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Published on: October 31, 2025

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

Sihan Wang1, Zixian Li2, Liangliang Li1

  • 1Department of Neonatology, The Affiliated Hospital of Qingdao University, Qingdao, China.

Translational Pediatrics
|June 15, 2026
PubMed

Insights

Multi-oil fat emulsion (SMOF) may protect preterm infants from bronchopulmonary dysplasia (BPD). This study found SMOF to be an independent protective factor against BPD without increasing other complications in infants born before 32 weeks gestation.

Area of Science:

  • Neonatal intensive care
  • Pediatric respiratory medicine
  • Nutritional science

Background:

  • Bronchopulmonary dysplasia (BPD) is a significant respiratory complication in preterm infants, impacting short- and long-term health.
  • Early nutrition, particularly intravenous lipid emulsions, plays a role in lung development and repair in very preterm infants.
  • Multi-oil fat emulsion (SMOF), containing fish oil and vitamin E, may reduce inflammation and oxidative stress compared to conventional medium-chain/long-chain triglyceride (MCT/LCT) emulsions.

Purpose of the Study:

  • To evaluate the association between the use of SMOF and the incidence of BPD in preterm infants born before 32 weeks' gestation.
  • To compare respiratory outcomes and other neonatal complications between infants receiving SMOF and those receiving conventional MCT/LCT emulsions.

Main Methods:

  • Retrospective analysis of 171 preterm infants (<32 weeks gestation) admitted to a tertiary neonatal intensive care unit.
  • Infants were divided into two groups: those receiving SMOF (n=96) and those receiving MCT/LCT (n=75) fat emulsions.
  • Comparison of BPD incidence, parenteral nutrition-related cholestasis (PNAC), retinopathy of prematurity (ROP), necrotizing enterocolitis (NEC), late-onset sepsis (LOS), brain injury, and mortality.

Main Results:

  • Multivariate analysis identified SMOF as an independent protective factor against BPD (OR = 0.317, 95% CI: 0.128-0.784).
  • No significant differences were found between the SMOF and MCT/LCT groups regarding PNAC, ROP, NEC, sepsis, brain injury, or mortality.

Conclusions:

  • SMOF may be a protective factor for BPD in preterm infants (<32 weeks gestation).
  • The use of SMOF did not increase the incidence of other common neonatal complications.
  • These preliminary findings suggest potential clinical utility of SMOF in this vulnerable population.
Abstract

Keywords:
Multi-oil fat emulsion (SMOF)bronchopulmonary dysplasia (BPD)parenteral nutrition (PN)preterm infant

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