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Association of intralipid intake in extremely low birthweight infants with neurodevelopmental outcomes

William Oh1, Lynn Przystac1, Leslie McKinley1

  • 1Department of Pediatrics, Women and Infants Hospital of Rhode Island, The Alpert Medical School of Brown University, Providence, RI, USA.

Acta Paediatrica (Oslo, Norway : 1992)
|December 24, 2017
PubMed

Insights

High intralipid (IL) intake in extremely low birthweight (ELBW) neonates was linked to poorer neurodevelopmental outcomes. However, breast milk intake mitigated these effects, highlighting its crucial role in infant development.

Area of Science:

  • Neonatalogy
  • Developmental Pediatrics
  • Nutritional Science

Background:

  • Extremely low birthweight (ELBW) neonates require intensive nutritional support, including intralipid (IL) emulsions.
  • The long-term neurodevelopmental impact of high IL intake in ELBW infants remains a critical area of research.
  • Early nutrition significantly influences neurodevelopmental trajectories in preterm infants.

Purpose of the Study:

  • To investigate the association between high intralipid (IL) intake and neurodevelopmental outcomes at two years corrected age in extremely low birthweight (ELBW) neonates.
  • To assess the relationship between IL dosage and neuroimpairment rates and Bayley III scores.
  • To explore the potential modifying effect of breast milk intake on these associations.

Main Methods:

  • A cohort of 389 ELBW infants was analyzed, categorizing intralipid (IL) intake into quartiles.
  • Logistic regression was used to determine the association between IL dose and neuroimpairment, adjusting for potential confounders.
  • Linear regression models predicted Bayley III scores based on IL intake, with subsequent analyses incorporating breast milk intake.

Main Results:

  • No significant association was observed between the dose of intralipid (IL) and the rate of neuroimpairment in ELBW neonates.
  • Higher IL intake was significantly associated with lower scores on the Bayley III cognitive, motor, and language assessments.
  • When breast milk intake was included in the regression models, the associations between IL dose and lower Bayley III scores were eliminated.

Conclusions:

  • Elevated intralipid (IL) intake in ELBW neonates correlates with diminished cognitive, motor, and language development.
  • The protective effect of breast milk intake neutralizes the negative impact of IL on neurodevelopmental scores.
  • These findings emphasize the paramount importance of breast milk in optimizing developmental outcomes for ELBW infants.
Abstract

Keywords:
Cognitive scoreExtremely low birthweightLanguage scoreLipid infusion

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