Long-chain polyunsaturated fatty acid supplementation in preterm infants
Related Experiment Video
Updated: Jun 4, 2026
Dietary Supplementation of Polyunsaturated Fatty Acids in Caenorhabditis elegans
Published on: November 29, 2013
Sven M Schulzke1, Sanjay K Patole, Karen Simmer
1Department of Neonatology, University of Basel Children's Hospital (UKBB), Spitalstrasse 21, Basel, Switzerland, 4031.
Insights
Supplementing preterm infant formula with longchain polyunsaturated fatty acids (LCPUFA) showed no clear long-term benefits or harms. Further research is needed to determine if LCPUFA are essential for preterm infant development.
Area of Science:
- Neonatal Nutrition
- Developmental Pediatrics
- Evidence-Based Medicine
Background:
- Preterm infants may have insufficient endogenous synthesis of longchain polyunsaturated fatty acids (LCPUFA).
- LCPUFA are crucial for the development of the brain and retina.
- The essentiality of LCPUFA for preterm infants remains a subject of debate.
Purpose of the Study:
- To evaluate the safety and efficacy of LCPUFA supplementation in preterm infant formula.
- To determine the impact of LCPUFA on neurodevelopment, visual acuity, and growth in preterm infants.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) identified through comprehensive database searches.
- Eligibility criteria focused on trials with clinical endpoints and LCPUFA-supplemented formula.
- Data extraction and quality assessment were performed by multiple authors.
Main Results:
- Most studies found no significant differences in visual acuity between supplemented and control groups.
- Meta-analyses showed no significant effect of LCPUFA supplementation on neurodevelopmental outcomes at 12 and 18 months post-term.
- Growth outcomes were mixed, with some studies reporting benefits at 2 months but no significant long-term effects on weight, length, or head circumference.
Conclusions:
- The reviewed trials included relatively mature and healthy preterm infants.
- Variations in study design, supplementation protocols, and control formulas limit definitive conclusions.
- Overall, no clear long-term benefits or harms were demonstrated for LCPUFA-supplemented formula in preterm infants.
Background:
Controversy exists over whether longchain polyunsaturated fatty acids (LCPUFA) are essential nutrients for preterm infants, who may not be able to synthesise sufficient amounts of LCPUFA to satisfy the needs of the developing brain and retina.
Objectives:
The aim of this review is to assess whether supplementation of formula with LCPUFA is safe and of benefit to preterm infants.
Search Strategy:
Trials were identified by MEDLINE (1966 to December 2009), Oxford Database of Perinatal Trials, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 4, 2009) and by checking reference lists of articles and conference proceedings.
Selection Criteria:
All randomised trials of formula supplemented with LCPUFA and with clinical endpoints were reviewed.
Data Collection And Analysis:
All authors assessed eligibility and trial quality, two authors extracted data separately. Study authors were contacted for additional information.
Main Results:
Of the 17 trials included in the review, 13 were classified as of high quality. Visual acuity Visual acuity over the first year was measured by Teller or Lea acuity cards in eight studies, by VEP in six studies and by ERG in two studies. Most studies found no significant differences in visual assessment between supplemented and control infants.Development Three out of seven studies reported some benefit of LCPUFA on neurodevelopment in different populations at different postnatal ages. Meta-analysis of Bayley Scales of Infant Development of four studies at 12 months (N = 364) and three studies at 18 months (N = 494) post-term showed no significant effect of supplementation on neurodevelopment.Growth Four out of 15 studies reported benefits of LCPUFA on growth of supplemented infants at different postnatal ages. Two trials suggested that LCPUFA supplemented infants grow less well than controls. One trial reported mild reductions in length and weight z scores at 18 months. Meta-analysis of five studies showed increased weight and length at two months post-term in supplemented infants. Meta-analysis of four studies at 12 months (N = 271) and two studies at 18 months (N = 396) post-term showed no significant effect of supplementation on weight, length or head circumference.
Authors' Conclusions:
Infants enrolled in the trials were relatively mature and healthy preterm infants. Assessment schedule and methodology, dose and source of supplementation and fatty acid composition of the control formula varied between trials. On pooling of results, no clear long-term benefits or harms were demonstrated for preterm infants receiving LCPUFA-supplemented formula.
More Related Videos
04:53A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition
Published on: September 20, 2019
03:19Modifying Levels of Maternal Dietary Folic Acid or Choline to Study the Impact of Deficiencies on Offspring Health Outcomes
Published on: June 28, 2024
Related Concept Videos
03:38Structure of Lipids
01:18Lipids: Dietary Sources and Requirements
01:31Lipid-derived Compounds in the Human Body
Fat-soluble Vitamins
Fat-soluble vitamins, including vitamins A, D, E, and K, are required in minimal quantities, but their deficiencies can lead to severely abnormal physiological conditions. For example, vitamin A deficiency can cause night blindness, dry skin, delayed...
01:24Lipid Absorption
These breakdown products bind with bile salts and lecithin to form micelles, which quickly pass between microvilli to come in close contact with the apical...