Medium-chain triglyceride supplementation in preterm infants: A prospective cohort study

Area of Science:

• Neonatal Nutrition
• Pediatric Gastroenterology
• Clinical Pediatrics

Background:

• Optimizing postnatal growth in preterm infants is a significant challenge in neonatal intensive care.
• Medium-chain triglycerides (MCTs) offer rapid energy availability, but their use and impact on growth in preterm infants require further investigation.
• Limited prospective data exist on MCT supplementation in routine neonatal care and its association with clinical complexity.

Purpose of the Study:

• To investigate the utilization of MCT supplementation in preterm infants.
• To explore the relationship between MCT supplementation and indicators of clinical complexity in this population.
• To assess the impact of MCT supplementation on growth and clinical outcomes in preterm infants.

Main Methods:

• A prospective cohort study included preterm infants (<37 weeks gestation, <2.500 g birth weight) admitted to a neonatal intensive care unit (NICU).
• Infants were stratified based on MCT supplementation status.
• Associations between birth characteristics, clinical outcomes, anthropometric parameters, and NICU length of stay were analyzed concerning MCT use.

Main Results:

• MCT supplementation was more frequent in infants with greater prematurity, low birth weight, bronchopulmonary dysplasia (BPD), and extrauterine growth restriction (EUGR).
• Among infants receiving MCT, only 9% achieved adequate weight at discharge.
• MCT supplementation was associated with the greatest drop in weight Z-score and longer hospital stays.

Conclusions:

• MCT supplementation was disproportionately administered to preterm infants with higher clinical severity.
• Findings suggest MCT supplementation may not be associated with improved growth or shorter hospital stays in complex preterm infants.
• Further robust studies are necessary to elucidate the precise role of MCT supplementation in neonatal nutrition and growth optimization.