Clinical nutrition (Edinburgh, Scotland) · 2026
Early neonatal lipid intake is associated with verbal comprehension and supramarginal gyrus volume at school age in very low birth weight preterm infants: A longitudinal cohort study.
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Uberos Jose, Carrasco-Solis Marta, Laynez-Rubio Carolina, Nieto-Ruiz Ana, Ruiz-López Aida, Fernández-Marin Elizabeth, Blanca-Jover Enrique, Campos-Martínez Ana, Collaborative NeuroPrem group
Аннотация
BACKGROUND AND AIMS: Early nutritional exposure may influence brain development in very low birth weight (VLBW) preterm infants, although its long-term relationship with specific cognitive domains remains unclear. The objective was to investigate the association between protein and lipid intake during the first week of life and verbal comprehension and brain regional volumes at school age.
METHODS: This longitudinal cohort study included 157 VLBW infants (<1500 g, <32 weeks gestation). Nutritional intake during the first week of life was prospectively recorded. At school age (6-16 years), 157 children underwent neuropsychological assessment and 115 underwent brain MRI. Regional brain volumes were obtained using FreeSurfer. Multivariable regression models were adjusted for gestational age, intracranial volume, age at assessment, and parental socioeconomic status.
RESULTS: Higher lipid intake during the first week of life was associated with better verbal comprehension scores and with larger left supramarginal gyrus volume. Protein intake was not associated with verbal comprehension but was associated with the volume of several frontal and temporal regions involved in language processing. Children with lower verbal comprehension exhibited smaller volumes in multiple regions, although after correction for multiple comparisons only the left rostral middle frontal gyrus, precentral gyrus, and temporal pole remained significant. Sensitivity analyses including CRIB II score attenuated the association between lipid intake and verbal comprehension, suggesting a possible influence of neonatal illness severity.
CONCLUSIONS: Higher lipid intake during the first week of life was associated with better verbal comprehension and larger supramarginal gyrus volume at school age in VLBW preterm infants, whereas protein intake was associated with the volume of several language-related cortical regions. Given the observational design and the attenuation of the association with verbal comprehension after adjustment for CRIB II score, these findings should be interpreted as associations rather than evidence of causality.
METHODS: This longitudinal cohort study included 157 VLBW infants (<1500 g, <32 weeks gestation). Nutritional intake during the first week of life was prospectively recorded. At school age (6-16 years), 157 children underwent neuropsychological assessment and 115 underwent brain MRI. Regional brain volumes were obtained using FreeSurfer. Multivariable regression models were adjusted for gestational age, intracranial volume, age at assessment, and parental socioeconomic status.
RESULTS: Higher lipid intake during the first week of life was associated with better verbal comprehension scores and with larger left supramarginal gyrus volume. Protein intake was not associated with verbal comprehension but was associated with the volume of several frontal and temporal regions involved in language processing. Children with lower verbal comprehension exhibited smaller volumes in multiple regions, although after correction for multiple comparisons only the left rostral middle frontal gyrus, precentral gyrus, and temporal pole remained significant. Sensitivity analyses including CRIB II score attenuated the association between lipid intake and verbal comprehension, suggesting a possible influence of neonatal illness severity.
CONCLUSIONS: Higher lipid intake during the first week of life was associated with better verbal comprehension and larger supramarginal gyrus volume at school age in VLBW preterm infants, whereas protein intake was associated with the volume of several language-related cortical regions. Given the observational design and the attenuation of the association with verbal comprehension after adjustment for CRIB II score, these findings should be interpreted as associations rather than evidence of causality.