Neurodevelopmental Outcome of Very Low Birth Weight Infants enrolled in a Trial of Early Enhanced Nutrition † 1217

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A randomized controlled trial of aggressive vs conservative nutritional management showed improved growth at hospital discharge, decreased sepsis and a tendency to reduction in death or BPD [Arch Dis Child 1997;F4-11].

Objectives: To compare the developmental, neurological and anthropometric outcome of infants given enhanced or normal nutrition in the neonatal period.

Design: Randomized controlled trial

Subjects: 125 infants who had been enrolled in a trial of enhanced or normal nutrition on the first day of life.

Methods: Children were followed up at 18 months corrected age by a blinded investigator. Intellectual ability was assessed using Bayley scales. Physical examination and anthropometry were carried out.

Results: 32 of the 125 infants had died. 85 of 93 attended for assessment (91%). The results of the 45 infants in the aggressive group are presented in comparison to the normal group. There was no significant difference in weight (9.9 +/- 1.3 vs 10.2 +/- 1.2kg), height (78.1 +/- 3.4 vs 79.1 +/- 3.6cm)or head circumference (47.9 +/- 2.2 vs 47.9 +/- 1.8cm). Cerebral palsy rates did not differ between the groups (20% vs 15% p=0.75). The mental development index in those children without cerebal palsy was 97+/- 22 vs 104 +/- 18 (p=0.19). Multiple regression analysis to account for baseline differences at randomization did not reveal a significant contribution of the nutritional regimen to the variance in intellectual outcome.

Conclusion: Aggressive nutritional management in the neonatal period did not confer any long term benefit.

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(Spon by: Seroj Saigal) Funded by B Braun, Germany.

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