Early Amino Acids in Extremely Preterm Infants and Neurodisability at 2 Years

This multicenter, double blind, randomized controlled trial investigated the effects of early high dose amino acid supplementation (1 g/day for 5 days) in 434 extremely preterm infants (birth weight <1000 g) across 8 NICUs in New Zealand and Australia. The primary outcome survival without neurodisability at 2 years corrected age showed no significant difference between the intervention (47.8%) and placebo groups (49.8%; adjusted RR 0.95, 95% CI 0.79–1.14). However, secondary analyses revealed higher rates of moderate to severe neurodisability (16.5% vs. 8.6%; RR 1.95, 95% CI 1.09–3.48) and patent ductus arteriosus (54% vs. 42%; RR 1.30) in the intervention group. The study challenges the practice of early high dose amino acid supplementation, suggesting it may not improve neurodevelopmental outcomes and could pose risks.

This multicenter, double blind, randomized controlled trial investigated the effects of early high dose amino acid supplementation (1 g/day for 5 days) in 434 extremely preterm infants (birth weight <1000 g) across 8 NICUs in New Zealand and Australia. The primary outcome survival without neurodisability at 2 years corrected age showed no significant difference between the intervention (47.8%) and placebo groups (49.8%; adjusted RR 0.95, 95% CI 0.79–1.14). However, secondary analyses revealed higher rates of moderate to severe neurodisability (16.5% vs. 8.6%; RR 1.95, 95% CI 1.09–3.48) and patent ductus arteriosus (54% vs. 42%; RR 1.30) in the intervention group. The study challenges the practice of early high dose amino acid supplementation, suggesting it may not improve neurodevelopmental outcomes and could pose risks.