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Published on: November 20, 2015
Smoflipid Is Better Than Lipofundin for Long-Term Neurodevelopmental Outcomes in Preterm Infants
I-Lun Chen1, Chih-Hsing Hung2, Hsin-Chun Huang1
1Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung 83301, Taiwan.
Insights
Smoflipid (SMOF), a lipid emulsion containing fish oil, improved neurodevelopmental outcomes in premature infants. This included reduced rates of epilepsy, ADHD, and autism spectrum disorder (ASD) by age five.
Area of Science:
- Neonatal Medicine
- Pediatric Neurology
- Nutritional Science
Background:
- Premature infants, especially those with low birth weight, face higher risks of neurodevelopmental morbidities.
- Lipid emulsions are crucial for parenteral nutrition in neonates, but their impact on long-term neurodevelopment varies.
- The composition of lipid emulsions, particularly the inclusion of fish oil, may influence neurodevelopmental outcomes.
Purpose of the Study:
- To investigate the comparative effects of two lipid emulsions, Lipofundin® MCT/LCT (LIPO) and Smoflipid® (SMOF), on neurodevelopmental outcomes in premature infants.
- To determine if the fish oil component in SMOF influences the incidence of specific neurodevelopmental disorders.
- To analyze outcomes based on birth weight stratification (<1500 g and ≥1500 g).
Main Methods:
- Retrospective cross-sectional study analyzing data from premature neonates (2001-2015) at Chang Gung Memorial Hospital.
- Two groups: infants receiving LIPO versus SMOF, with SMOF containing fish oil.
- Neurodevelopmental outcomes assessed using International Classification of Diseases (ICD-9/10) codes up to age five years.
- Stratified analysis by birth weight (<1500 g and ≥1500 g).
Main Results:
- Smoflipid (SMOF) group showed significantly decreased rates of epilepsy, cerebral palsy, developmental disorder, and attention-deficit hyperactivity disorder (ADHD) at age two years.
- At age five years, the SMOF group had significantly lower rates of epilepsy, language delay (LD), ADHD, and autism spectrum disorder (ASD).
- In infants <1500 g, SMOF reduced ADHD at ages two and five, and ASD at age five. In infants ≥1500 g, SMOF reduced epilepsy, LD, and ADHD at age two, and LD at age five.
Conclusions:
- Lipid emulsions containing fish oil, such as Smoflipid (SMOF), are associated with improved neurodevelopmental outcomes in premature infants.
- SMOF demonstrates a protective effect against several neurodevelopmental disorders, including epilepsy, ADHD, and ASD.
- These findings suggest that the formulation of lipid emulsions can play a significant role in mitigating long-term neurodevelopmental morbidities in vulnerable premature populations.
Abstract:
Neurodevelopmental morbidities developed more commonly in low-birth-weight premature infants. We sought to determine the effects of different lipid emulsions on the neurodevelopmental outcomes of children born prematurely. This retrospective cross-sectional study had two intervention legs, Lipofundin® MCT/LCT (LIPO) versus Smoflipid® (SMOF), which are mainly differentiated by fish oil. Data of premature neonates born between 2001 and 2015 from the research database of Chang Gung Memorial Hospital with corresponding individual medical records up to July 2020 were analyzed. Long-term neurodevelopmental outcomes were defined by the international classification of disease codes -9 or -10. The prevalence of diseases was compared between LIPO and SMOF groups at five and five years old and further analyzed by stratification of 1500 g birth weight. The LIPO and SMOF groups each included 1120 neonates. Epilepsy, cerebral palsy, developmental disorder and attention-deficit hyperactivity disorder (ADHD) were significantly decreased at age two years in the SMOF group, and epilepsy, language delay (LD), ADHD and autism spectrum disorder (ASD) were significantly decreased in the SMOF group at age five years. In children with birth weight < 1500 g, ADHD was decreased in the SMOF group at ages two and five years, and ASD was decreased in the SMOF group at age five years. In children with birth weight ≥ 1500 g, epilepsy, LD and ADHD were decreased in the SMOF group at age two years. LD was decreased in the SMOF group at age five years. We conclude that lipid emulsions with fish oil improve the neurodevelopmental outcomes of children born prematurely.
