Plasma Oxidative Status in Preterm Infants Receiving LCPUFA Supplementation: A Pilot Study

Area of Science:

• Neonatal nutrition
• Biochemistry
• Pediatric oxidative stress

Background:

• Preterm infants often have deficiencies in essential long-chain polyunsaturated fatty acids (LCPUFAs) like arachidonic acid (ARA) and docosahexaenoic acid (DHA).
• These deficiencies increase the risk of oxidative stress-related pathologies in neonates.
• Antioxidant defenses are crucial for mitigating oxidative damage in preterm infants.

Purpose of the Study:

• To evaluate the impact of LCPUFA supplementation on the antioxidant defenses of preterm infants.
• To assess whether supplementing with ARA and DHA influences plasma antioxidant status and oxidative damage markers.
• To investigate the effects of ARA:DHA supplementation on fatty acid profiles in preterm neonates.

Main Methods:

• A randomized controlled trial involving 21 preterm infants, divided into ARA:DHA-S and medium-chain triglycerides (MCT-S) groups.
• Plasma LCPUFAs, antioxidants (glutathione, catalase, thiols), and oxidative damage biomarkers (MDA, carbonyls) were measured at birth, day 28, and 36 weeks postmenstrual age (WPA).
• Gas chromatography-mass spectroscopy and spectrophotometry were used for biochemical analyses, with calculated antioxidant and oxidative damage scores.

Main Results:

• At 36 WPA, the ARA:DHA-S group showed decreased levels of linoleic acid (LA) and dihomo-γ-linolenic acid (DGLA), and increased α-linolenic acid (ALA) compared to the MCT-S group.
• The LA:DHA ratio was significantly lower in the ARA:DHA-S group.
• Catalase, thiol groups, and overall antioxidant status (Antiox-S) were significantly higher in the ARA:DHA-S group, with no significant differences in oxidative damage biomarkers.

Conclusions:

• Supplementation with ARA and DHA in preterm neonates improves the antioxidant to oxidant balance.
• The supplementation led to a favorable shift in fatty acid precursors, favoring the n-3 pathway over the n-6 pathway.
• These findings suggest that ARA:DHA supplementation can potentially reduce oxidative stress and inflammation in preterm infants.