The lives of premature babies are threatened by sugary nutrition
Many prematurely born infants are given sugary parenteral nutrition as it has so far been the belief that it was good for their development. But new research from the University of Copenhagen performed on pigs shows that it may cause life-threatening sepsis if the baby already has an infection.
Nine months. That is how long little new lives optimally stay in their mothers' bellies before they are ready to meet the world because, by then, their bodies, stomachs and organs are well prepared to cope with environmental challenges.
But every year around 15 million infants are born prematurely around the world. Many of them start life on baby formula and what is called parenteral nutrition because they need a lot of energy to develop. However, new research from the University of Copenhagen shows that the high sugar content in parenteral nutrition can actually cost lives among those born prematurely who simultaneously have an infection.
”Clinicians often think, that when babies need parental nutrition, they need a lot of glucose, which is also one of the main nutrients to provide energy for the body. But the high parenteral glucose level in the bloodstream causes a lot of inflammatory response when the baby has an infection,” explains Associate Professor Duc Ninh Nguyen, one of the researchers behind the study from the Department of Veterinary and Animal Sciences at the University of Copenhagen.
The study was carried out on pigs. But according to Duc Ninh Nguyen, there is a high probability that you will see the same reaction in humans.
“Relative to rodents, preterm pigs have more similar size, gastrointestinal structure, and immature immune system to human preterm infants,” says Duc Ninh Nguyen.
A change at the hospitals
Between 20 and 40 percent of prematurely born infants suffer from an infection during the first month of their lives. This happens because their immune systems and bodies are not ready to fight off infections in the same way as infants who are born close to the due date. It may be infections such as pneumonia, meningitis or systemic infection.
“Our study shows a possible relation between parenteral glucose supply and the risks of life-threatening sepsis in infected preterm newborns. Our data may shed light on new nutritional therapies to prevent infected infants from life-threatening sepsis,” says Duc Ninh Nguyen.
According to Duc Ninh Nguyen, if doctors suspect an infection in prematurely born infants, they should rather prescribe a special type of parenteral nutrition with less sugar in order to reduce the risk of sepsis.
”Neonatal infections in preterm infants can be treated by broad-spectrum antibiotics and the babies can recover. But if they still receive redundant parenteral glucose during suspected infections, it can trigger more life threatening conditions. Our hope is to prevent that infections lead to sepsis,” says Duc Ninh Nguyen.
Not far from research lab to the hospital room
Today, there are no specific guidelines for the parenteral nutrition administered to prematurely born infants where an infection is suspected, but this may need to change.
”We collaborate with the doctors in Rigshospitalet’s neonatal department. They also think, that the current clinical practice can be improved. Based on this study, we are planning to set up a safety trial at Rigshospitalet to further test if we need to go forward with a lower parenteral glucose approach in preterm infants without causing adverse effect,” says Duc Ninh Nguyen.
This also means that it will not be long before the new results can reach the country's units for infants that are born prematurely.
”The study has clinical relevance and it may lead to an immediate change in clinical practice. Following animal studies, it needs to be tested in humans before we really know if it will help the patients, and that might take a few years,” says Duc Ninh Nguyen.
The study has been published in JCI Insight, and the full study can be read here.
In the study, the researchers investigated prematurely born pigs that have an infection. The infection was caused by a bacterium that is often found in prematurely born infants, and the pigs got the nutrition directly into the blood, with varying sugar contents. In this way, the researchers were able to study how the prematurely born pigs with different nutritional approaches responded to an infection, and whether they began developing sepsis which is the life-threatening organ dysfunctions caused by uncontrollable reactions to an infection.
In order for the results from the study to be implemented in the hospitals, the research must go through phase 1, 2 and 3 clinical studies. The researchers plan to start the first phase at Rigshospitalet in the near future.
Contact:
Associate Professor Duc Ninh Nguyen
+45 52 76 32 86
dnn@sund.ku.dk
Journalist and Press Officer Sascha Kael Rasmussen
+45 93 56 51 68
sascha.kael.rasmussen@sund.ku.dk