Children born very preterm who received higher neonatal protein intake exhibited thinner lateral occipital and parietal cortices at 7 years, according to a recent study.

In the study, published in JAMA Network Open, researchers conducted a cohort study to assess the association between neonatal protein intake and brain structure at 7 years of age in children born very preterm. They included 99 children born prior to 30 weeks’ gestation or with a birth weight under 1,500 g at National Women’s Hospital in Auckland, New Zealand. The participants were stratified into two groups based on whether they received neonatal nutrition prior to or following a 2007 protocol change that increased protein intake. Structural and diffusion-weighted magnetic resonance imaging scans at 7 years assessed brain volume and white matter microstructure.

Neonatal protein intake was significantly higher in the new protocol group compared with the old protocol group at both 7 days (mean [SD] intake = 21 [2] g/kg^-1 vs 17 [2] g/kg^-1) and 14 days after birth (45 [7] g/kg^-1 vs 41 [6] g/kg^-1). At 7 years, the new protocol group had a smaller brain volume as a percentage of intracranial volume (80% [4%] vs 86% [7%]), whereas total brain volume remained similar between groups. The patients in the new protocol group exhibited significantly thinner lateral occipital and lateral parietal cortices (P < .05).

Analyses combining both groups demonstrated that greater early neonatal protein, fat, energy, and breast milk intake were associated with more mature white matter diffusion tensor metrics, including higher fractional anisotropy and lower mean diffusivity, across multiple tracts. However, these associations did not reach statistical significance for every tract examined.

Increased neonatal protein intake was associated with differences in cortical thickness and white matter microstructure at 7 years in very preterm infants. Prior research has linked higher protein intake to cortico-thalamic connectivity and an increased risk of cerebral palsy. The findings contributed to the broader evaluation of neonatal nutrition strategies and their potential neurodevelopmental implications.

Full disclosures can be found in the published study.