Effects of a Lipid Emulsion Containing Fish Oil on Polyunsaturated Fatty Acid Profiles, Growth and Morbidities in Extremely Premature Infants: A Randomized Controlled Trial

Overview

Journal Clin Nutr ESPEN

Specialties Endocrinology
Nutritional Sciences

Date 2017 Oct 27

PMID 29072164

Citations 61

Authors

Svetlana Najm

Chatarina Lofqvist

Gunnel Hellgren

Eva Engstrom

Pia Lundgren

Anna-Lena Hard

Alexandre Lapillonne

Karin Savman

Anders K Nilsson

Mats X Andersson

Lois E H Smith

Ann Hellstrom

Affiliations

Soon will be listed here.

Abstract

Background & Aims: The purpose of the study was to compare the effects of the parenteral emulsion SMOFlipid, with 15% fish oil, with Clinoleic on retinopathy of prematurity (ROP) and other morbidities and growth, and to compare their impact on longitudinal serum levels of fatty acids. Retinopathy of prematurity, other morbidity and growth were correlated with each parenteral lipid supplement.

Methods: Ninety infants born at gestational age <28 weeks were randomized to treatment with SMOFlipid or Clinoleic. Two thirds (66%) of the infants received parenteral nutrition for up to 14 days birth (median 8, range 2-14 days), and additional 25% of the infants received for up to 28 days after birth (median 21, range 15-28 days). Cord blood samples and then venous blood samples were obtained at ages 1, 7, 14, and 28 days and at postmenstrual age (PMA) 32, 36, and 40 weeks. Breastmilk was collected at postnatal day 7, and at PMA 32 and 40 weeks. Serum phospholipid and breastmilk total fatty acids were analyzed by gas chromatography-mass spectrometry. Treatment groups were compared with regard to ROP, bronchopulmonary dysplasia, necrotizing enterocolitis, patent ductus arteriosus sepsis and growth between birth and 36 weeks.

Results: Infants on SMOFlipid had higher fractions of omega-3 LCPUFA eicosapentaenoic acid (EPA) and slightly higher omega-3 LCPUFA docosahexaenoic acid (DHA) fraction and a decreased arachidonic acid (AA) to DHA ratio from one week after birth up to 32 postmenstrual weeks compared to infants on Clinoleic. Treatment groups did not differ in morbidities or growth.

Conclusion: Supplementation with SMOFlipid containing 15% fish oil during parenteral nutrition increased EPA substantially, DHA marginally, reduced AA and decreased AA to DHA ratio. It did not reduce morbidity or affect growth. Since extremely preterm infants accumulate a large deficit of DHA and AA, studies on more prolonged or different levels of DHA and AA supplementation are warranted.

Citing Articles

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Postnatal Dysregulation of Androgens in Extremely Preterm Male Infants.

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