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Effect on the Incidence of Allergic and Infectious Diseases in the First Year of Life

Anemone van den Berg, MD, PhD; Annelies van Zwol, MD; Henriëtte A. Moll, MD, PhD; Willem P. F. Fetter, MD, PhD; Ruurd M. van Elburg, MD, PhD

Arch Pediatr Adolesc Med. 2007;161(11):1095-1101.

Objective  To determine the effect of glutamine-enriched enteral nutrition in very low-birth-weight infants on the incidence of allergic and infectious diseases during the first year of life.

Design  Follow-up study.

Setting  Tertiary care hospital.

Participants  All surviving infants who participated in a trial of glutamine-enriched enteral nutrition in very low-birth-weight infants.

Intervention  Enteral glutamine supplementation (L-glutamine, 0.3 g/kg per day) from 3 through 30 days of life.

Main Outcome Measures  The incidence of allergic and infectious diseases during the first year of life, as assessed by means of validated questionnaires.

Results  Seventy-seven of 90 infants (86%) participated in the follow-up study. Baseline patient, maternal, and environmental characteristics did not differ between the glutamine-supplemented (n = 37) and control (n = 40) groups, except for the incidence of serious neonatal infections and child care attendance. After adjustment for confounding factors, the risk for atopic dermatitis was lower in the glutamine-supplemented group (odds ratio [OR], 0.13; 95% confidence interval [CI], 0.02-0.97). However, the incidence of bronchial hyperreactivity (OR, 0.34; 95% CI, 0.10-1.21) and infections of the upper respiratory (OR, 0.99; 95% CI, 0.35-2.79), lower respiratory (OR, 0.39; 95% CI, 0.13-1.24), and gastrointestinal (OR 1.25, 95% CI 0.23-6.86) tracts was not different between the treatment groups.

Conclusions  Glutamine-enriched enteral nutrition in very low-birth-weight infants decreased the incidence of atopic dermatitis during the first year of life but had no effect on the incidence of bronchial hyperreactivity and infectious diseases during the first year of life.

Author Affiliations: Division of Neonatology, Department of Pediatrics, VU University Medical Center, Amsterdam, the Netherlands (Drs van den Berg, van Zwol, Fetter, and van Elburg); and Department of Pediatrics, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, the Netherlands (Dr Moll).

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