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Adjudication committee
- First opponent: Professor Liisa Lehtonen, University of Turku
- Second opponent: Professor Susan E. Carlson, University of Kansas Medical Center
- Chair of the Committee: Professor Anders Christofer Lundqvist, University of Oslo
Chair of defence
Professor Guttorm Haugen, University of Oslo
Principal supervisors
Professor Christian A. Drevon, University of Oslo
Summary
Very low birth weight (VLBW, birth weight < 1500 g) infants are at risk of postnatal growth restriction and impaired cognitive function. Optimal nutrient supply is essential for satisfactory growth and development.
The thesis Growth, neurodevelopment, metabolic markers and intestinal microbiota in very low birth weight infants on enhanced nutrient supply by Elin W Blakstad is based on a randomized controlled intervention study investigating the effects of enhanced nutrient supply to VLBW infants. The aim was to investigate if enhanced nutrient supply improves growth and reduces postnatal growth restriction. Secondary outcomes were effects on metabolic markers, intestinal microbiota and cognitive function.
Fifty VLBW infants were randomized to an intervention group, receiving increased supply of energy, protein, fat, arachidonic and docosahexaenoic acid and vitamin A or a control group receiving standard nutritional care. Anthropometric measurements were collected until 2 years corrected age and converted to growth z-scores. Metabolic markers (adiponectin, leptin and IGF-1) were measured in blood. Fecal microbial composition was quantified with 16S rRNA amplicon sequencing. Cognitive function was investigated by a neurophysiological test.
Infants receiving enhanced nutrient supply had more steady growth patterns, with better weight gain and head growth, whereas infants receiving standard nutrient supply had poor growth immediately after birth, followed by a later catch-up growth. The proportion of growth restricted infants increased in the control group. Metabolic markers were associated with nutrients and growth. Adiponectin concentrations increased in the intervention group. Few group differences were seen in intestinal microbiota, but a healthier microbiota composition was associated with better weight gain. The neurophysiological test showed a more consistent response to visual perception of global motion among infants receiving enhanced nutrient supply as compared to controls.
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