Dietary supplementation of long-chain polyunsaturated fatty acids in preterm infants: effects on cerebral maturation.
OBJECTIVE
To study the influence of dietary-supplied long-chain polyunsaturated fatty acids on structural brain maturation in preterm infants and to investigate parameters of functional brain development, relating them to structural maturation. Other studies have suggested that dietary supplementation of long-chain polyunsaturated fatty acids in preterm infants may enhance their visual development. The influence on structural brain development has never been evaluated.


METHODS
In a prospective, double-blind study, 42 formula-fed premature infants were randomized to be fed either a standard preterm formula without long-chain polyunsaturated fatty acids or an identical formula supplemented with docosahexaenoic acid (0.015 g/100 ml) and arachidonic acid (0.031 g/100 ml). Infants with significant cerebral damage, retinopathy, chronic disease or feeding problems were excluded. Follow-up was focused on assessment of cerebral myelination by MRI. Psychomotor, mental and visual development was analysed and flash-visual evoked potentials were recorded.


RESULTS
It was found that progress of myelination, mental and motor development and latencies of visual evoked potentials were not positively influenced by supplementation of long-chain polyunsaturated fatty acids. At each test age, visual acuity was slightly better in the supplemented infants than in the non-supplemented infants, but the difference never reached significance level


CONCLUSIONS
Supplementation of long-chain polyunsaturated fatty acids did not have a demonstrable positive influence on structural brain maturation. Related to this finding, in this small cohort of preterm infants without significant neurological damage, sample size being restricted by strict inclusion criteria and MRI procedures, no significant positive effects were found on psychomotor, mental and visual development.
van Wezel-Meijler
G
G
Department of Paediatrics, Free University Medical Centre, Amsterdam, The Netherlands. G.van_Wezel-Meijler@lumc.nl
van der Knaap
M S
MS
Huisman
J
J
Jonkman
E J
EJ
Valk
J
J
Lafeber
H N
HN
D000704:Analysis of Variance; D016718:Arachidonic Acid / Q000008:administration & dosage*; D001921:Brain / Q000254:growth & development* / Q000473:pathology; D002657:Child Development / Q000502:physiology*; D019587:Dietary Supplements; D004281:Docosahexaenoic Acids / Q000008:administration & dosage*; D004311:Double-Blind Method; D005074:Evoked Potentials, Visual; D005260:Female; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008279:Magnetic Resonance Imaging; D008297:Male; D011446:Prospective Studies; D012016:Reference Values; D012680:Sensitivity and Specificity; D014792:Visual Acuity
D004281:Docosahexaenoic Acids; D016718:Arachidonic Acid