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Updated: Jul 11, 2025
Three-Dimensional Phase Resolved Functional Lung Magnetic Resonance Imaging
Published on: June 21, 2024
Lung function in preterm infants at 3 months corrected age after neonatal LC-PUFA supplementation
Kristina Wendel1,2, Madelaine Eloranta Rossholt2,3, Gunnthorunn Gunnarsdottir2,4
1Department of Neonatal Intensive Care, Oslo University Hospital, Oslo, Norway.
Insights
Long-chain polyunsaturated fatty acid (LC-PUFA) supplementation did not improve lung function in very preterm infants. Bronchopulmonary dysplasia (BPD) was linked to poorer lung function, while better growth correlated with higher tidal volumes.
Area of Science:
- Neonatal care
- Pediatric pulmonology
- Nutritional science
Background:
- Very preterm infants often experience impaired lung function.
- Bronchopulmonary dysplasia (BPD) is a significant complication affecting lung development in these infants.
- Long-chain polyunsaturated fatty acids (LC-PUFAs) are crucial for infant development, but their impact on preterm infant lung function requires further investigation.
Purpose of the Study:
- To evaluate the effect of LC-PUFA supplementation on lung function in very preterm infants.
- To explore the relationship between BPD, growth, and lung function at 3 months corrected age.
Main Methods:
- A secondary analysis of the ImNuT trial involving 121 infants (gestational age <29 weeks).
- Infants were randomized to receive daily LC-PUFA (arachidonic acid and docosahexaenoic acid) or MCT-oil (control) supplements.
- Lung function was assessed at 3 months corrected age using tidal flow volume loops, measuring tPTEF/tE ratio and tidal volume (VT) per body weight.
Main Results:
- No significant difference in lung function (tPTEF/tE ratio or VT) was observed between the LC-PUFA and control groups.
- BPD was independently associated with a reduced tPTEF/tE ratio (p=0.03).
- Increased linear growth after 36 weeks postmenstrual age positively correlated with higher VT (p=0.03).
Conclusions:
- Neonatal LC-PUFA supplementation does not enhance lung function at 3 months corrected age in very preterm infants.
- BPD is a key factor negatively impacting lung function in this population.
- Longitudinal growth is positively associated with improved tidal volumes, suggesting its importance for respiratory outcomes.
Objective:
To test the hypothesis that long-chain polyunsaturated fatty acid (LC-PUFA) supplementation improves lung function at 3 months corrected age (CA) compared with standard treatment in very preterm infants. We also aimed to investigate the association between bronchopulmonary dysplasia (BPD), longitudinal growth, and lung function at 3 months CA.
Methods:
A secondary analysis from the ImNuT trial, in which 121 infants with gestational age <29 weeks were randomized to a daily supplement with arachidonic acid (ARA) and docosahexaenoic acid (DHA) (ARA:DHA group) or MCT-oil (control group) from birth up to 36 weeks postmenstrual age (PMA). Lung function was assessed at 3 months CA by tidal flow volume loops and the outcomes were the ratio of time to peak tidal expiratory flow to expiratory time (tPTEF /tE ) and tidal volume (VT ) per body weight (mL/kg).
Results:
Thirty-nine infants in the ARA:DHA group versus 51 in the control group had a successful lung function test. There was no mean difference (MD) in tPTEF /tE ratio (MD: 0.01, 95% confidence interval [CI]: -0.04 to 0.05; p = .77) or VT (MD: 0.09 mL/kg, 95% CI: -0.79 to 0.62; p = .81) between the study groups. The multivariable regression model showed that BPD was associated with tPTEF /tE ratio ≤ 0.25 (p = .03) and that an increase in z score for length after 36 weeks PMA correlated positively with VT (mL/kg) (p = .03).
Conclusion:
Neonatal LC-PUFA supplementation did not improve lung function at 3 months CA in very preterm infants. BPD was independently associated with reduced lung function, while improved linear growth correlated with higher tidal volumes.
