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Published on: November 20, 2015
Do different lipid emulsions affect brain development? A single-center retrospective analysis
Samuele Caruggi1, Andrea Calandrino1, Benedetta Corradi2
1Neonatal Intensive Care Unit, Department of Maternal and Neonatal Health, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Insights
This study found no significant differences in brain maturation or neurodevelopment at two years for very low birth weight infants receiving either SMOFlipid® or Intralipid® during parenteral nutrition.
Area of Science:
- Neonatal Medicine
- Neuroscience
- Nutritional Science
Background:
- Preterm birth poses risks to infant brain development due to extrauterine factors.
- Parenteral nutrition lipid choices may impact neurodevelopmental outcomes.
- SMOFlipid®, rich in omega-3 fatty acids, may reduce inflammation and bronchopulmonary dysplasia risk.
Purpose of the Study:
- To compare brain maturation using MRI and neurodevelopment at two years in VLBW infants.
- To evaluate the effect of SMOFlipid® versus Intralipid® in parenteral nutrition on preterm infant outcomes.
Main Methods:
- Retrospective observational cohort study of 121 VLBW infants.
- Infants received either multi-component lipid emulsion (MLE) or soybean lipid emulsion (SLE).
- Brain maturation assessed by Total Maturation Score (TMS) on MRI; neurodevelopment assessed by Griffith's scales at 24 months corrected age.
Main Results:
- No statistically significant differences in TMS between SLE and MLE groups.
- Neurodevelopmental outcomes also showed no significant differences between the groups.
- 121 VLBW infants were included, with 62 in the MLE group and 49 in the SLE group.
Conclusions:
- This study did not identify an optimal lipid emulsion for preterm infants.
- Further research is needed to determine the best lipid formulations for parenteral nutrition in VLBW infants.
Background:
Preterm birth is a critical period for brain development, as extrauterine factors can impair growth and myelination, thereby increasing the risk of neurodevelopmental impairment. Adequate nutrition and rapid weight gain are associated with better cognitive outcomes, and the choice of lipid emulsion during parenteral nutrition may influence these results. SMOFlipid®, enriched with omega-3 long-chain polyunsaturated fatty acids, could reduce inflammation and oxidative stress, potentially lowering bronchopulmonary dysplasia (BPD) risk. This study compared brain maturation at term-equivalent age (TEA) using MRI and neurodevelopment at 2 years in infants receiving either SMOFlipid® or Intralipid®.
Methods:
In this single-center retrospective observational cohort study, we included all very low birth weight (VLBW) infants admitted to the NICU of our institution between 2017 and 2021. Infants who underwent brain MRI at term-equivalent age and completed neurodevelopmental assessment at 2 years were included, and those with severe brain lesions were excluded. Patients were categorized into two groups based on the lipid emulsion administered during parenteral nutrition. The primary outcome was neurodevelopment at 24 months of corrected age (CA). The secondary outcome was brain maturation assessed by the total maturation score (TMS) on magnetic resonance imaging (MRI).
Results:
A total of 121 VLBW infants were included and categorized into two cohorts based on the lipid formulation administered: multi-component lipid emulsion (MLE) in 62 and soybean lipid emulsion (SLE) in 49 infants. TMS showed non-statistically significant differences among infants treated with SLE compared with those treated with MLE, as well as in neurodevelopmental outcomes assessed using Griffith's scales.
Conclusion:
Despite integrating brain imaging and clinical follow-up data, this study could not determine the optimal lipid emulsion for preterm infants.
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