Effect of arachidonic and docosahexaenoic acid supplementation on quality of growth in preterm infants: A secondary analysis of a randomized controlled trial

Rossholt, Madelaine Eloranta; Bratlie, Marianne; Wendel, Kristina; Aas, Marlen Fossan; Gunnarsdottir, Gunnthorunn; Fugelseth, Drude; Pripp, Are Hugo; Domellöf, Magnus; Størdal, Ketil; Stiris, Tom; Moltu, Sissel Jennifer

doi:10.1016/j.clnu.2023.10.005

Cited by 2 publications

(1 citation statement)

References 42 publications

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“…There was also no difference in lung function at 3 months corrected age [50]. The combined supplementation group showed better linear growth from birth to term equivalent age compared to the control group; however, the difference was no longer observed at 3 months corrected age [51]. Interestingly, this study suggested that the combined ARA and DHA supplementation improved brain microstructure development by demonstrating improvement in white matter maturation compared to controls [52 ▪▪ ].…”

Section: Long Chain-polyunsaturated Fatty Acids Functional Role and S...mentioning

confidence: 98%

Evidence on docosahexaenoic acid and arachidonic acid supplementation for preterm infants

Lapillonne,

Lembo,

Moltu

2024

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Purpose of review For many decades, docosahexaenoic acid (DHA) supplementation was tested in premature infants to achieve an intake equivalent to the average level in breast milk, but this approach has led to conflicting results in terms of development and health outcomes. Higher doses of DHA closer to fetal accumulation may be needed. Recent findings The efficacy of DHA supplementation for preterm infants at a dose equivalent to the estimated fetal accumulation rate is still under investigation, but this may be a promising approach, especially in conjunction with arachidonic acid supplementation. Current data suggest benefit for some outcomes, such as brain maturation, long-term cognitive function, and the prevention of retinopathy of prematurity. The possibility that supplementation with highly unsaturated oils increases the risk of neonatal morbidities should not be ruled out, but current meta-analyzes do not support a significant risk. Summary The published literature supports a DHA intake in preterm infants that is closer to the fetal accumulation rate than the average breast milk content. Supplementation with DHA at this level in combination with arachidonic acid is currently being investigated and appears promising.

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Section: Long Chain-polyunsaturated Fatty Acids Functional Role and S...mentioning

confidence: 98%

Evidence on docosahexaenoic acid and arachidonic acid supplementation for preterm infants

Lapillonne,

Lembo,

Moltu

2024

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Effect of parenteral lipids on essential fatty acid deficiency in pediatric intestinal failure: A retrospective cohort study

Johnson,

Phillips,

Lamb

et al. 2024

J Parenter Enteral Nutr

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BackgroundPediatric patients with intestinal failure require long‐term parenteral nutrition owing to impaired enteral nutrition absorption. A potential complication is essential fatty acid deficiency (EFAD), resulting from decreased linoleic and α‐linolenic acid concentrations and defined by an increased triene:tetraene ratio (TTR; Mead acid:arachidonic acid). Historically, soybean oil lipid emulsion (SOLE) was the only commercially available parenteral lipid in the United States. Recently, a composite lipid emulsion (CLE) and fish oil lipid emulsion (FOLE) received US Food and Drug Administration approval. This study investigated whether lipid emulsion regimen impacts EFAD incidence in pediatric patients with intestinal failure.MethodsThis study was a 10‐year retrospective cohort study of pediatric patients with intestinal failure who received parenteral SOLE, CLE, or FOLE. The primary outcome was EFAD incidence, defined as a TTR ≥ 0.2. Secondary outcomes included TTR ≥ 0.05, cholestasis incidence, lipid dose effect on EFAD incidence, and fatty acid parameter differences.ResultsA total of 144 fatty acid profiles from 47 patients were reviewed. EFAD did not occur in any lipid emulsion group. There were no differences in the incidence of TTR ≥ 0.05 or cholestasis. The effect of dose could not be evaluated because of no EFAD incidence. Lastly, although each group had varied fatty acid parameters, none saw decreased essential fatty acid levels.ConclusionThis study found that, with close monitoring, the lipid emulsion regimen did not impact EFAD incidence. This suggests that FOLE and CLE do not increase EFAD risk compared with SOLE in pediatric patients with intestinal failure.

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Effect of arachidonic and docosahexaenoic acid supplementation on quality of growth in preterm infants: A secondary analysis of a randomized controlled trial

Cited by 2 publications

References 42 publications

Evidence on docosahexaenoic acid and arachidonic acid supplementation for preterm infants

Evidence on docosahexaenoic acid and arachidonic acid supplementation for preterm infants

Effect of parenteral lipids on essential fatty acid deficiency in pediatric intestinal failure: A retrospective cohort study

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