Effects of a lipid emulsion containing fish oil on polyunsaturated fatty acid profiles, growth and morbidities in extremely premature infants: A randomized controlled trial
Najm S, Löfqvist C, Hellgren G, Engström E, Lundgren P, Hård AL, Lapillonne A, Sävman K, Nilsson AK, Andersson MX, Smith LEH, Hellström A
Clinical nutrition ESPEN · 116 citations
How it was studied
- Design
- Randomized controlled trial (indexed by PubMed)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
Who paid for it
- Funding
- Possibly industry funded
- Government
- National Eye Institute
- Government
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
- Government
- NEI NIH HHS
- Government
- NICHD NIH HHS
- Grants
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (P30 HD-018655); National Eye Institute (R24-EY-024864); National Eye Institute (R01EY017017); Eunice Kennedy Shriver National Institute of Child Health and Human Development (U54HD090255)
Based on 4 listed funder(s) and full-text disclosure statement.
Publication
- Published
- 2017-05-03 · Clin Nutr ESPEN · vol. 20 · pp. 17–23
- Publisher
- Elsevier BV
- Cited
- 139 citations · more than 99% of similar papers · 9.3× the field average
- Impact
- Top 10% most cited in its field
- References
- 44 works
- Access
- Open access (hybrid journal) · CC-BY-NC-ND
- Research areas
- Neonatal Respiratory Health Research · Fatty Acid Research and Health · Retinopathy of Prematurity Studies
- Keywords
- Retinopathy of prematurity, Necrotizing enterocolitis, Medicine, Fish oil, Bronchopulmonary dysplasia, Eicosapentaenoic acid, Docosahexaenoic acid, Parenteral nutrition, Gestational age, Arachidonic acid, Gastroenterology, Polyunsaturated fatty acid, Respiratory distress, Randomized controlled trial, Sepsis, Fatty acid, Internal medicine, Pregnancy, Surgery, Biochemistry, Biology
- MeSH
- humans, bronchopulmonary dysplasia, retinopathy of prematurity, fat emulsions, intravenous, fatty acids, unsaturated, fish oils, treatment outcome, parenteral nutrition, child development, infant, newborn, female, male, infant, extremely premature
12 authors
From SE, FR, US
- Svetlana NajmUniversity of Gothenburg
- Chatarina Löfqvist · correspondingUniversity of Gothenburg
- Gunnel HellgrenUniversity of Gothenburg
- Eva EngströmUniversity of Gothenburg
- Pia LundgrenUniversity of Gothenburg
- Anna‐Lena HårdUniversity of Gothenburg
Abstract
Background & aims
The purpose of the study was to compare the effects of the parenteral emulsion SMOFlipid®, with 15% fish oil, with Clinoleic® on retinopathy of prematurity (ROP) and other morbidities and growth, and to compare their impact on longitudinal serum levels of fatty acids. Retinopathy of prematurity, other morbidity and growth were correlated with each parenteral lipid supplement.
Methods
Ninety infants born at gestational age ® or Clinoleic®. Two thirds (66%) of the infants received parenteral nutrition for up to 14 days birth (median 8, range 2-14 days), and additional 25% of the infants received for up to 28 days after birth (median 21, range 15-28 days). Cord blood samples and then venous blood samples were obtained at ages 1, 7, 14, and 28 days and at postmenstrual age (PMA) 32, 36, and 40 weeks. Breastmilk was collected at postnatal day 7, and at PMA 32 and 40 weeks. Serum phospholipid and breastmilk total fatty acids were analyzed by gas chromatography-mass spectrometry. Treatment groups were compared with regard to ROP, bronchopulmonary dysplasia, necrotizing enterocolitis, patent ductus arteriosus sepsis and growth between birth and 36 weeks.
Results
Infants on SMOFlipid® had higher fractions of omega-3 LCPUFA eicosapentaenoic acid (EPA) and slightly higher omega-3 LCPUFA docosahexaenoic acid (DHA) fraction and a decreased arachidonic acid (AA) to DHA ratio from one week after birth up to 32 postmenstrual weeks compared to infants on Clinoleic®. Treatment groups did not differ in morbidities or growth.
Conclusion
Supplementation with SMOFlipid® containing 15% fish oil during parenteral nutrition increased EPA substantially, DHA marginally, reduced AA and decreased AA to DHA ratio. It did not reduce morbidity or affect growth. Since extremely preterm infants accumulate a large deficit of DHA and AA, studies on more prolonged or different levels of DHA and AA supplementation are warranted.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY-NC-ND).
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