Impact of l-carnitine supplementation on metabolic profiles in premature infants
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Published on: June 28, 2024
R H Clark1, D H Chace1, A R Spitzer1
1Pediatrix-Obstetrix Center for Research, Education and Quality, Pediatrix Medical Group, Sunrise, FL, USA.
Insights
l-Carnitine supplementation in premature infants increases carnitine levels but does not improve short-term hospital outcomes. This finding is crucial for neonatal care guidelines.
Area of Science:
- Neonatal Medicine
- Biochemistry
- Pediatric Nutrition
Background:
- Premature infants often receive l-carnitine supplementation.
- Acylcarnitine profiles are important biomarkers in neonates.
- Understanding the impact of supplementation on outcomes is critical.
Purpose of the Study:
- To investigate the effect of l-carnitine supplementation on acylcarnitine profiles.
- To determine if l-carnitine supplementation influences hospital outcomes in premature infants.
Main Methods:
- Secondary analysis of a previously reported study.
- Metabolic profiles analyzed from infants born between 23-31 weeks gestation.
- Samples collected at multiple time points within the first 42 days of life.
Main Results:
- Infants receiving l-carnitine had higher free carnitine (FC) levels.
- Non-supplemented infants were more likely to have low FC levels on day 28.
- No significant improvement in short-term hospital outcomes was observed with supplementation.
Conclusions:
- l-Carnitine supplementation is associated with increased carnitine levels in premature neonates.
- Supplementation did not demonstrate a benefit for short-term hospital outcomes.
- Current supplementation practices warrant re-evaluation based on these findings.
Objective:
To describe the influence that of l-carnitine supplementation on acylcarnitine (AC) profiles and hospital outcomes in premature infants.
Study Design:
This study is a secondary analysis of previously reported work. Metabolic profiles were obtained using standard newborn techniques on infants born between 23 and 31 completed weeks of gestation. The profiles were drawn within the first 24 h after birth and on approximately days 7, 28 and 42 of life, or at the time of discharge. A single, central, contract laboratory analyzed and managed the samples.
Results:
We studied 995 patients; none was subsequently diagnosed with an inborn error of metabolism. l-Carnitine was added to parenteral nutrition in 390 (39%) study subjects; 592 (60%) did not receive supplementation. Non-supplemented infants were more likely to develop low levels of free carnitine (FC; <7 μm) on day 28; (41% vs 5%, P<0.01); and FC values were lower on day 7. Despite higher levels of FC and fewer patients with significant carnitine deficiencies, we found no evidence that l-carnitine supplementation was associated with improved short-term hospital outcomes.
Conclusion:
l-Carnitine supplementation is common in prematurely born neonates and is associated with higher carnitine levels, but is not associated with improved short-term hospital outcomes.
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