Extra Amino Acids Failed to Decrease Neurodisability Risks in Preterm Infants: Study

The findings of a new study suggests that giving additional amino acids to low birth weight, preterm infants does not decrease their risk of neurodisability, raising questions about the common practice.

Premature infants often miss out on important nutrients they would receive in utero, which can provide health benefits and improved growth. This can increase their risk of side effects and birth defects, including neurodisability, and additional amino acids are often recommended.

In a new study published this month in the New England Journal of Medicine, researchers from New Zealand examined whether providing parenteral amino acids to preterm infants would reduce the risk of disability or negative outcomes.

Researchers conducted a multi-center, randomized, placebo-controlled trial, which included 434 infants with birth weights of less than 1,000 grams, which is about 2.5 pounds, who were born at eight neonatal intensive care units. Infants were randomized to receive amino acids at a dose of 1 gram per day or a placebo, in addition to their usual nutrition for the first five days after birth.

Parenteral administration of amino acids is done through intravenous infusion, administering amino acids outside of the normal digestive tract to bypass the intestines and provide additional nutrition and calories outside of normal feedings. This can be important in preterm infants if they haven’t fully developed, allowing the body to absorb the nutrition easier.

No Statistical Significance in Infants Given Amino Acids

The data from the study indicated only 48% of infants in the amino acid intervention group survived with no neurodevelopmental disability. However, the survival rate of infants free from neurodisability was similar in the placebo group. In that group, 50% of the infants were free from neurodisability. The rates were virtually the same.

Death rates before the age of two were 18% in the amino acid intervention group, and 19% in the placebo group. Again, there was not a significant difference.

About 41% of infants in the amino acid intervention group suffered from neurodisability. Comparatively, 37% of infants in the placebo group suffered from neurodisablity, with slightly fewer infants having neurological disabilities if they were not given the extra amino acids.

More so, more children in the amino acid intervention group suffered from patent ductus arterioles, a type of heart defect that is caused by problems in the heart’s development, and had refeeding syndrome. Refeeding syndrome is a potentially fatal shift in fluids and electrolytes that often occurs in malnourished patients who are given artificial feeding, such as parenteral feeding.

Overall, eight serious adverse events occurred among all of the infants. Neurodisability was moderate to severe in 16% of the infants overall.

“In infants with extremely low birth weight, extra parenteral amino acids at a dose of 1 g per day for 5 days after birth did not increase the number who survived free from neurodisability at 2 years,” the researchers concluded.

Preterm birth can increase a child’s risk of suffering from a number of health conditions during childhood and into adulthood. Side effects can include developmental disabilities and neurological disabilities that can impact learning, attention, behavior, focus, and lead to cognitive impairments.

Preterm birth also increases a child’s risk of suffering from cardiovascular conditions later in life.