Preterm infant body composition trajectories, neurodevelopment, and cardiometabolic health

The National Institute of Child Health and Human Development awarded Brigham & Womens Hospital Inc. $498,848 under Project Grant R56HD122751 on September 1, 2026, to investigate body composition trajectories in preterm infants and their associations with neurodevelopmental and cardiometabolic outcomes. The award operates under the Child Health and Human Development Extramural Research program (CFDA 93.865).

The project examines longitudinal body composition assessment in the neonatal intensive care unit and during the first two years after discharge to predict both neurodevelopment and cardiometabolic risk in childhood. Over 63,000 very preterm infants are born annually in the United States, with 90% now surviving NICU discharge; however, 50–60% experience neurodevelopmental impairment, and the population faces elevated lifetime risks for hypertension and diabetes. The research applies bioimpedance analysis to measure fat-free mass and fat mass accretion—a feasible innovation for the NICU setting and post-discharge follow-up. The study applies the concept of "growth quality" to neonatal nutrition research, aiming to establish initial targets for optimal fat-free mass and adiposity balance to improve long-term health outcomes through evidence-based nutritional assessment and care.

Performance occurs in Boston, Massachusetts, from September 1, 2026, through August 31, 2028. Brigham & Womens Hospital is a subsidiary of Partners Healthcare System Incorporated and holds extensive NIH grant-funded research activity across biomedical and health services domains.

Abstract

Each year, over 63,000 U.S. Infants are born very preterm at 90% now surviving to discharge from the neonatal intensive care unit (nicu), reducing the short- and long-term morbidities has become the highest priority. Neurodevelopmental impairment affects 50-60% of very preterm infants after nicu discharge, and this population also faces increased risks for chronic conditions later in life, including hypertension and diabetes. Nutrition is a cornerstone of clinical care in the nicu and represents a highly modifiable strategy to support healthy growth during a sensitive period in development, thereby reducing a myriad of long-term morbidities. A current GAP exists in accurate, specific, and feasible strategies to differentiate FAT-free mass from FAT mass and monitor their accretion over time during early infancy. Greater FAT- free mass correlates with larger brain size and predicts better neurodevelopment, whereas greater FAT mass predicts obesity and related conditions. The overall aim of this project is to determine the utility of longitudinally assessed body composition in the nicu and in the first 2 years after discharge to predict both neurodevelopment and cardiometabolic risks later in childhood. This study applies the innovative concept of "growth quality" to nicu nutrition research. Innovative approaches include the application of bioimpedance analysis to feasibly measure body composition in the nicu setting and after discharge. Our overarching goal is to improve long-term health outcomes of very preterm infants through pragmatic, evidence-based innovations in nutritional assessment and care in the nicu and after discharge. The results of this study will provide initial targets for FAT-free mass and FAT mass accretion, including an ideal balance between FAT-free mass and adiposity accrual. This work will lay the foundation for studying targeted dietary interventions in the nicu setting. This project has strong potential to provide an impactful paradigm shift in the approach to the assessment and monitoring of nutritional status and ultimately the leveraging of nutritional strategies during a sensitive period in development to improve outcomes for this population.