Arachidonic and docosahexaenoic acid supplementation and brain maturation in preterm infants; a double blind RCT.

Arachidonic acid Brain Docosahexaenoic acid Fatty acid supplementation Neurodevelopment Preterm

Journal

Clinical nutrition (Edinburgh, Scotland)
ISSN: 1532-1983
Titre abrégé: Clin Nutr
Pays: England
ID NLM: 8309603

Informations de publication

Date de publication:
29 Nov 2023
Historique:
received: 25 08 2023
revised: 24 11 2023
accepted: 26 11 2023
medline: 8 12 2023
pubmed: 8 12 2023
entrez: 7 12 2023
Statut: aheadofprint

Résumé

Arachidonic acid (ARA) and docosahexaenoic acid (DHA) are important structural components of neural cellular membranes and possess anti-inflammatory properties. Very preterm infants are deprived of the enhanced placental supply of these fatty acids, but the benefit of postnatal supplementation on brain development is uncertain. The aim of this study was to test the hypothesis that early enteral supplementation with ARA and DHA in preterm infants improves white matter (WM) microstructure assessed by diffusion-weighted MRI at term equivalent age. In this double-blind, randomized controlled trial, infants born before 29 weeks gestational age were allocated to either 100 mg/kg ARA and 50 mg/kg DHA (ARA:DHA group) or medium chain triglycerides (control). Supplements were started on the second day of life and provided until 36 weeks postmenstrual age. The primary outcome was brain maturation assessed by diffusion tensor imaging (DTI) using Tract-Based Spatial Statistics (TBSS) analysis. We included 120 infants (60 per group) in the trial; mean (range) gestational age was 26 This study suggests that supplementation with ARA and DHA at doses matching estimated fetal accretion rates improves WM maturation compared to control treatment, but further studies are needed to ascertain any functional benefit. www. gov; ID:NCT03555019.

Sections du résumé

BACKGROUND BACKGROUND
Arachidonic acid (ARA) and docosahexaenoic acid (DHA) are important structural components of neural cellular membranes and possess anti-inflammatory properties. Very preterm infants are deprived of the enhanced placental supply of these fatty acids, but the benefit of postnatal supplementation on brain development is uncertain. The aim of this study was to test the hypothesis that early enteral supplementation with ARA and DHA in preterm infants improves white matter (WM) microstructure assessed by diffusion-weighted MRI at term equivalent age.
METHODS METHODS
In this double-blind, randomized controlled trial, infants born before 29 weeks gestational age were allocated to either 100 mg/kg ARA and 50 mg/kg DHA (ARA:DHA group) or medium chain triglycerides (control). Supplements were started on the second day of life and provided until 36 weeks postmenstrual age. The primary outcome was brain maturation assessed by diffusion tensor imaging (DTI) using Tract-Based Spatial Statistics (TBSS) analysis.
RESULTS RESULTS
We included 120 infants (60 per group) in the trial; mean (range) gestational age was 26
CONCLUSION CONCLUSIONS
This study suggests that supplementation with ARA and DHA at doses matching estimated fetal accretion rates improves WM maturation compared to control treatment, but further studies are needed to ascertain any functional benefit.
CLINICAL TRIAL REGISTRATION BACKGROUND
www.
CLINICALTRIALS RESULTS
gov; ID:NCT03555019.

Identifiants

pubmed: 38061271
pii: S0261-5614(23)00416-8
doi: 10.1016/j.clnu.2023.11.037
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT03555019']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

176-186

Informations de copyright

Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.

Auteurs

Sissel J Moltu (SJ)

Department of Neonatal Intensive Care, Oslo University Hospital, 0424 Oslo, Norway. Electronic address: uxsilt@ous-hf.no.

Tone Nordvik (T)

Department of Neonatal Intensive Care, Oslo University Hospital, 0424 Oslo, Norway.

Madelaine E Rossholt (ME)

Department of Pediatrics and Adolescence Medicine, Oslo University Hospital, 0424 Oslo, Norway.

Kristina Wendel (K)

Department of Neonatal Intensive Care, Oslo University Hospital, 0424 Oslo, Norway.

Maninder Chawla (M)

Division of Radiology and Nuclear Medicine, Oslo University Hospital, 0424 Oslo, Norway.

Andres Server (A)

Division of Radiology and Nuclear Medicine, Oslo University Hospital, 0424 Oslo, Norway.

Gunnthorunn Gunnarsdottir (G)

Department of Pediatric Neurology, Oslo University Hospital, 0424 Oslo, Norway.

Are Hugo Pripp (AH)

Oslo Centre of Biostatistics and Epidemiology, Oslo University Hospital, 0424 Oslo, Norway.

Magnus Domellöf (M)

Department of Clinical Sciences, Pediatrics, Umeå University, 90185 Umeå, Sweden.

Marianne Bratlie (M)

Department of Pediatrics and Adolescence Medicine, Oslo University Hospital, 0424 Oslo, Norway.

Marlen Aas (M)

Department of Neonatal Intensive Care, Oslo University Hospital, 0424 Oslo, Norway.

Petra S Hüppi (PS)

Department of Woman, Child and Adolescent Medicine, University of Geneva, 1211 Geneva, Switzerland.

Alexandre Lapillonne (A)

Department of Neonatal Intensive Care, APHP Necker-Enfants Malades Hospital, Paris University, 75015 Paris, France.

Mona K Beyer (MK)

Division of Radiology and Nuclear Medicine, Oslo University Hospital, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

Tom Stiris (T)

Department of Neonatal Intensive Care, Oslo University Hospital, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

Ivan I Maximov (II)

Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway.

Oliver Geier (O)

Department of Physics and Computational Radiology, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norwary.

Helle Pfeiffer (H)

Department of Neonatal Intensive Care, Oslo University Hospital, 0424 Oslo, Norway; Department of Pediatric Neurology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.

Classifications MeSH