Food for thought: does nutrition improve outcome after preterm birth?
Preterm birth can have lifelong consequences for the brain development of a child. Current treatment methods to positively impact the rapidly developing brain are very limited. Providing nutrients that serve as building blocks and cofactors for the synthesis of brain cells, will enable cell connections and growth of different brain structures, which in turn might improve brain development. This has been demonstrated in animal models of brain injury and a recent pilot study in infants born too early and with brain injury. In this collaboration between the department of Neonatology at the UMC Utrecht, Utrecht University and Danone Nutricia Research we aim to investigate the effect of an early nutritional intervention (The Dolphin Concept) on brain development and neurodevelopmental outcome.
Approximately 1 in 10 infants is born preterm (i.e., born before 37 weeks of gestation). The chance of having brain injury increases with lower gestational age. The incidence of brain injury in the extremely preterm born infant (i.e., born before 28 weeks of gestation) is around 30%. Brain injury may lead to delayed neurodevelopmental outcome. In fact, in infants born preterm, 25-40% experiences disturbances in motor development and about half of them experiences problems with cognition, behavior, or socialization. This is associated with increased lifetime medical and societal costs. So far, there are few interventions that improve outcome and reduce costs. Studying the Dolphin concept may provide an easy, home-based intervention to improve outcome in this vulnerable population.
In this study, infants born before 30 weeks of gestation are randomized to receive either the Dolphin Concept or placebo during 12 months. The primary outcome for the study is brain MRI, performed at corrected age of 3 months. In addition, cognitive and language development is monitored during the first two years of life, to correlate these measures to early MRI outcomes and the nutritional intervention. In order to demonstrate a possible effect, we aim to acquire an MRI in 90 infants.
In March 2025, when the project formally ended, we had been able to include 135 infants and obtained 72 good quality MRI’s. The primary research question could therefore not yet be answered. Therefore, we aim to continue our study and expect that an additional two months are needed to include enough infants. The last MRI will be made in autumn 2025, after which the primary outcome can be studied. If the study demonstrates an effect on brain development, it will be an important step towards making this nutritional supplement available to preterm babies and babies with brain injury to improve their outcome.
