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Abstract：
(1) Background: Recent evidence reported a reduced tolerance of macronutrient parenteral intakes in subjects in critically ill conditions. We designed a prospective cohort study to evaluate the effects of hyperglycemia (HG) related to parenteral nutrition (PN) on neurodevelopment (NDV) in survived preterm newborns. (2) Methods: Enrolled newborns with gestational age < 32 weeks or birth weight < 1500 g, were divided in two cohorts: (A) exposed to moderate or severe HG (glucose blood level > 180 mg/dL) in the first week of life; (B) not exposed to HG. We considered as the primary outcome the rate of preterm newborns survived without NDV delay at 24 months of life, evaluated with Bayley Scales of Infants Development III edition. (3) Results: We analyzed 108 (A 32 vs. B 76) at 24 months of life. Newborns in cohort A showed a higher rate of cognitive and motor delay (A 44% vs. B 22 %, p = 0.024; A 38% vs. B 8%, p < 0.001). When adjusting for background characteristics, HG remained a risk factor for motor delay. (4) Conclusions: High nutritional intakes through PN soon after birth increase the risk of HG. The consequences of this severe metabolic complication affect long-term NDV and survival in preterm newborns.
摘要：
（1）背景：最近的证据报道了危重病患者对大量营养素肠胃外摄入量的耐受性降低。我们设计了一项前瞻性队列研究，以评估与肠外营养（PN）相关的高血糖（HG）对存活早产新生儿神经发育（NDV）的影响。（2）方法：胎龄<32周或出生体重<1500g的新生儿，分为两组:(A)在生命的第一周暴露于中度或重度HG(血糖水平>180mg/dL);(B)不暴露于HG。我们认为早产新生儿在没有NDV延迟的情况下存活24个月的主要结果，使用Bayley婴儿发展量表III版进行评估。（3）结果：我们分析了108（A32与B76)在24个月的生命。队列A中的新生儿表现出更高的认知和运动延迟率（A44％与B22%,p=0.024；38%与B8%,p<0.001)。调整背景特征时，HG仍然是运动延迟的危险因素。（4）结论：出生后不久通过PN摄入大量营养会增加HG的风险。这种严重的代谢并发症的后果会影响早产儿的长期NDV和生存率。
