Associations between neonatal nutrition and visual outcomes in 7-year-old children born very preterm

Kulmaganbetov M. Leung M. Alsweiler J.M. Black J. Bloomfield F.H. Gamble G.D. Harding J.E. Jiang Y. Poppe T. Tottman A.C. Wouldes T.A. Thompson B.
March 2024 John Wiley and Sons Inc

Ophthalmic and Physiological Optics
2024 #44 Issue 2 347 - 355 pp.

Purpose: There is uncertainty about the effect of increased neonatal protein intake on neurodevelopmental outcomes following preterm birth. The aim of this study was to assess the effect of a change in neonatal nutrition protocol at a major tertiary neonatal intensive care unit intended to increase protein intake on ophthalmic and visual development in school-age children born very preterm. Methods: The study cohort comprised children (n = 128) with birthweight <1500 g or gestational age < 30 weeks born at Auckland City Hospital before (OldPro group, n = 55) and after (NewPro group, n = 73) a reformulation of parenteral nutrition that resulted in increased total protein intake during the first postnatal week and decreased carbohydrate, total parenteral fluid and sodium intake. Clinical and psychophysical vision assessments were completed at 7 years corrected age, including visual acuity, global motion perception (a measure of dorsal stream function), stereoacuity, ocular motility and ocular health. Composite measures of favourable overall visual, binocular and functional visual outcomes along with individual vision measures were compared between the groups using logistic and linear regression models. Results: Favourable overall visual outcome did not differ between the two groups. However, global motion perception was better in the NewPro group (p = 0.04), whereas the OldPro group were more likely to have favourable binocular visual outcomes (60% vs. 36%, p = 0.02) and passing stereoacuity (p = 0.02). Conclusions: These results indicate subtle but complex associations between early neonatal nutrition after very preterm birth and visual development at school age.

binocular vision , motion perception , premature birth , protein

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Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong
Kazakh Eye Research Institute, Almaty, Kazakhstan
School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
Discipline of Optometry and Vision Science, University of Canberra, Canberra, ACT, Australia
Liggins Institute, University of Auckland, Auckland, New Zealand
Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
Newborn Services, National Womens Health, Auckland City Hospital, Auckland, New Zealand
Department of Statistics, Faculty of Science, University of Auckland, Auckland, New Zealand
School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, Canada

Centre for Eye and Vision Research (CEVR)
Kazakh Eye Research Institute
School of Optometry and Vision Science
Discipline of Optometry and Vision Science
Liggins Institute
Department of Paediatrics: Child and Youth Health
Newborn Services
Department of Statistics
School of Optometry and Vision Science

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