Preterm infants on early solid foods and neurodevelopmental outcome – a secondary outcome analysis of a randomized controlled trial

Background Introduction of solid foods in preterm infants is a highly discussed topic and evidence-based recommendations do not exist so far.

Aims Aim of this study was to examine whether two different timepoints of introduction of solid foods in preterm infants have an impact on neurodevelopmental outcome in the first three years of life.

Methods This is a secondary outcome analysis of a prospective, randomized, two arm intervention trial of very low birth weight (VLBW) infants randomized to an early (10-12th week of life corrected age) or a late (16-18th week of life corrected age) complementary feeding group. Neurodevelopmental outcome was assessed at one and two years corrected age, and at three years, four months uncorrected age using the Bayley Scales of Infant-Toddler Development, third edition, German norms.

Results In total, 177 infants were randomized, 89 to the early group and 88 infants to the late group. Mean gestational age was 27+1 in both groups.

91%, 89%, and 71% of data on neurodevelopmental outcome were available for analysis at one and two years corrected age, and at three years, four months of uncorrected age, respectively. To evaluate differences in neurodevelopmental outcome between study groups, a linear mixed effects model was fit through study group, gestational age at birth, sex, nutrition at discharge, highest education of parents, and IVH with a random intercept to adjust for possible correlation between siblings of multiple births. There were not differences between groups at one year corrected age (early group: motor mean 81.6 [95%CI 74.2-89], cognitive mean 95 [95%CI 90-110], language mean 91 [95%CI 83.75-97]; late group: motor mean 91 [95%CI 85-98.5], cognitive mean 100 [95%CI 90-110], language mean 91 [95%CI 84.5-100]; all p-values n.s.), two years corrected age (early group: motor mean 97 [95%CI 88-103], cognitive mean 95 [95%CI 90-105], language mean 89 [95%CI 72.5-97]; late group: motor mean 94 [95%CI 85-106], cognitive mean 95 [95%CI 85-110], language mean 86 [95%CI 77-97]; all p-values n.s.), and three years, four months of uncorrected age (early group: motor mean 94 [95%CI 85-102.25], cognitive mean 100 [95%CI 95-105], language mean 94 [95%CI 86-101.5]; late group: motor mean 97 [95%CI 85-100.75], cognitive mean 100 [95%CI 90-105], language mean 97 [95%CI 83-100]; all p-values n.s.).

Conclusions The timepoint of introduction of solid foods had no impact on neurodevelopmental outcome at one and two years corrected age, and at three years, four months uncorrected age.

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Artikel online veröffentlicht:
06. Juni 2023