Lisa M Hortensius1,2, William Hellström3, Karin Sävman3,4, Rolf A Heckemann5, Isabella M Björkman-Burtscher6, Floris Groenendaal1,2, Mats X Andersson7, Anders K Nilsson8, Maria Luisa Tataranno1,2, Ruurd M van Elburg1,9, Ann Hellström8, Manon J N L Benders10,11. 1. Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. 2. University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands. 3. Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 4. Region Västra Götaland, Department of Neonatology, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden. 5. Department of Medical Radiation Sciences, Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 6. Department of Radiology, Clinical Sciences, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden. 7. Department of Biology and Environmental Sciences, The Faculty of Science, University of Gothenburg, Gothenburg, Sweden. 8. Section for Ophthalmology, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 9. Emma Children's Hospital, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands. 10. Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. m.benders@umcutrecht.nl. 11. University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands. m.benders@umcutrecht.nl.
Abstract
BACKGROUND: Docosahexaenoic acid (DHA) and arachidonic acid (AA) are important for fetal brain growth and development. Our aim was to evaluate the association between serum DHA and AA levels and brain volumes in extremely preterm infants. METHODS: Infants born at <28 weeks gestational age in 2013-2015, a cohort derived from a randomized controlled trial comparing two types of parenteral lipid emulsions, were included (n = 90). Serum DHA and AA levels were measured at postnatal days 1, 7, 14, and 28, and the area under the curve was calculated. Magnetic resonance (MR) imaging was performed at term-equivalent age (n = 66), and volumes of six brain regions were automatically generated. RESULTS: After MR image quality assessment and area under the curve calculation, 48 infants were included (gestational age mean [SD] 25.5 [1.4] weeks). DHA levels were positively associated with total brain (B = 7.966, p = 0.012), cortical gray matter (B = 3.653, p = 0.036), deep gray matter (B = 0.439, p = 0.014), cerebellar (B = 0.932, p = 0.003), and white matter volume (B = 3.373, p = 0.022). AA levels showed no association with brain volumes. CONCLUSIONS: Serum DHA levels during the first 28 postnatal days were positively associated with volumes of several brain structures in extremely preterm infants at term-equivalent age. IMPACT: Higher serum levels of DHA in the first 28 postnatal days are positively associated with brain volumes at term-equivalent age in extremely preterm born infants. Especially the most immature infants suffer from low DHA levels in the first 28 postnatal days, with little increase over time. Future research is needed to explore whether postnatal fatty acid supplementation can improve brain development and may serve as a nutritional preventive and therapeutic treatment option in extremely preterm infants.
BACKGROUND: Docosahexaenoic acid (DHA) and arachidonic acid (AA) are important for fetal brain growth and development. Our aim was to evaluate the association between serum DHA and AA levels and brain volumes in extremely preterm infants. METHODS: Infants born at <28 weeks gestational age in 2013-2015, a cohort derived from a randomized controlled trial comparing two types of parenteral lipid emulsions, were included (n = 90). Serum DHA and AA levels were measured at postnatal days 1, 7, 14, and 28, and the area under the curve was calculated. Magnetic resonance (MR) imaging was performed at term-equivalent age (n = 66), and volumes of six brain regions were automatically generated. RESULTS: After MR image quality assessment and area under the curve calculation, 48 infants were included (gestational age mean [SD] 25.5 [1.4] weeks). DHA levels were positively associated with total brain (B = 7.966, p = 0.012), cortical gray matter (B = 3.653, p = 0.036), deep gray matter (B = 0.439, p = 0.014), cerebellar (B = 0.932, p = 0.003), and white matter volume (B = 3.373, p = 0.022). AA levels showed no association with brain volumes. CONCLUSIONS: Serum DHA levels during the first 28 postnatal days were positively associated with volumes of several brain structures in extremely preterm infants at term-equivalent age. IMPACT: Higher serum levels of DHA in the first 28 postnatal days are positively associated with brain volumes at term-equivalent age in extremely preterm born infants. Especially the most immature infants suffer from low DHA levels in the first 28 postnatal days, with little increase over time. Future research is needed to explore whether postnatal fatty acid supplementation can improve brain development and may serve as a nutritional preventive and therapeutic treatment option in extremely preterm infants.
Authors: Berthold Koletzko; Karin Bergmann; J Thomas Brenna; Philip C Calder; Cristina Campoy; M Tom Clandinin; John Colombo; Mandy Daly; Tamás Decsi; Hans Demmelmair; Magnus Domellöf; Nataša FidlerMis; Ines Gonzalez-Casanova; Johannes B van Goudoever; Adamos Hadjipanayis; Olle Hernell; Alexandre Lapillonne; Silke Mader; Camilia R Martin; Valerie Matthäus; Usha Ramakrishan; Cornelius M Smuts; Sean J J Strain; Conny Tanjung; Patrick Tounian; Susan E Carlson Journal: Am J Clin Nutr Date: 2020-01-01 Impact factor: 7.045
Authors: Patricia Álvarez; David Ramiro-Cortijo; María Teresa Montes; Bárbara Moreno; María V Calvo; Ge Liu; Ana Esteban Romero; Marta Ybarra; Malaika Cordeiro; Marina Clambor Murube; Eva Valverde; Aurora Sánchez-Pacheco; Javier Fontecha; Robert Gibson; Miguel Saenz de Pipaon Journal: Front Pediatr Date: 2022-08-25 Impact factor: 3.569