Postnatal RBC arachidonic and docosahexaenoic acids deficiencies are associated with higher risk of neonatal morbidities and mortality in preterm infants

Fares, Samira; Sethom, M.M.; Hammami, Mohamed; Chéour, M.; Feki, Moncef; Hadj-Taieb, Sameh; Kacem, Samia

doi:10.1016/j.plefa.2017.09.015

Cited by 11 publications

(15 citation statements)

References 37 publications

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“…Although SO provides the parent essential fatty acids, LA and ALA, many people believe there is a need for preformed ARA and DHA in lipid emulsions in the neonatal intensive care unit. First, preterm infants have an increased demand for ARA and DHA . Second, in preterm and cholestatic infants, endogenous synthesis of ARA and DHA from their parent essential fatty acid is inefficient .…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to our study population, preterm neonates receiving PN with SO, even when dosed at 3 g/kg/d, demonstrate a postnatal decline in ARA and DHA over the first couple weeks of age. 23,24 Although SO provides the parent essential fatty acids, LA and ALA, many people believe there is a need for preformed ARA and DHA in lipid emulsions in the neonatal intensive care unit. First, preterm infants have an increased demand for ARA and DHA.…”

Section: Discussionmentioning

confidence: 99%

“…First, preterm infants have an increased demand for ARA and DHA. 5,23,24 Second, in preterm and cholestatic infants, endogenous synthesis of ARA and DHA from their parent essential fatty acid is inefficient. [23][24][25] Third, in preterm infants, low DHA and ARA levels are linked to sepsis, retinopathy of prematurity, chronic lung disease, and developmental delays.…”

Section: Discussionmentioning

confidence: 99%

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Intravenous Fish Oil and Serum Fatty Acid Profiles in Pediatric Patients With Intestinal Failure–Associated Liver Disease

Ong

Venick

Shew

et al. 2019

J Parenter Enteral Nutr

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Background: Intravenous fish oil (FO) treats pediatric intestinal failure associated liver disease (IFALD). There are concerns that a lipid emulsion composed of omega-3 fatty acids will cause an essential fatty acid deficiency (EFAD). This study’s objective was to quantify the risk for abnormal fatty acid concentrations in children treated with FO. Methods: Inclusion criteria for this prospective study was children with intestinal failure. Intravenous soybean oil (SO) was replaced with FO for no longer than 6 months. Serum fatty acids were analyzed using linear and logistic models, and compared to age-based norms to determine the percentage of subjects with low and high concentrations. Results: Subjects (n=17) started receiving FO at a median of 3.6 months of age (IQR 2.4-9.6 months). Over time, α-linolenic, linoleic, arachidonic and Mead acid decreased, while docosahexaenoic and eicosapentanoic acid increased (p<0.001 for all). Triene:tetraene ratios remained unchanged (p=1). Although subjects were 1.8 times more likely to develop a low linoleic acid while receiving FO vs. SO (95% CI 1.4-2.3, p<0.01), there was not a significant risk for low arachidonic acid. Subjects were 1.6 times more likely to develop high docosahexaenoic acid while receiving FO vs. SO; however this was not significant (95% CI 0.9-2.6, p=0.08). Conclusion: In this cohort of parenteral nutrition-dependent children, switching from SO to FO led to a decrease in essential fatty acid concentrations, but an EFAD was not evident. Low and high levels of fatty acids developed. Further investigation is needed to clarify if this is clinically significant. Trial Identifier:

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Intravenous Fish Oil and Serum Fatty Acid Profiles in Pediatric Patients With Intestinal Failure–Associated Liver Disease

Ong

Venick

Shew

et al. 2019

J Parenter Enteral Nutr

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“…Previous studies suggested that term infants had a higher LC-PUFA status compared to that in preterm infants [11][12][13], and cord DHA levels in term infants positively correlated with later cognitive development [22]. In addition, it is important to maintain the appropriate DHA/ARA ratio in an infant to prevent mildly abnormal general movement [23].…”

Section: Discussionmentioning

confidence: 99%

“…LC-PUFA is preferentially transferred across the placenta in the third trimester [9], and DHA levels in the cord blood may be associated with cognitive development in infants and toddlers [10]. In preterm infants because of the relatively short duration of gestational period, LC-PUFA content is relatively lower than that in term infants [11][12][13]. However, to the best of our knowledge, no report to date has compared the fatty acid composition among the early-term, full-term, and late-term infants.…”

Section: Introductionmentioning

confidence: 99%

Fatty Acid Composition of the Erythrocyte Membranes Varies between Early-Term, Full-Term, and Late-Term Infants in Japan

et al. 2018

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Background: Term infants can be categorized into 3 sub-groups: early term (37w0d to 38w6d), full term (39w0d to 40w6d), and late term (41w0d and beyond). However, the fatty acid composition among the 3 groups of term infants has not been investigated. The association between fatty acid composition and gestational period of term infants in Japan is unclear. Methods: We assessed the fatty acid composition of maternal erythrocyte membranes in the third trimester and of cord erythrocyte membranes at birth in 212 healthy term Japanese infants using data from a prospective hospital-based cohort study. Results: In maternal erythrocyte membranes, docosahexaenoic acid (DHA) levels and omega-3 index were significantly higher in the late-term group than in the early-term group. In cord erythrocyte membranes, DHA levels were not significantly different between the 3 groups; late-term infants showed significantly higher DHA/arachidonic acid (ARA) and lower 20: 3n-6 and ARA levels compared to early-term infants. Gestational period positively correlated with the DHA status in maternal and cord erythrocyte membranes. Conclusions: Fatty acid composition in maternal and cord erythrocyte membranes varies between early-, full-, and late-term infants, and the greater gestational period may contribute to the relatively high n-3 polyunsaturated fatty acids status in term infants. Furthermore, maternal DHA status in the third semester directly correlates with gestational period in pregnant Japanese women.

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Long‐Chain Polyunsaturated Fatty Acids and Lipid Peroxidation Products in Donor Human Milk in the United Kingdom: Results From the LIMIT 2‐Centre Cross‐Sectional Study

Nessel

Rooy

Khashu

et al. 2020

J Parenter Enteral Nutr

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Background: Donor human milk (DHM) is used as alternative to maternal milk to feed preterm infants; however, it may provide less long-chain (LC) polyunsaturated fatty acids (PUFAs) and more oxidized lipids, which may be detrimental to preterm infant health and development. Levels have not been reported for DHM in the United Kingdom. Methods: DHM (n = 19) from 2 neonatal units, preterm milk from a neonatal unit (n = 10), and term milk from the community (n = 11) were analyzed for fatty acids, malondialdehyde, 4-hydroxy-2-nonenal, and hexanal. Study registration: NCT03573531. Results: DHM had significantly lower absolute LCPUFA content than term (P < .001) and significantly lower ω-3 PUFAs than preterm milk (P < .05), although relative LCPUFA composition did not differ. Exclusive DHM feeding leads to significantly lower fat (3.7 vs 6.7 g/d) and LCPUFA (docosahexaenoic acid [DHA]: 10.6 vs 16.8 mg/d; arachidonic acid [ARA]: 17.4 vs 25.2 mg/d) intake than recommended by the European Society for Pediatric Gastroenterology, Hepatology and Nutrition, and provides 17.3% and 43.1% of the in utero accreted ARA and DHA. DHM had the highest proportion of lipid peroxidation. Conclusions: This study confirms that DHM in the United Kingdom has insufficient LCPUFAs for preterm infants. It demonstrates for the first time that DHM has the highest level of lipid peroxidation, compared with preterm or term milk. This has important implications for preterm infant nutrition, as exclusive DHM feeding might not be suitable long term and may contribute to the development of major preterm neonatal morbidities.

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Postnatal RBC arachidonic and docosahexaenoic acids deficiencies are associated with higher risk of neonatal morbidities and mortality in preterm infants

Cited by 11 publications

References 37 publications

Intravenous Fish Oil and Serum Fatty Acid Profiles in Pediatric Patients With Intestinal Failure–Associated Liver Disease

Intravenous Fish Oil and Serum Fatty Acid Profiles in Pediatric Patients With Intestinal Failure–Associated Liver Disease

Fatty Acid Composition of the Erythrocyte Membranes Varies between Early-Term, Full-Term, and Late-Term Infants in Japan

Long‐Chain Polyunsaturated Fatty Acids and Lipid Peroxidation Products in Donor Human Milk in the United Kingdom: Results From the LIMIT 2‐Centre Cross‐Sectional Study

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