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Long chain polyunsaturated fatty acids and visual function in preterm infants
A Leaf1, A Gosbell, L McKenzie
1Newborn Services, Monash Medical Centre, Clayton, Victoria, Australia.
Insights
This study found no significant difference in retinal maturation between preterm infants fed varying amounts of breast milk. However, subtle links between fatty acids like docosahexaenoic acid (DHA) and visual function were observed.
Area of Science:
- Neonatal nutrition
- Ophthalmology
- Neuroscience
Background:
- Premature infants often have altered fatty acid metabolism.
- Docosahexaenoic acid (DHA) is crucial for retinal development.
- The impact of dietary DHA on visual maturation in preterm infants requires further investigation.
Purpose of the Study:
- To investigate the relationship between dietary intake of breast milk, docosahexaenoic acid (DHA), and arachidonic acid (AA) with retinal function in preterm infants.
- To assess whether increased dietary DHA enhances retinal maturation in premature infants.
- To evaluate visual acuity at corrected ages.
Main Methods:
- Electroretinograms (ERGs) were recorded in 18 preterm infants at 40 weeks post-conceptual age (PCA).
- Plasma and red blood cell phospholipid fatty acid composition was analyzed.
- Dietary intake, particularly breast milk percentage, was meticulously recorded.
Main Results:
- A strong correlation was found between breast milk intake and DHA levels in plasma and red blood cells.
- No significant difference in retinal sensitivity was observed between infants receiving >50% or <50% breast milk.
- Positive correlations were noted between DHA and scotopic b-wave implicit time, and between arachidonic acid (AA) and rod ERG amplitude.
Conclusions:
- Increased dietary DHA did not enhance retinal maturation in this cohort of preterm infants.
- Subtle relationships exist between long-chain polyunsaturated fatty acids and visual function.
- All infants demonstrated age-appropriate visual development at follow-up.
Abstract:
Electroretinograms (ERG) were recorded at 40 weeks post-conceptual age (PCA) in 18 infants born prematurely (25-32 weeks gestation). Fatty acid composition of plasma and red cell phospholipids was measured within 4 days of birth and at time of ERG testing, and detailed record was kept of dietary intake. Correlations were seen between percentage intake of breast milk and docosahexaenoic acid (DHA) in both plasma (r = 0.818, P < 0.0001) and red cells (r = 0.534, P = 0.035) and significant differences in fatty acid profiles were seen between infants receiving > 50% and < 50% breast milk. No difference was seen in retinal sensitivity between infants receiving > 50% or < 50% breast milk. A positive correlation was seen between scotopic (rod) b-wave implicit time on ERG and DHA in both plasma (r = 0.733, P = 0.001) and red cells (r = 0.502, P = 0.04). A positive correlation was seen between arachidonic acid and rod ERG amplitude (r = 0.565, P = 0.022) which may reflect the higher AA/DHA ratio in the developing retina. These data did not support our hypothesis that increased dietary DHA results in enhanced retinal maturation. Visual acuity measured at 40 weeks PCA and again 3 months later was similar between groups. While subtle relationships were demonstrated between long chain polyunsaturated fatty acids and visual function, all infants were felt to be within age-appropriate normal range at expected date of delivery and at 3 months corrected age.