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[Fat emulsion tolerance in preterm infants of different gestational ages in the early stage after birth]
Hui Tang1, Chuan-Zhong Yang, Huan Li
1Department of Neonatology, Shenzhen Maternity and Child Health Care Hospital Affiliated to Southern Medical University, Shenzhen, Guangdong 518028, China. yangczgd@163.com.
Insights
Extremely preterm infants have a reduced ability to metabolize long-chain fatty acids shortly after birth. These infants may not tolerate high-dose fat emulsions, unlike moderate-to-late preterm infants.
Area of Science:
- Neonatalogy
- Biochemistry
- Pediatric Nutrition
Background:
- Preterm infants require nutritional support, including fat emulsions, for growth and development.
- Fat metabolism capacity varies with gestational age in neonates.
- Understanding early fat emulsion tolerance is crucial for optimizing neonatal care.
Purpose of the Study:
- To assess fat emulsion tolerance in preterm infants based on gestational age.
- To investigate the relationship between gestational age and acylcarnitine profiles.
- To determine optimal fat emulsion dosing in early neonatal periods for different preterm groups.
Main Methods:
- 98 preterm infants categorized by gestational age: extremely preterm, early preterm, and moderate-to-late preterm.
- Analysis of short-, medium-, and long-chain acylcarnitines using tandem mass spectrometry.
- Comparison of acylcarnitine levels in umbilical cord blood and dried blood spots within 3 days post-birth, stratified by fat emulsion dose.
Main Results:
- Extremely and early preterm infants showed lower long-chain acylcarnitines than moderate-to-late preterm infants, correlating positively with gestational age.
- In extremely preterm infants, lower fat emulsion doses were associated with higher acylcarnitine levels on day 2.
- No significant differences in acylcarnitine levels were observed between low- and high-dose fat emulsion subgroups in early and moderate-to-late preterm infants.
Conclusions:
- Extremely and early preterm infants exhibit diminished long-chain fatty acid metabolism capacity within 3 days post-birth.
- Early and moderate-to-late preterm infants appear to tolerate high-dose fat emulsions.
- Extremely preterm infants may have impaired capacity to metabolize high-dose fat emulsions in the early neonatal period.
Objective:
To investigate the fat emulsion tolerance in preterm infants of different gestational ages in the early stage after birth.
Methods:
A total of 98 preterm infants were enrolled and divided into extremely preterm infant group (n=17), early preterm infant group (n=48), and moderate-to-late preterm infant group (n=33). According to the dose of fat emulsion, they were further divided into low- and high-dose subgroups. The umbilical cord blood and dried blood filter papers within 3 days after birth were collected. Tandem mass spectrometry was used to measure the content of short-, medium-, and long-chain acylcarnitines.
Results:
The extremely preterm infant and early preterm infant groups had a significantly lower content of long-chain acylcarnitines in the umbilical cord blood and dried blood filter papers within 3 days after birth than the moderate-to-late preterm infant group (P<0.05), and the content was positively correlated with gestational age (P<0.01). On the second day after birth, the low-dose fat emulsion subgroup had a significantly higher content of short-, medium-, and long-chain acylcarnitines than the high-dose fat emulsion subgroup among the extremely preterm infants (P<0.05). In the early preterm infant and moderate-to-late preterm infant groups, there were no significant differences in the content of short-, medium-, and long-chain acylcarnitines between the low- and high-dose fat emulsion subgroups within 3 days after birth.
Conclusions:
Compared with moderate-to-late preterm infants, extremely preterm infants and early preterm infants have a lower capacity to metabolize long-chain fatty acids within 3 days after birth. Early preterm infants and moderate-to-late preterm infants may tolerate high-dose fat emulsion in the early stage after birth, but extremely preterm infants may have an insufficient capacity to metabolize high-dose fat emulsion.
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