The repercussions of reduced energy and protein intake during the early
neonatal period of very-low-birth-weight infants on their lung function
during childhood
Abstract
Background Prematurity and bronchopulmonary dysplasia can modify lung
function in children and adults. Postnatal nutrition and rapid growth
catch-up may influence the long-term development of lung function.
Methods This prospective observational study was based on a cohort of
334 very-low-birth-weight (VLBW) neonates, born between 1 January 2008
and 12 December 2015. Patients with severe neurological damage, death or
incomplete data record were excluded. When these infants reached a mean
age of 7.7 years, a spirometry evaluation was performed, to determine
FEV1, FEF25-75%, FVC and the FEV1/FVC ratio. The relation between these
parameters and nutritional intake in the early neonatal period was
determined by regression analysis. Results In total, 40 spirometry tests
were performed. The results obtained, after adjusting for age and sex by
Z-scores for the spirometry variables, showed that the schoolchildren
who had been VLBW recorded significantly lower spirometry results (FVC,
FEV1, FEF25-75%) than the reference values. Furthermore, there was a
significant association between the FEV1/FVC ratio and the intake of
macronutrients and energy in the first week of life. It is hypothesised
that increasing energy intake and achieving a higher protein/energy
ratio in the first week of life would improve the FEV1/FVC ratio by the
time these VLBW infants reach school age. Conclusions Active nutritional
management in the early neonatal period is associated with improved lung
function, as reflected by the spirometry findings obtained.