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Early parenteral lipid intake supports cerebellar neurometabolism at term-age in preterm infants

Sudeepta K Basu1,2,3, Katherine M Ottolini1,2,3, Kushal J Kapse2

  • 1Neonatology, Children's National Hospital, Washington, DC, USA.

Journal of Perinatology : Official Journal of the California Perinatal Association
|June 23, 2025
PubMed

Insights

Early parenteral lipid and caloric intake in preterm infants is linked to better cerebellar neurometabolite levels. Specifically, higher lipid intake supports higher N-acetylaspartate (NAA) and glutamate (Glx) concentrations, crucial for brain development.

Area of Science:

  • Neonatal neuroscience
  • Pediatric nutrition
  • Neuroimaging

Background:

  • Parenteral nutrition is vital for preterm infants, but its impact on brain development is not fully understood.
  • Early nutritional strategies may influence neurometabolism in the developing preterm brain.

Purpose of the Study:

  • To investigate the relationship between early parenteral nutrition (lipid and caloric intake) and cerebellar neurometabolites in very preterm infants.
  • To characterize how parenteral nutrition affects specific brain metabolites in the cerebellum.

Main Methods:

  • A prospective observational cohort study included very preterm infants (≤32-week gestational age).
  • Proton magnetic resonance spectroscopy (¹H-MRS) was used to assess cerebellar neurometabolites at term-age.
  • Parenteral lipid and caloric intake were calculated from the first 4 weeks of life via chart review.

Main Results:

  • Cerebellar N-acetylaspartate (NAA) positively correlated with 4-week parenteral lipid and caloric intake.
  • Glutamate (Glx) showed a positive trend with parenteral intake.
  • Adjusted analyses confirmed that higher 4-week parenteral lipid intake was associated with increased cerebellar NAA and Glx concentrations.

Conclusions:

  • Parenteral lipid intake in early life is associated with higher cerebellar NAA and Glx levels in preterm infants.
  • These findings suggest that parenteral lipids support critical aspects of cerebellar development and neurometabolism.
Abstract

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