UNICORN babies: understanding circulating and cerebral creatine levels of the preterm infant. An observational study protocol

Berry, Mary J, Schlegel, Melissa, Kowalski, Grzegorz M, Bruce, Clinton R, Callahan, Damien L, Davies-Tuck, Miranda L, Dickinson, Hayley, Goodson, Angus, Slocombe, Angie, Snow, Rodney J, Walker, David W and Ellery, Stacey J 2019, UNICORN babies: understanding circulating and cerebral creatine levels of the preterm infant. An observational study protocol, Frontiers in physiology, vol. 10, pp. 1-8, doi: 10.3389/fphys.2019.00142.

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Title UNICORN babies: understanding circulating and cerebral creatine levels of the preterm infant. An observational study protocol
Author(s) Berry, Mary J
Schlegel, Melissa
Kowalski, Grzegorz MORCID iD for Kowalski, Grzegorz M orcid.org/0000-0002-1599-017X
Bruce, Clinton R
Callahan, Damien LORCID iD for Callahan, Damien L orcid.org/0000-0002-6384-8717
Davies-Tuck, Miranda L
Dickinson, Hayley
Goodson, Angus
Slocombe, Angie
Snow, Rodney JORCID iD for Snow, Rodney J orcid.org/0000-0002-4796-6916
Walker, David W
Ellery, Stacey J
Journal name Frontiers in physiology
Volume number 10
Article ID 142
Start page 1
End page 8
Total pages 8
Publisher Frontiers Media
Place of publication Lausanne, Switzerland
Publication date 2019-03
ISSN 1664-042X
Keyword(s) brain metabolism
cellular energy
neurodevelopment
nutrition
premature
Science & Technology
Life Sciences & Biomedicine
Physiology
Summary Creatine is an essential metabolite for brain function, with a fundamental role in cellular (ATP) energy homeostasis. It is hypothesized that preterm infants will become creatine deplete in the early postnatal period, due to premature delivery from a maternal source of creatine and a limited supply of creatine in newborn nutrition. This potential alteration to brain metabolism may contribute to, or compound, poor neurological outcomes in this high-risk population. Understanding Creatine for Neurological Health in Babies (UNICORN) is an observational study of circulating and cerebral creatine levels in preterm infants. We will recruit preterm infants at gestational ages 23+0-26+6, 27+0-29+6, 30+0-32+6, 33+0-36+6, and a term reference group at 39+0-40+6 weeks of gestation, with 20 infants in each gestational age group. At birth, a maternal capillary blood sample, as well as a venous cord blood sample, will be collected. For preterm infants, serial infant plasma (heel prick), urine, and nutrition samples [total parenteral nutrition (TPN), breast milk, or formula] will be collected between birth and term "due date." Key fetomaternal information, including demographics, smoking status, and maternal diet, will also be collected. At term corrected postnatal age (CPA), each infant will undergo an MRI/1H-MRS scan to evaluate brain structure and measure cerebral creatine content. A general movements assessment (GMA) will also be conducted. At 3 months of CPA, infants will undergo a second GMA as well as further neurodevelopmental evaluation using the Developmental Assessment of Young Children - Second Edition (DAYC-2) assessment tool. The primary outcome measures for this study are cerebral creatine content at CPA and plasma and urine creatine and guanidinoacetate (creatine precursor) concentrations in the early postnatal period. We will also determine associations between (1) creatine levels at term CPA and neurodevelopmental outcomes (MRI, GMA, and DAY-C); (2) dietary creatine intake and circulating and cerebral creatine content; and (3) creatine levels and maternal characteristics. Novel approaches are needed to try and improve preterm-associated brain injury. Inclusion of creatine in preterm nutrition may better support ex utero brain development through improved cerebral cellular energy availability during a period of significant brain growth and development. Ethics Ref: HDEC 18/CEN/7 New Zealand. ACTRN: ACTRN12618000871246.
Language eng
DOI 10.3389/fphys.2019.00142
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2019, Berry, Schlegel, Kowalski, Bruce, Callahan, Davies-Tuck, Dickinson, Goodson, Slocombe, Snow, Walker and Ellery
Persistent URL http://hdl.handle.net/10536/DRO/DU:30120359

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