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Neurodevelopmental outcomes of preterm infants fed high-dose docosahexaenoic acid: a randomized controlled trial

Maria Makrides1, Robert A Gibson, Andrew J McPhee

  • 1Child Nutrition Research Centre, Women's and Children's Health Research Institute, Women's and Children's Hospital, 72 King William Rd, North Adelaide SA 5006, Australia. maria.makrides@cywhs.sa.gov.au

JAMA
|January 15, 2009
PubMed

Insights

Higher dietary docosahexaenoic acid (DHA) did not improve neurodevelopment in preterm infants overall. However, increased DHA intake positively impacted cognitive scores in preterm girls at 18 months corrected age.

Area of Science:

  • Neonatal Nutrition
  • Neurodevelopmental Pediatrics
  • Omega-3 Fatty Acids

Background:

  • The neurodevelopmental benefits of dietary docosahexaenoic acid (DHA) in preterm infants remain uncertain.
  • Preterm infants have specific nutritional requirements for optimal brain development.

Purpose of the Study:

  • To investigate the impact of meeting estimated DHA requirements on the neurodevelopment of preterm infants.
  • To assess cognitive outcomes at 18 months corrected age in relation to early DHA intake.

Main Methods:

  • A randomized, double-blind controlled trial involving preterm infants (<33 weeks gestation).
  • Infants received either high-DHA (1% total fatty acids) or standard-DHA (0.3% total fatty acids) enteral feeds from early life until term corrected age.
  • Neurodevelopment was assessed using the Bayley Mental Development Index (MDI) at 18 months corrected age, with subgroup analyses by sex and birth weight.

Main Results:

  • Overall, no significant difference in Bayley MDI scores was observed between high-DHA and standard-DHA groups.
  • Preterm girls fed high-DHA demonstrated improved MDI scores compared to those on standard DHA.
  • No significant differences in MDI scores were found for preterm boys or for infants with higher birth weights (≥1250 g).

Conclusions:

  • Early life high-DHA supplementation (1% total fatty acids) did not enhance overall neurodevelopment in preterm infants born before 33 weeks gestation.
  • A higher DHA intake showed a beneficial effect on the cognitive development of preterm girls.
  • Further research may be needed to elucidate sex-specific effects of DHA on neurodevelopment in preterm populations.
Abstract

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