A double-blind, randomized clinical trial of the effect of ω-3 fatty acids on the oxidative stress of preterm neonates fed through parenteral nutrition

Abstract

Background/Objectives: The aim of this study was to research and draw conclusions about the effect of a parenteral nutrition (PN) fat emulsion, rich in o-3 fatty acids, on the antioxidant markers of preterm infants, when compared with a standard fat emulsion. This was a double-blind, parallel-group study conducted in Athens, Greece, using an equal randomization method. Subjects/Methods: Thirty-eight infants were selected using a double-blind method and a computer-generated randomization list. Both groups received PN, based on the same protocols. Group A received SMOFlipid fat emulsion, while group B received the standard fat emulsion (Intralipid). Serum levels of vitamin A, E and total antioxidant potential (TAP) were measured on days 0, 7 and 14 of PN support. Clinical and biochemical data were collected on days 0, 14 and on the day of discharge. Results: Serum levels of vitamin E and A were significantly increased in group A, while only vitamin A serum level was increased in group B on the fourteenth day (group A: vitamin E: P-value ¼ 0.002, vitamin A: P-value ¼ 0.000, group B: vitamin E: P-value ¼ 0.065, vitamin A: P-value ¼ 0.000). TAP was increased only in the intervention group (group A: P-value ¼ 0.000, group B: P-value ¼ 0.287). Mild anemia was developed in both groups, while no differences were detected in the infection rate, days of hospitalization, days of ventilator support and days of phototherapy. Conclusions: Oxidative stress was significantly reduced in those neonates fed with o-3 fatty acids, whereas no effect was observed in the neonates fed with standard lipids. Intervention had no effect on infants' growth and clinical outcome.

Facultative to strict anaerobes ratio in the preterm infant microbiota

“…30 These findings have prompted researchers to focus their attention on antioxidant supplementations in preterm babies by the use of non-enzymatic proteins, such as transferrin and ferritin, antioxidant enzymes or oxidizable molecules, including vitamins, fatty acids or aminoacids, among others, 26,27 for some of which positive results have been published. 31,32 Interestingly, probiotic microorganism could also play a role as antioxidants, since strains displaying this property have been reported 33 and probiotic metabolites able to prevent the production of proinflammatory cytokines induced by oxidative stress have been recently identified. 34 Therefore, in the context of nutritional interventions the inclusion on infant formula of antioxidants, able to reduce the redox potential also in the while none of the preterm infants was exclusively in breast-feeding.…”

Omega-3 Long-Chain Polyunsaturated Fatty Acids for Extremely Preterm Infants: A Systematic Review

“…Eighteen of these studies were RCTs. [11][12][13][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] Among nonrandomized studies, 4 were interventional studies with a control group [30][31][32][33] and the remaining 2 studies 8,34 did not test an intervention because they examined the association of BPD with LCPUFA concentrations in blood or in tracheal aspirates. Fifteen RCTs presented dichotomous outcomes.…”

“…Several studies examined .1 neonatal outcome at a time (Table 1). Only a few studies reported other relevant neonatal outcomes, such as number of days of ventilation, or the use or duration of supplementation oxygen, 13,20,22,27,28 patent ductus arteriosus, 12,20,23,[30][31][32] cholestasis, 31,32 or number of days of hospital admission. 8,11,13,18,31,32 Effect Estimates for Dichotomous Neonatal Outcomes…”

Componentes de las mezclas de nutrición parenteral para pediatría

“…Ambas, cuando se comparaban con el LCT como única fuente lipídica, tenían la ventaja de ser más estables en las emulsiones de NP (6) generar menor cantidad de peróxidos (ya que esta generación está relacionada con la cantidad de ácidos grasos poliinsaturados [AGPI] y el aporte de vitamina E) y disminuir la producción de ácido araquidónico y sus derivados proinflamatorios debido al menor aporte de ácido linoleico. Actualmente se ha incorporado a estas mezclas aceite de pescado y, en comparación con las de LCT, parece que estas nuevas mezclas generan menor estrés oxidativo (7,8), atenúan la respuesta inflamatoria (9), disminuyen la incidencia de broncodisplasia pulmonar (10), y pueden revertir la colestasis asociada a NP en neonatos (11,12). Sin embargo una revisión Cochrane reciente no encuentra diferencias significativas en la evolución clínica de niños prematuros (13).…”