Nutrition Impacts Brain Development of Preterm-Born Children


Preterm birth may lead to impaired brain development

According to the WHO “preterm birth is defined as babies born alive before 37 weeks of pregnancy are completed”. Preterm birth is a major risk for the development of lower educational attainment, cerebral palsy, and cognitive defects. It is observed that children born preterm are more likely to develop schizophrenia, autism, and attention disorders. Very preterm birth (<32 weeks’ gestation) almost always results in morbidity with a sizable population of survivors developing motor impairments. Those children who manage to escape major impairments may go on to have subtle defects in cognitive abilities which are later diagnosed at preschool and school age. Motor and cognitive disabilities in children born preterm have been linked to the dysmaturation of the brain, especially in the prefrontal cortices which are associated with higher-order cognitive functions. Longitudinal and cross-sectional neuroimaging studies have found alterations in brain structural and functional developments in children born preterm, along with alterations in the white matter of the brain, lesser brain volume, and cortical thickness in the thalamus, amygdala, hippocampus, frontal, parietal, and temporal cortices. 

Role of nutrition in brain development

Calorie intake and nutrition have a major role to play in cognitive and emotional development, especially during the early years. Poor diet and exposure to stress can lead to cognitive dysfunctions throughout life. Researches also suggested that increased nutrition in preterm born children may protect brain structure and function. Compared to preterm infants subjected to a standard diet, those randomized to a high nutrient diet have higher verbal IQs, especially in boys. 

Greater energy and lipid intake during the first two weeks after birth is associated with larger subcortical structures, cerebellum, and total brain, and accelerated white matter microstructural maturation. Protein intake also influences cognitive and motor abilities in low-weight-born neonates. Processing speed and visual perceptual abilities at seven years of age are observed to be associated with greater strength between the thalamocortical networks. The same study also found that seven-year-old children born preterm, who were subjected to high nutritional intake in the first week as well as the first 28 days after birth showed positive predictions in the strength of the connectivity between subcortical and cortical resting-state networks. The study also predicted that this connectivity is associated with specific neurocognitive skills. 

Clinical implications:

During preconception, it is very important to make sure that women of childbearing age should undertake nutritional counseling and be screened for common nutrient deficiencies. During gestation, maternal stress has a direct effect on the fetal brain and influences the nutritional uptake by the fetus. In the postnatal period, especially in the case of preterm birth the best strategy to sustain healthy brain development is breastfeeding. The concentration of certain nutrients in breastmilk is influenced by the diet of the mother. Hence, breastfeeding women must have a nutritionally rich diet. 

WHO’s Millennium Development Goals emphasize reducing infant mortality – it is estimated that 45% of all deaths in children below five years of age are due to undernutrition and sub-optimal breastfeeding. It is, therefore, important that public health policies, especially in low to medium-income countries focus on access to quality food for pre-conceptual, pregnant, and lactating women. Special care should be taken to ensure a high nutritional diet for children during the first three years of age. 

Reference (A5-May-21)

Author Biography: A master’s student pursuing Neuroscience from Sophia college, Mumbai. Ananya has completed my undergraduate degree in Biotechnology and has sufficient hands-on training in this field. I aim to get as much knowledge as possible and at the same time share any knowledge I have with others.

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