Background: Nutrients and electrolytes in amniotic fluid swallowed by fetuses are important for growth and development. Yet, preterm infants requiring parenteral nutrition (PN) receive minimal or no oral inputs. With the limited availability of amniotic fluid, we evaluated the responses of preterm pigs receiving PN to an oral fluid supplement (OFS) based on the electrolyte and nutrient composition of amniotic fluid.
Materials And Methods: Preterm pigs (92% of term) received a combination of PN (6 mL/kg-h) and 4 mL/kg-h of supplemental fluid as an experimental OFS (n = 9), lactated Ringer's either enterally (n = 10) or intravenously (n = 8). Outcome measures after 96 hours were weight gain, blood chemistry, organ weights, and small intestine mass and brush-border membrane carbohydrases.
Results: The OFS did not improve weight gain compared with providing lactated Ringer's orally or intravenously, or increase serum urea nitrogen values, but resulted in higher serum total and low-density lipoprotein cholesterol, as well as improved glucoregulation and heavier intestines, livers, kidneys, and brains and lighter lungs.
Conclusions: Providing supplemental fluid and electrolytes during PN either intravenously or orally increases weight gain after preterm birth. An oral fluid supplement based on amniotic fluid may accelerate development and maturation of organs critical for extrauterine life after preterm birth and may enhance neurodevelopment.
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http://dx.doi.org/10.1177/0148607115574746 | DOI Listing |
J Dev Orig Health Dis
January 2025
School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, Australia.
Preterm birth exposes the neonate to hypoxic-ischaemic and excitotoxic insults that impair neurodevelopment and are magnified by the premature loss of placentally supplied, inhibitory neurosteroids. The cerebellum is a neuronally dense brain region, which undergoes critical periods of development during late gestation, when preterm births frequently occur. We propose that neurosteroid replacement therapy using tiagabine and zuranolone will protect the cerebellum against preterm-associated insults.
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November 2024
Department of Physiology, University of Toronto, Toronto, ON, Canada.
Antenatal corticosteroids (ACS) are administered where there is risk of preterm birth to promote fetal lung development and improve perinatal survival. However, treatment may be associated with increased risk of developing neurobehavioural disorders. We have recently identified that ACS results in significant changes to DNA methylation patterns in the newborn and juvenile prefrontal cortex (PFC) of exposed guinea pig offspring.
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Laboratory of Iron Molecular Biology, Department of Molecular Biology, Institute of Genetics and Animal Biotechnology, Polish Academy of Sciences, 05-552 Jastrzębiec, Poland.
Physiol Rep
October 2024
Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand.
Dev Psychobiol
November 2024
School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, Australia.
The postnatal environment is challenging for the preterm neonate with exposure to hypoxic and excitotoxic events, amplified by premature loss of placentally derived neurosteroids. Between preterm birth and term equivalent age (TEA), cerebellar development continues despite these challenges. We hypothesize that neurosteroid replacement therapy during this time will support optimal cerebellar development.
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