Pediatr Res. 2025 Nov 11. doi: 10.1038/s41390-025-04557-1. Online ahead of print.
ABSTRACT
BACKGROUND: Extremely preterm infants represent a highly vulnerable population, facing a high risk of growth faltering and adverse neurodevelopment. Despite advances in neonatal care, nutritional strategies to support adequate growth, which is linked to improved neurodevelopment, remain uncertain. Body composition analysis, particularly fat-free mass (FFM), has emerged as a promising tool for evaluating nutritional status, and has been linked to larger brain size. However, its relationship with long-term neurodevelopment, especially in extremely preterm infants, remains unclear.
METHODS: The objective of this study was to investigate the association between early body composition changes, growth faltering, and neurodevelopmental outcomes, in a cohort of extremely preterm infants. This study included 105 infants born <28 weeks of gestation between 2017 and 2021, all of whom underwent body composition assessment at term-equivalent age and neurodevelopmental follow-up assessments at 1, 2, and 3 years of age.
RESULTS: FFM Z-Score was significantly and independently associated with higher neurodevelopmental scores up to 3 years of age. In contrast, fat mass Z-Score and growth faltering were not significantly associated with improved neurodevelopmental outcomes through 3 years of age.
CONCLUSION: These findings suggest that early body composition analysis, particularly FFM, may serve as a potential predictor of long-term neurodevelopment.
IMPACT: Measurement of body composition, particularly fat-free mass (FFM), at term-equivalent age is associated with improved neurodevelopmental outcomes in extremely preterm infants. This study represents the largest cohort of extremely preterm infants in which FFM Z-Score rather than fat mass Z-Score, was positively associated with neurodevelopmental outcomes at 1, 2, and 3 years of age. Early gains in FFM appear to be critical for promoting favorable long-term neurodevelopmental outcome, underscoring the importance of targeted nutritional strategies.
PMID:41219463 | DOI:10.1038/s41390-025-04557-1
