Longchain polyunsaturated fatty acid supplementation in preterm infants

Area of Science:

• Neonatal Nutrition
• Developmental Pediatrics
• Essential Fatty Acids

Background:

• Preterm infants may have insufficient capacity to synthesize long-chain polyunsaturated fatty acids (LCPUFA).
• LCPUFA are crucial for developing brain and retina, leading to debate on their essentiality for preterm infants.

Purpose of the Study:

• To evaluate the safety and efficacy of supplementing preterm infant formula with LCPUFA.
• To determine if LCPUFA supplementation offers benefits to preterm infants.

Main Methods:

• Systematic review of eleven randomized trials assessing clinical endpoints.
• Searches included MEDLINE, Oxford Database of Perinatal Trials, and Cochrane Central Register of Controlled Trials.
• Data collection involved reviewing trials with clinical outcomes and assessing study quality.

Main Results:

• Most studies found no significant differences in visual acuity (measured by Teller acuity cards, VEP, ERG) between supplemented and control infants.
• Meta-analysis of Bayley Scales of Infant Development (BSID) showed no significant effect on development; some studies indicated potential impacts on novelty preference.
• Growth outcomes were generally not significantly affected, though some trials reported decreased growth while others showed increased weight and length.

Conclusions:

• No long-term benefits were demonstrated for preterm infants receiving formula supplemented with LCPUFA.
• Supplementation with n-3 and n-6 LCPUFA did not impair the growth of preterm infants.
• Variations in trial methodology, dosage, and formula composition limit definitive conclusions.