Background: Very low‐birth‐weight (VLBW) infants are at risk for neurodevelopment impairment. This study assessed the effect of early aggressive parenteral nutrition (PN) on long‐term outcome in VLBW infants. Materials and Methods: Directly after birth, VLBW infants (birth weight <1500 g, n = 142) were randomized to 5 different PN regimes. Controls (n = 46) received glucose and standard‐dose amino acids (AAs; 2.4 g/[kg·d]) from birth onward and pure soybean oil fat emulsion (SOY) on the second day of life. Two intervention groups received glucose, standard‐dose AAs, and lipids from birth onward: SOY (n = 24) or mixed fat emulsion (MIX, n = 25). The 2 other intervention groups received glucose, high‐dose AAs (3.6 g/[kg·d]), and lipids from birth onward: SOY (n = 24) or MIX (n = 23). The primary outcome of this follow‐up study was the composite outcome of “death or major disability” at 2 years corrected age. Secondary outcomes were death, major disabilities, neurodevelopmental scores, and anthropometry. Results: Follow‐up rate was 92% (n = 134). Thirty‐five (26%) infants had died or had a major disability, with no differences between intervention groups and controls. Increased odds for death were observed in the standard‐dose AA‐MIX group (odds ratio, 5.4; 95% confidence interval [CI], 1.1–27.0). Neurodevelopmental scores and incidence of major disabilities did not differ between groups. Growth in the high‐dose AA‐MIX group was enhanced compared with growth in controls at 2 years corrected age (+0.51 [0.01–1.02] weight SDS). Conclusion: This randomized controlled hypothesis‐generating study demonstrated no beneficial effect of early high‐dose AA administration and mixed fat emulsions on survival and neurodevelopmental outcome in VLBW infants, although growth was enhanced.,
Journal of Parenteral and Enteral Nutrition
Department of Pediatrics

Roelants, J., Vlaardingerbroek, H., van den Akker, C., de Jonge, R., van Goudoever, H., & Vermeulen, M. (2018). Two-Year Follow-up of a Randomized Controlled Nutrition Intervention Trial in Very Low-Birth-Weight Infants. Journal of Parenteral and Enteral Nutrition, 42(1), 122–130. doi:10.1177/0148607116678196