Impact of protein and carnitine consuption on outcomes of care development of full-term newborns with critical perinatal diseases

Abstract

There were studied results of the impact of increased consumption of proteins and L-carnitine in the nutrition program of full-term newborns with perinatal diseases on the results of physical development and inpatient treatment features. The purpose of the work was to study the correlations between short-term higher consumption of protein and carnitine by full-term newborns and the results of their physical development, the duration of hospital care development. The vital signs of 59 full-term newborns were studied in a randomized controlled trial in the period 2017-2020. The main critical disease of the perinatal period in newborns of both groups was found to be hypoxic-ischemic encephalopathy of a moderate degree in 86.7% and 86.2%, without a statistically significant difference. One group (n=30) received nutrition with mother's milk or formula, the second group (n=29) received similar nutrition with fortification with a protein and L-carnitine supplement during the hospital stay. At the beginning and at the end of the treatment, physical development of the newborns was studied and correlations between the obtained data were investigated. Newborns of both groups did not differ in characteristics at the beginning of the study. The proportions of the newborns' weight corresponded to the limits of the 50% percentile. The group with increased consumption of protein and carnitine, fortification group (FG) demonstrated better indicators of physical development, they regained body mass faster. Body mass of the newborns of the fortification group goup was 3966.9±439.1 g, compared to the standard nutrition (SN) group, with indicators being 3554.6±452.3 g, at p=0.003. The rate of increase in body length in FG was twice that of the SN group. Consumption of a larger dose of protein was accompanied by a shorter stay in the intensive care unit – 10.0 (8.0; 12.0) days versus 12.0 (11.0; 16.0) days, with U=235.0; p=0.002; earlier discharge from the hospital – 21.0 (19.0; 27.0) days versus 26.5 (22.0; 31.0) days, with U=267.0, p=0.01. Carnitine supplementation in the FG group led to an increase in the level of free carnitine in the blood plasma samples taken before the discharge from the hospital. The study of correlations revealed a positive correlation between the consumption of a full dose of proteins and the total increase in height (R=0.3, p<0.05), the increase in body weight (R=0.3, p<0.05). A negative correlation was found between the protein level and the duration of treatment in the hospital (R= -0.3, p<0.05). The level of free carnitine had a positive effect on the increase in body length (R=0.51, p<0.05), daily weight gain (R=0.3, p<0.05). A poor increase in body length was associated with a longer duration of respiratory support: the correlation had an inverse direction R= -0.4, p<0.05. Improving nutritional strategies has significant prospects for improving care development of full-term babies with critical perinatal states.

Keywords

• hypoxic-ischemic encephalopathy
• newborns
• children
• carnitin
• physical development
• breast milk
• correlations