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Belyaeva IA, Bombardirova EP, Prihodko EA, Kruglyakov AY, Mikheeva AA, Larina AR. Clinical Phenotypes of Malnutrition in Young Children: Differential Nutritional Correction. CURRENT PEDIATRICS 2023. [DOI: 10.15690/vsp.v21i6.2495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
This review article summarizes current data on malnutrition etiology and pathogenesis in infants. Topical requirements for revealing this condition, its diagnosis and severity assessment via centile metrics are presented. The characteristics of the most common clinical phenotypes of postnatal growth insufficiency in infants (premature infants with different degree of maturation, including patients with bronchopulmonary dysplasia) are described. Differential approaches for malnutrition nutritional correction in these children are presented. The final section of the article describes special nutritional needs for children with congenital heart defects in terms of hemodynamic disorders nature and severity. Modern nutritional strategies for preparation of these patients to surgery and for their postoperative period are presented. The use of high-calorie/high-protein product for malnutrition correction in the most vulnerable patients with described in this review phenotypes is worth noticing.
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Affiliation(s)
- I. A. Belyaeva
- Research Institute of Pediatrics and Children’s Health in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical University; Morozovskaya Children’s City Hospital
| | - E. P. Bombardirova
- Research Institute of Pediatrics and Children’s Health in Petrovsky National Research Centre of Surgery
| | | | | | - A. A. Mikheeva
- Research Institute for Healthcare Organization and Medical Management
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Marino LV, Paulson S, Ashton JJ, Weeks C, Young A, Pappachan JV, Swann J, Johnson MJ, Beattie RM. A Scoping Review: Urinary Markers of Metabolic Maturation in Preterm Infants and Future Interventions to Improve Growth. Nutrients 2022; 14:nu14193957. [PMID: 36235609 PMCID: PMC9571892 DOI: 10.3390/nu14193957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/10/2022] [Accepted: 09/20/2022] [Indexed: 11/21/2022] Open
Abstract
Background: Growth failure in infants born preterm is a significant issue, increasing the risk of poorer neurodevelopmental outcomes and metabolic syndrome later in life. During the first 1000 days of life biological systems mature rapidly involving developmental programming, cellular senescence, and metabolic maturation, regulating normal growth and development. However, little is known about metabolic maturation in infants born preterm and the relationship with growth. Objective: To examine the available evidence on urinary markers of metabolic maturation and their relationship with growth in infants born preterm. Eligibility criteria: Studies including in this scoping review using qualitative or quantitative methods to describe urinary markers of metabolic maturation and the relationship with growth in infants born preterm. Results: After a screening process 15 titles were included in this review, from 1998–2021 drawing from China (n = 1), Italy (n = 3), Germany (n = 3), Greece (n = 1), Japan (n = 2), Norway (n = 1), Portugal (n = 1), Spain (n = 2) and USA (n = 1). The included studies examined urinary metabolites in 1131 infants. A content analysis identified 4 overarching themes relating to; (i) metabolic maturation relative to gestational age, (ii) metabolic signature and changes in urinary metabolites over time, (iii) nutrition and (iv) growth. Conclusion: The results of this scoping review suggest there are considerable gaps in our knowledge relating to factors associated with metabolic instability, what constitutes normal maturation of preterm infants, and how the development of reference phenome age z scores for metabolites of interest could improve nutritional and growth outcomes.
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Affiliation(s)
- Luise V. Marino
- Paediatric Intensive Care Unit, Southampton Children’s Hospital, NIHR Southampton Biomedical Research Centre, University Hospital Southampton, NHS Foundation Trust, Southampton S016 6YD, UK
- Faculty of Health Science, University of Southampton, Southampton SO17 1BJ, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton, NHS Foundation, Southampton S016 6YD, UK
- Correspondence: ; Tel.: +44-(0)-23-8079-6000
| | - Simone Paulson
- Paediatric Intensive Care Unit, Southampton Children’s Hospital, NIHR Southampton Biomedical Research Centre, University Hospital Southampton, NHS Foundation Trust, Southampton S016 6YD, UK
| | - James J. Ashton
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton, NHS Foundation, Southampton S016 6YD, UK
- Paediatric Gastroenterology, Southampton Children’s Hospital, NIHR Southampton Biomedical Research Centre, University Hospital Southampton, NHS Foundation Trust, Southampton S016 6YD, UK
- Human Genetics and Genomic Medicine, University of Southampton, Southampton SO17 1BJ, UK
| | - Charlotte Weeks
- Paediatric Intensive Care Unit, Southampton Children’s Hospital, NIHR Southampton Biomedical Research Centre, University Hospital Southampton, NHS Foundation Trust, Southampton S016 6YD, UK
| | - Aneurin Young
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton, NHS Foundation, Southampton S016 6YD, UK
- Human Genetics and Genomic Medicine, University of Southampton, Southampton SO17 1BJ, UK
- Department of Neonatal Medicine, Southampton Children’s Hospital, University Hospital Southampton, NHS Foundation Trust, Southampton S016 6YD, UK
| | - John V. Pappachan
- Paediatric Intensive Care Unit, Southampton Children’s Hospital, NIHR Southampton Biomedical Research Centre, University Hospital Southampton, NHS Foundation Trust, Southampton S016 6YD, UK
- Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK
| | - Jonathan Swann
- Biomolecular Medicine, School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK
| | - Mark J. Johnson
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton, NHS Foundation, Southampton S016 6YD, UK
- Department of Neonatal Medicine, Southampton Children’s Hospital, University Hospital Southampton, NHS Foundation Trust, Southampton S016 6YD, UK
- Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK
| | - Robert Mark Beattie
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton, NHS Foundation, Southampton S016 6YD, UK
- Paediatric Gastroenterology, Southampton Children’s Hospital, NIHR Southampton Biomedical Research Centre, University Hospital Southampton, NHS Foundation Trust, Southampton S016 6YD, UK
- Human Genetics and Genomic Medicine, University of Southampton, Southampton SO17 1BJ, UK
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Lucaccioni L, Iughetti L, Berardi A, Predieri B. Challenges in the growth and development of newborns with extra-uterine growth restriction. Expert Rev Endocrinol Metab 2022; 17:415-423. [PMID: 35941822 DOI: 10.1080/17446651.2022.2110468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 08/03/2022] [Indexed: 10/16/2022]
Abstract
INTRODUCTION Extra-uterine growth restriction (EUGR) is a condition caused by the failure of very preterm infants to reach their potential growth during the NICU hospital stay. Despite enormous improvements in nutritional support and strategies, the growth pattern of preterm infants is still far from the one expected. AREAS COVERED This review focuses on what EUGR is, highlighting controversial aspects of this topic. EUGR is still missing a univocal definition, and the international debate is also open on what is the best growth chart to use. Moreover, professionals in NICU may not be trained on how to perform anthropometric measurements, increasing the risk of over- or underestimation, especially for length assessment. EUGR has recently been described as one of the main comorbidities in NICU, influencing growth, metabolism, and neurodevelopment later in life. EXPERT OPINION There is still much to investigate about what the best growth pattern in the NICU should be. What is known so far is that the majority of preterm neonates develop EUGR, and this leads to several short- and long-term consequences. It is imperative that neonatologists and pediatric endocrinologists work together, to modulate growth in the NICU.
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Affiliation(s)
- Laura Lucaccioni
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Lorenzo Iughetti
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Alberto Berardi
- Neonatology Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Barbara Predieri
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
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