Modification of serum fatty acids in preterm infants by parenteral lipids and enteral docosahexaenoic acid/arachidonic acid: A secondary analysis of the Mega Donna Mega trial

Sjöbom, Ulrika; Andersson, Mats X.; Pivodic, Aldina; Lund, Anna-My; Vanpée, Mireille; Hansen‐Pupp, Ingrid; Ley, David; Wackernagel, Dirk; Sävman, Karin; Smith, Lois E H; Löfqvist, Chatarina; Hellström, Ann; Nilsson, Anders

doi:10.1016/j.clnu.2023.04.020

Cited by 4 publications

(3 citation statements)

References 38 publications

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“…All infants received at least some parenteral nutrition in the neonatal period. Details of the nutritional strategy and definitions of perinatal morbidities have been published previously 23,24 Written informed consent was obtained from the parents or guardians before inclusion.…”

Section: Methodsmentioning

confidence: 99%

The development of blood protein profiles in extremely preterm infants follows a stereotypic evolution pattern

et al. 2023

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Background Preterm birth is the leading cause of neonatal mortality and morbidity. Early diagnosis and interventions are critical to improving the clinical outcomes of extremely premature infants. Blood protein profiling during the first months of life in preterm infants can shed light on the role of early extrauterine development and provide an increased understanding of maturation after extremely preterm birth and the underlying mechanisms of prematurity-related disorders. Methods We have investigated the blood protein profiles during the first months of life in preterm infants on the role of early extrauterine development. The blood protein levels were analyzed using next generation blood profiling on 1335 serum samples, collected longitudinally at nine time points from birth to full-term from 182 extremely preterm infants. Results The protein analysis reveals evident predestined serum evolution patterns common for all included infants. The majority of the variations in blood protein expression are associated with the postnatal age of the preterm infants rather than any other factors. There is a uniform protein pattern on postnatal day 1 and after 30 weeks postmenstrual age (PMA), independent of gestational age (GA). However, during the first month of life, GA had a significant impact on protein variability. Conclusions The unified pattern of protein development for all included infants suggests an age-dependent stereotypic development of blood proteins after birth. This knowledge should be considered in neonatal settings and might alter the clinical approach within neonatology, where PMA is today the most dominant age variable.

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Section: Methodsmentioning

confidence: 99%

The development of blood protein profiles in extremely preterm infants follows a stereotypic evolution pattern

et al. 2023

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Section: Estimates Of the Need For Long Chain-polyunsaturated Fatty A...mentioning

confidence: 99%

“…Both human milk [12] and intravenous lipid emulsions [13 ▪ ] strongly influence circulating LC-PUFA levels in preterm infants. The greatest changes occur in the first weeks after birth, and interestingly the relative levels of DHA and ARA also decrease when fish-oil contain lipids are administered [13 ▪ ,14]. Postnatal fatty acid trajectories differ significantly between relative or absolute units [13 ▪ ], but most studies have shown that preterm infants fed either breast milk or the common preterm formulas (containing 0.2–0.37% of total fatty acids as DHA) have blood levels of LC-PUFAs consistent with DHA deficiency [15].…”

Section: Estimates Of the Need For Long Chain-polyunsaturated Fatty A...mentioning

confidence: 99%

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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Arachidonic acid and docosahexaenoic acid levels correlate with the inflammation proteome in extremely preterm infants

Klevebro,

Kebede Merid,

Sjöbom

et al. 2024

Clinical Nutrition

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Modification of serum fatty acids in preterm infants by parenteral lipids and enteral docosahexaenoic acid/arachidonic acid: A secondary analysis of the Mega Donna Mega trial

Cited by 4 publications

References 38 publications

The development of blood protein profiles in extremely preterm infants follows a stereotypic evolution pattern

The development of blood protein profiles in extremely preterm infants follows a stereotypic evolution pattern

Evidence on docosahexaenoic acid and arachidonic acid supplementation for preterm infants

Arachidonic acid and docosahexaenoic acid levels correlate with the inflammation proteome in extremely preterm infants

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