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

( N Engl J Med . 2022;387:1661–1672) Adequate fetal amino acid intake is an essential part of proper growth and development in utero. Despite its importance, the optimal protein intake for extremely low birth weight (<1000 g) infants has yet to be determined. The primary aim of this study is to determine whether an additional intake of 1 g per day of amino acids in extremely low birth weight infants beginning within 24 hours of delivery through the first 5 days of life will increase 2-year survival rates of children without neurodisability, adjusting for gestational age at the time of delivery. Secondary aims are to determine what neonatal morbidity and growth outcomes are associated with the additional intake of 1 g per day of amino acids in the same patient population.