Abstract：
We performed a systematic review to study the effect of enteral and parenteral energy intakes on neurodevelopment (NDV) and cerebral growth in preterm infants, evaluated by NDV scales, magnetic resonance imaging, and head circumference (HC).
The MEDLINE, Scopus, and ISI Web of Knowledge databases were searched, using the following medical subject headings and terms: \"Premature infants,\" \"nutrition,\" \"brain,\" \"nervous system/growth,\" and \"development.\" A manual search of the reference lists of all eligible articles was conducted. Studies in which the intervention applied was different energy intakes in parenteral nutrition and/or enteral nutrition (EN) during the first weeks of life and NDV was investigated were included. Data regarding nutrition and NDV were collected and analyzed.
Thirty-five studies were included, of which 12 were randomized controlled trials (RCTs) and 23 were cohort studies. Eight RCTs and 15 cohort studies investigated NDV using NDV scales. Of these studies, two RTCs and five cohort studies found no significant difference in NDV evaluated with the Bayley scale between neonates fed high-caloric nutrition and those who received lower energy intakes during early life. In one RCT and two cohort studies was observed a positive effect of EN on NDV. Conversely, in one cohort study, a negative correlation between parenteral energy intake and NDV was described. The analysis of the data from RCTs and cohort studies showed greater HC in the groups receiving aggressive parenteral and total enhanced nutrition, respectively. However, two RCTs and one cohort study did not report any differences in terms of HC. Inconclusive results were reported by studies that investigated cerebral growth by magnetic resonance imaging. The studies observing a positive effect of enhanced nutrition on cerebral and basal ganglia growth, caudate nucleus, cerebellum, and thalami volume investigated only the influence of EN.
The impact of energy intake during early life on NDV remains undefined. A positive impact on brain development encourages the administration of recommended energy intake, mainly by EN, and suggests a more cautious approach to enhanced nutritional strategies by the parenteral route. Further studies are advocated to elucidate the optimal nutritional intervention for preterm infants to improve NDV.
The MEDLINE, Scopus, and ISI Web of Knowledge databases were searched, using the following medical subject headings and terms: \"Premature infants,\" \"nutrition,\" \"brain,\" \"nervous system/growth,\" and \"development.\" A manual search of the reference lists of all eligible articles was conducted. Studies in which the intervention applied was different energy intakes in parenteral nutrition and/or enteral nutrition (EN) during the first weeks of life and NDV was investigated were included. Data regarding nutrition and NDV were collected and analyzed.
Thirty-five studies were included, of which 12 were randomized controlled trials (RCTs) and 23 were cohort studies. Eight RCTs and 15 cohort studies investigated NDV using NDV scales. Of these studies, two RTCs and five cohort studies found no significant difference in NDV evaluated with the Bayley scale between neonates fed high-caloric nutrition and those who received lower energy intakes during early life. In one RCT and two cohort studies was observed a positive effect of EN on NDV. Conversely, in one cohort study, a negative correlation between parenteral energy intake and NDV was described. The analysis of the data from RCTs and cohort studies showed greater HC in the groups receiving aggressive parenteral and total enhanced nutrition, respectively. However, two RCTs and one cohort study did not report any differences in terms of HC. Inconclusive results were reported by studies that investigated cerebral growth by magnetic resonance imaging. The studies observing a positive effect of enhanced nutrition on cerebral and basal ganglia growth, caudate nucleus, cerebellum, and thalami volume investigated only the influence of EN.
The impact of energy intake during early life on NDV remains undefined. A positive impact on brain development encourages the administration of recommended energy intake, mainly by EN, and suggests a more cautious approach to enhanced nutritional strategies by the parenteral route. Further studies are advocated to elucidate the optimal nutritional intervention for preterm infants to improve NDV.
摘要：
我们进行了系统评价，以研究肠内和肠外能量摄入对早产儿神经发育（NDV）和脑生长的影响，通过NDV量表评估，磁共振成像，和头围（HC）。
MEDLINE,Scopus,并搜索了ISIWebofKnowledge数据库，使用以下医学主题词和术语：“早产儿，“营养”，\"\"大脑,神经系统/生长，“和”发展。“对所有符合条件的文章的参考列表进行了手动搜索。包括在生命的最初几周内采用不同能量摄入的肠外营养和/或肠内营养（EN）的干预措施，并调查了NDV。收集和分析有关营养和NDV的数据。
纳入了35项研究，其中12项为随机对照试验(RCT),23项为队列研究.8项RCT和15项队列研究使用NDV量表调查了NDV。在这些研究中,两项RTC和5项队列研究发现,用Bayley量表评估的NDV在接受高热量营养的新生儿和早期接受较低能量摄入的新生儿之间没有显著差异.在一项RCT和两项队列研究中，观察到EN对NDV的积极影响。相反，在一项队列研究中，肠外能量摄入与NDV呈负相关.对来自随机对照试验和队列研究的数据的分析显示，在接受积极的肠胃外和全营养增强的组中，HC更高，分别。然而,两项RCT和一项队列研究在HC方面没有报告任何差异.通过磁共振成像研究大脑生长的研究报告了不确定的结果。观察到营养增强对脑和基底神经节生长的积极影响的研究，尾状核,小脑,和丘脑体积只研究了EN的影响。
生命早期能量摄入对NDV的影响尚不明确。对大脑发育的积极影响鼓励推荐的能量摄入，主要是EN,并建议采用更谨慎的方法通过肠胃外途径加强营养策略。提倡进一步研究阐明早产儿改善NDV的最佳营养干预措施。
MEDLINE,Scopus,并搜索了ISIWebofKnowledge数据库，使用以下医学主题词和术语：“早产儿，“营养”，\"\"大脑,神经系统/生长，“和”发展。“对所有符合条件的文章的参考列表进行了手动搜索。包括在生命的最初几周内采用不同能量摄入的肠外营养和/或肠内营养（EN）的干预措施，并调查了NDV。收集和分析有关营养和NDV的数据。
纳入了35项研究，其中12项为随机对照试验(RCT),23项为队列研究.8项RCT和15项队列研究使用NDV量表调查了NDV。在这些研究中,两项RTC和5项队列研究发现,用Bayley量表评估的NDV在接受高热量营养的新生儿和早期接受较低能量摄入的新生儿之间没有显著差异.在一项RCT和两项队列研究中，观察到EN对NDV的积极影响。相反，在一项队列研究中，肠外能量摄入与NDV呈负相关.对来自随机对照试验和队列研究的数据的分析显示，在接受积极的肠胃外和全营养增强的组中，HC更高，分别。然而,两项RCT和一项队列研究在HC方面没有报告任何差异.通过磁共振成像研究大脑生长的研究报告了不确定的结果。观察到营养增强对脑和基底神经节生长的积极影响的研究，尾状核,小脑,和丘脑体积只研究了EN的影响。
生命早期能量摄入对NDV的影响尚不明确。对大脑发育的积极影响鼓励推荐的能量摄入，主要是EN,并建议采用更谨慎的方法通过肠胃外途径加强营养策略。提倡进一步研究阐明早产儿改善NDV的最佳营养干预措施。
