined by dual-energy X-ray absorptiometry. Long-term growth trajectories of both cohorts were evaluated separately for participants born appropriate (AGA) and small for gestational age (SGA), stratified by gender. Multivariate linear regression was used to examine the effect of nutritional intake and clinical covariates on length and bone mineralization. Results Both cohorts achieved a catch-up in length to SDS within the normal range by 6 months (length SDS: estimated mean (95{\%} confidence interval (CI): 6 months: Cohort 2004: − 0.7 (− 1.1, − 0.3) Cohort 2005: − 0.5 (− 0.8, − 0.2)). Bone mineral content and density were within the normal range and not different between the cohorts. SGA children achieved a catch-up in length at 5 years with bone mineralization comparable to AGA children. Only for girls birth weight was significantly associated with length SDS (per gram: β 0.001; 95{\%} CI (0.000, 0.003); p = 0.03) There was no evidence of an association between early nutritional intake and bone mineralization. Conclusion Children born as appropriate or small for gestational age preterm infants are able to catch up in length after the postnatal period, and achieve a normal length and bone mineralization at age nine–ten years. An improvement of calcium and phosphate intake during the first 14 days after birth was not associated with improvement in length and bone development.",
author = "V. Christmann and {van der Putten}, {M. E.} and L. Rodwell and K. Steiner and M. Gotthardt and {van Goudoever}, {J. B.} and {van Heijst}, {A. F. J.}",
year = "2018",
doi = "10.1016/j.bone.2017.12.022",
language = "English",
volume = "108",
pages = "89--97",
journal = "Bone",
issn = "8756-3282",
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Christmann, V, van der Putten, ME, Rodwell, L, Steiner, K, Gotthardt, M, van Goudoever, JB & van Heijst, AFJ 2018, 'Effect of early nutritional intake on long-term growth and bone mineralization of former very low birth weight infants' Bone, vol. 108, pp. 89-97. https://doi.org/10.1016/j.bone.2017.12.022

Effect of early nutritional intake on long-term growth and bone mineralization of former very low birth weight infants. / Christmann, V.; van der Putten, M. E.; Rodwell, L.; Steiner, K.; Gotthardt, M.; van Goudoever, J. B.; van Heijst, A. F. J.

In: Bone, Vol. 108, 2018, p. 89-97.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Effect of early nutritional intake on long-term growth and bone mineralization of former very low birth weight infants

AU - Christmann, V.

AU - van der Putten, M. E.

AU - Rodwell, L.

AU - Steiner, K.

AU - Gotthardt, M.

AU - van Goudoever, J. B.

AU - van Heijst, A. F. J.

PY - 2018

Y1 - 2018

N2 - Background Preterm infants are at risk for impaired bone mineralization and growth in length later in life due to inadequate nutritional intake in the early postnatal period. Objective To investigate whether increased nutritional supplementation of calcium, phosphate and protein in Very Low Birth Weight (VLBW) infants during the first 14 days after birth was associated with improvement in length and bone development until 9–10 years of age. Design Observational follow-up study of VLBW infants (birth weight < 1500 g or gestational age < 32 weeks) born in two consecutive years (eligible infants: 2004 n: 63 and 2005: n: 66). Cohort 2005 received higher intake of calcium, phosphate and protein with parenteral nutrition compared to Cohort 2004. Anthropometric data were collected during standard follow-up visits until five years, and additionally at 9–10 years of age including measurements of bone mineral content, bone mineral density of the whole body and lumbar spine determined by dual-energy X-ray absorptiometry. Long-term growth trajectories of both cohorts were evaluated separately for participants born appropriate (AGA) and small for gestational age (SGA), stratified by gender. Multivariate linear regression was used to examine the effect of nutritional intake and clinical covariates on length and bone mineralization. Results Both cohorts achieved a catch-up in length to SDS within the normal range by 6 months (length SDS: estimated mean (95% confidence interval (CI): 6 months: Cohort 2004: − 0.7 (− 1.1, − 0.3) Cohort 2005: − 0.5 (− 0.8, − 0.2)). Bone mineral content and density were within the normal range and not different between the cohorts. SGA children achieved a catch-up in length at 5 years with bone mineralization comparable to AGA children. Only for girls birth weight was significantly associated with length SDS (per gram: β 0.001; 95% CI (0.000, 0.003); p = 0.03) There was no evidence of an association between early nutritional intake and bone mineralization. Conclusion Children born as appropriate or small for gestational age preterm infants are able to catch up in length after the postnatal period, and achieve a normal length and bone mineralization at age nine–ten years. An improvement of calcium and phosphate intake during the first 14 days after birth was not associated with improvement in length and bone development.

AB - Background Preterm infants are at risk for impaired bone mineralization and growth in length later in life due to inadequate nutritional intake in the early postnatal period. Objective To investigate whether increased nutritional supplementation of calcium, phosphate and protein in Very Low Birth Weight (VLBW) infants during the first 14 days after birth was associated with improvement in length and bone development until 9–10 years of age. Design Observational follow-up study of VLBW infants (birth weight < 1500 g or gestational age < 32 weeks) born in two consecutive years (eligible infants: 2004 n: 63 and 2005: n: 66). Cohort 2005 received higher intake of calcium, phosphate and protein with parenteral nutrition compared to Cohort 2004. Anthropometric data were collected during standard follow-up visits until five years, and additionally at 9–10 years of age including measurements of bone mineral content, bone mineral density of the whole body and lumbar spine determined by dual-energy X-ray absorptiometry. Long-term growth trajectories of both cohorts were evaluated separately for participants born appropriate (AGA) and small for gestational age (SGA), stratified by gender. Multivariate linear regression was used to examine the effect of nutritional intake and clinical covariates on length and bone mineralization. Results Both cohorts achieved a catch-up in length to SDS within the normal range by 6 months (length SDS: estimated mean (95% confidence interval (CI): 6 months: Cohort 2004: − 0.7 (− 1.1, − 0.3) Cohort 2005: − 0.5 (− 0.8, − 0.2)). Bone mineral content and density were within the normal range and not different between the cohorts. SGA children achieved a catch-up in length at 5 years with bone mineralization comparable to AGA children. Only for girls birth weight was significantly associated with length SDS (per gram: β 0.001; 95% CI (0.000, 0.003); p = 0.03) There was no evidence of an association between early nutritional intake and bone mineralization. Conclusion Children born as appropriate or small for gestational age preterm infants are able to catch up in length after the postnatal period, and achieve a normal length and bone mineralization at age nine–ten years. An improvement of calcium and phosphate intake during the first 14 days after birth was not associated with improvement in length and bone development.

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U2 - 10.1016/j.bone.2017.12.022

DO - 10.1016/j.bone.2017.12.022

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VL - 108

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EP - 97

JO - Bone

JF - Bone

SN - 8756-3282

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