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Long-chain polyunsaturated fatty acid status and early growth of low birth weight infants
H A Woltil1, C M van Beusekom, A Schaafsma
1Department of Paediatrics, Martini Hospital, Groningen, The Netherlands.
Insights
Early neonatal arachidonic acid (AA) status relates to intrauterine growth, while post-natal brain growth depends on docosahexaenoic acid (DHA) and protein intake in low birth weight infants.
Area of Science:
- Neonatal nutrition
- Developmental pediatrics
- Biochemistry
Background:
- Low birth weight infants (< or = 2500 g) require specific nutritional support for optimal growth and development.
- Essential fatty acids, arachidonic acid (AA) and docosahexaenoic acid (DHA), play critical roles in infant development.
- Understanding the impact of different feeding regimens on fatty acid status is crucial for preterm infants.
Purpose of the Study:
- To correlate arachidonic acid (AA) and docosahexaenoic acid (DHA) status with anthropometric measures and growth rates in low birth weight infants.
- To investigate the relationship between fatty acid status, feeding type (maternal milk, preterm formula with or without long-chain polyunsaturated fatty acids [LCP]), and early postnatal growth.
- To determine the influence of DHA and protein intake on brain growth in the first six weeks of life.
Main Methods:
- Cross-sectional study involving 143 low birth weight infants (gestational ages 30-41 weeks).
- Measurement of erythrocyte (RBC) and plasma cholesterol ester (CE) AA and DHA status between days 10 and 42.
- Categorization of infants into three feeding groups: preterm formula without LCP, preterm formula with LCP, and maternal milk.
Main Results:
- Arachidonic acid (AA) status on day 10 correlated with birth weight and standard deviation scores (SDS) for weight, length, and occipito-frontal circumference in formula-fed infants.
- Brain weight was associated with RBC and CE DHA levels on days 10 and 42 in formula-fed infants.
- DHA status on day 42 and protein intake from days 10-42 explained 21-34% of the variance in brain growth parameters on day 42.
Conclusions:
- Early neonatal arachidonic acid (AA) status is linked to intrauterine growth rather than postnatal growth.
- Postnatal brain growth in low birth weight infants is significantly influenced by docosahexaenoic acid (DHA) status and dietary protein intake.
- Adequate dietary DHA is essential for supporting brain development during the first six postnatal weeks in this vulnerable population.
Unlabelled:
We correlated arachidonic acid (AA) and docosahexaenoic acid (DHA) status with anthropometric measures and growth rates in a group of low birth weight infants (< or = 2500 g; gestational ages 30-41 weeks; n = 143). AA and DHA status were measured in erythrocytes (RBC) and plasma cholesterol esters (CE) during days 10 to 42. Infants received preterm formula without long-chain polyunsaturated fatty acids (LCP; n = 81), with LCP (n = 29) or maternal milk (n = 33). RBC AA contents on day 10 were correlated (P < 0.05) with birth weight in breast-fed infants and all formula-fed infants, with on day 10 a standard deviation score (SDS) for weight, length and occipito-frontal circumference in all formula-fed infants, and with on day 10 an SDS for length in breast-fed infants. Brain weight was related to RBC DHA and CE DHA contents on both day 10 and day 42 in formula-fed infants. Of the variances of brain growth parameters on day 42, 21-34% were explained by DHA status on day 42 and protein intake from days 10-42.
Conclusion:
We conclude that parameters of early neonatal AA status are related to intra-uterine rather than to post-natal growth. Parameters of post-natal brain growth are related to RBC DHA and CE DHA contents on day 42, and to dietary protein intake. These results point to the importance of dietary DHA for brain growth in the first 6 post-natal weeks.