Association between multi-oil fat emulsion and bronchopulmonary dysplasia in preterm infants <32 weeks

Bronchopulmonary dysplasia (BPD) is a major respiratory morbidity in preterm infants and remains an important cause of adverse short- and long-term outcomes. Early postnatal nutrition may influence lung growth and injury repair, and intravenous lipid emulsions are a key component of parenteral nutrition in very preterm infants. Compared with conventional medium-chain/long-chain triglyceride fat emulsions (MCT/LCT), multi-oil fat emulsion (SMOF) contains fish oil and vitamin E, etc., and has a lower relative proportion of ω-6 fatty acids, and may theoretically attenuate inflammation and oxidative stress. However, current evidence regarding whether SMOF reduces the incidence of BPD remains inconsistent. This study aimed to evaluate the association between SMOF and BPD in preterm infants born at <32 weeks' gestation.

A retrospective analysis included 171 preterm infants (<32 weeks) admitted to a tertiary neonatal intensive care unit, divided into SMOF (n=96) and MCT/LCT (n=75) groups. The outcome of respiratory system and other complications such as parenteral nutrition-related cholestasis (PNAC), retinopathy of prematurity (ROP), necrotizing enterocolitis (NEC), late-onset of sepsis (LOS), brain injury and mortality were compared between the two groups.

Among the 171 preterm infants in the study, the mean gestational age was 29.51±1.55 weeks, with birth weight of 1,229.39±299.06 g. Multivariate analysis identified SMOF as an independent protective factor against BPD [odds ratio (OR) =0.317, 95% confidence interval (CI): 0.128-0.784]. No significant differences were observed in PNAC, ROP, NEC, sepsis, brain injury, or mortality between groups.

We preliminarily conclude that SMOF is a potentially protective factor for BPD in preterm infants <32 weeks without increasing complications such as PNAC, ROP, NEC, sepsis, and brain injury. These findings may support its clinical utility in this population.