title: Growth, metabolic markers, and cognition in 8-year old children born prematurely, follow-up of a randomized controlled trial with essential fatty acids.
abstract: The study is a follow-up of a randomized, double-blinded, placebo-controlled trial of supplementation with docosahexaenoic acid (DHA) and arachidonic acid (AA) to 129 very low birth weight (VLBW; birth weight <1500 g) infants fed human milk. The main hypothesis was that supplementation would affect growth, metabolic markers, and cognitive function. The secondary aim was to describe predictors of metabolic markers and cognitive status at follow-up. Ninety-eight children met for 8-year follow-up with anthropometric measures, blood biomarkers, and cognitive testing. The intervention group had significantly lower insulin-like growth factor-1 (IGF-1) at 8 years, whereas no differences in growth or intelligence quotient (IQ) were found. For the total cohort, weight gain during first year of life was neither associated with BMI, metabolic markers, nor IQ at follow-up. Blood DHA at 8 years was positively associated with IQ.
  
  
  CONCLUSIONS
  The study is the first long-term follow-up of a randomized controlled trial with essential fatty acids investigating growth, metabolic factors, and IQ. IGF-1 levels were significantly lower in the intervention group at 8 years. First-year growth was not associated with BMI, metabolic markers, or IQ at follow-up. Current DHA status was a significant predictor of higher IQ at follow-up.
  
  
  BACKGROUND
  • Preterm children have increased risk of lower intelligence quotient (IQ), reduced growth, and abnormal metabolic status. • Early intake of docosahexaenoic acid (DHA) and arachidonic acid (AA), as well as early growth pattern, may influence both IQ and metabolic status. What is New: • Early intervention with DHA and AA led to reduced insulin-like growth factor-1 in blood at 8 years of age. • Weight gain during first year of life was neither associated with impaired metabolic markers nor improved IQ at follow-up. • Current DHA status was a significant predictor of higher IQ at 8 years, also when maternal education and birth weight were included in the model.
authors: Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, P.O. Box 1046, Blindern, 0317, Oslo, Norway. christine.henriksen@medisin.uio.no.
authors: Christine
authors: http://orcid.org/0000-0002-8079-8467
authors: C
authors: Henriksen
authors: Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, P.O. Box 1046, Blindern, 0317, Oslo, Norway.|Akershus University Hospital and Faculty Division AHUS, Institute for Clinical Medicine, University of Oslo, Nordbyhagen, Norway.
authors: Astrid N
authors: AN
authors: Almaas
authors: Norwegian School of Health Sciences, Kristiania University College, Oslo, Norway.
authors: Ane C
authors: AC
authors: Westerberg
authors: Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, P.O. Box 1046, Blindern, 0317, Oslo, Norway.
authors: Christian A
authors: CA
authors: Drevon
authors: Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, P.O. Box 1046, Blindern, 0317, Oslo, Norway.
authors: Per O
authors: PO
authors: Iversen
authors: Akershus University Hospital and Faculty Division AHUS, Institute for Clinical Medicine, University of Oslo, Nordbyhagen, Norway.
authors: Britt
authors: B
authors: Nakstad
mesh_terms: D000704:Analysis of Variance; D016718:Arachidonic Acid / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002648:Child; D002657:Child Development / Q000187:drug effects*; D003071:Cognition / Q000187:drug effects*; D004281:Docosahexaenoic Acids / Q000097:blood / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005527:Food, Fortified; D006128:Growth / Q000187:drug effects; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood / Q000254:growth & development; D019102:Infant, Very Low Birth Weight; D007360:Intelligence / Q000187:drug effects*; D008297:Male; D047928:Premature Birth; D013002:Somatomedins / Q000187:drug effects*; D018709:Statistics, Nonparametric
chemical_list: D015415:Biomarkers; D013002:Somatomedins; D004281:Docosahexaenoic Acids; D016718:Arachidonic Acid
keywords: Growth; Intelligence quotient; Polyunsaturated fatty acids; Premature infants