Longchain polyunsaturated fatty acid supplementation in preterm infants

Area of Science:

• Neonatal Nutrition and Development
• Pediatric Gastroenterology
• Clinical Trials and Evidence Synthesis

Background:

• Preterm infants may have limited ability to synthesize longchain polyunsaturated fatty acids (LCPUFA), raising questions about their essentiality.
• LCPUFA are crucial for the development of the brain and retina, making their adequate intake vital for preterm infants.

Purpose of the Study:

• To evaluate the safety and efficacy of supplementing preterm infant formula with LCPUFA.
• To assess the impact of LCPUFA supplementation on visual function, neurodevelopment, and physical growth in preterm infants.

Main Methods:

• A systematic review and meta-analysis of randomized controlled trials (RCTs) involving enterally-fed preterm infants.
• Searched multiple databases including Cochrane CENTRAL, MEDLINE, Embase, and CINAHL up to April 2016.
• Included 17 trials with 2260 preterm infants, focusing on outcomes related to visual development, neurodevelopment, and physical growth.

Main Results:

• Most studies found no significant differences in visual acuity between LCPUFA-supplemented and control groups.
• Meta-analysis showed no significant effect of LCPUFA supplementation on neurodevelopmental outcomes at 12 and 18 months.
• Short-term increases in weight and length were observed at two months post-term, but no significant long-term effects on physical growth were found.

Conclusions:

• Current evidence does not demonstrate clear long-term benefits or harms of LCPUFA-supplemented formula for preterm infants.
• Variations in trial methodology, infant maturity, and supplementation protocols limit definitive conclusions.
• The overall quality of evidence for visual function, neurodevelopment, and growth outcomes was assessed as low.