Randomized controlled trial of early arachidonic acid and docosahexaenoic acid enteral supplementation in very preterm infants

Álvarez, Patricia; Ramiro-Cortijo, David; Montes, María Teresa Escobar Gil de; Moreno, Bárbara; Calvo, María V.; Liu, Ge; Romero, Ana Esteban; Ybarra, Marta; Cordeiro, Malaika; Murube, Marina Clambor; Valverde, Eva; Sánchez-Pacheco, Aurora; Fontecha, Javier; Gibson, Robert; Pipaón, Miguel Sáenz de

doi:10.3389/fped.2022.947221

Cited by 2 publications

(1 citation statement)

References 56 publications

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“…Numerous studies have looked at the effects of these fatty acids on neurological development, as they are thought to play a role in brain and vision development. Other possible outcomes such as retinopathy of prematurity (ROP) and bronchopulmonary dysplasia (BPD) may also be influenced by these fatty acids due to their role as mediators of inflammation and/or oxidative stress [1,2]. However, determining the appropriate intake of LC-PUFA in infants is difficult because the levels of these fatty acids in breast milk vary [3 ▪ ,4 ▪ ,5] and they can also be synthesized endogenously.…”

Section: Introductionmentioning

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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Section: Introductionmentioning

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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Association of maternal body composition and diet on breast milk hormones and neonatal growth during the first month of lactation

et al. 2023

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IntroductionPreterm birth is associated with altered growth patterns and an increased risk of cardiometabolic diseases, with breast milk (BM) being a counteracting factor. Preterm infants also show alterations in adipokines and gut hormones influencing appetite and metabolism. Since these hormones are present in BM, it is possible that their levels may equilibrate deficiencies improving infant growth. We aimed to assess 1) the BM levels of ghrelin, resistin, leptin, insulin, peptide YY, and the gastrointestinal peptide in women with preterm and term labor; 2) the relationship between BM hormones and neonatal growth; and 3) the influence of maternal body composition and diet on these BM hormones.MethodsBM from 48 women (30 term and 18 preterm labor) was collected at days 7, 14, and 28 of lactation. Maternal body composition was evaluated by bioimpedance, and neonate anthropometric parameters were collected from medical records. The maternal dietary pattern was assessed by a 72-h dietary recall at days 7 and 28 of lactation. BM hormones were analyzed by the U-Plex Ultra-sensitive method. Data were analyzed using linear regression models. BM from women with preterm labor had lower ghrelin levels, with the other hormones being significantly higher compared to women with term delivery.ResultsIn premature infants, growth was positively associated with BM ghrelin, while, in term infants, it was positively associated with insulin and negatively with peptide YY. In the first week of lactation, women with preterm labor had higher body fat compared to women with term labor. In this group, ghrelin levels were positively associated with maternal body fat and with fiber and protein intake. In women with term labor, no associations between anthropometric parameters and BM hormones were found, and fiber intake was negatively associated with peptide YY.DiscussionPreterm labor is a factor influencing the levels of BM adipokines and gut hormones, with BM ghrelin being a relevant hormone for premature infant growth. Since ghrelin is lower in BM from women with preterm labor and the levels are associated with maternal fat storage and some dietary components, our data support the importance to monitor diet and body composition in women who gave birth prematurely to improve the BM hormonal status.

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Randomized controlled trial of early arachidonic acid and docosahexaenoic acid enteral supplementation in very preterm infants

Cited by 2 publications

References 56 publications

Evidence on docosahexaenoic acid and arachidonic acid supplementation for preterm infants

Evidence on docosahexaenoic acid and arachidonic acid supplementation for preterm infants

Association of maternal body composition and diet on breast milk hormones and neonatal growth during the first month of lactation

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