Improved Cognitive Development Among Preterm Infants Attributable to Early Supplementation of Human Milk With Docosahexaenoic Acid and Arachidonic Acid

Henriksen, Christine; Haugholt, Kristin; Lindgren, Magnus; Aurvåg, Anne Karin; Rønnestad, Arild; Grønn, Morten; Solberg, Rønnaug; Møen, Atle; Nakstad, Britt; Berge, Rolf K.; Smith, Lars; Iversen, Per Ole; Drevon, Christian A.

doi:10.1542/peds.2007-1511

Cited by 218 publications

(184 citation statements)

References 27 publications

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“…Eighteen of these studies were RCTs. [11][12][13][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] Among nonrandomized studies, 4 were interventional studies with a control group [30][31][32][33] and the remaining 2 studies 8,34 did not test an intervention because they examined the association of BPD with LCPUFA concentrations in blood or in tracheal aspirates. Fifteen RCTs presented dichotomous outcomes.…”

Section: Overview Of Included Studiesmentioning

confidence: 99%

“…Several studies examined .1 neonatal outcome at a time (Table 1). Only a few studies reported other relevant neonatal outcomes, such as number of days of ventilation, or the use or duration of supplementation oxygen, 13,20,22,27,28 patent ductus arteriosus, 12,20,23,[30][31][32] cholestasis, 31,32 or number of days of hospital admission. 8,11,13,18,31,32 Effect Estimates for Dichotomous Neonatal Outcomes…”

Section: Characteristics Of Exposure and Outcomesmentioning

confidence: 99%

“…Recent studies have investigated associations between reduced nutritional omega-3 during the perinatal or neonatal period and adverse neonatal outcomes, with the hope that supplementation may improve those outcomes. [11][12][13] However, whether supplementing in omega-3 improves neonatal health in extremely preterm infants is unknown.…”

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confidence: 99%

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Omega-3 Long-Chain Polyunsaturated Fatty Acids for Extremely Preterm Infants: A Systematic Review

et al. 2014

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BACKGROUND AND OBJECTIVE: Omega-3 long chain polyunsaturated fatty acid (LCPUFA) exposure can be associated with reduced neonatal morbidities. We systematically review the evidence for the benefits of omega-3 LCPUFAs for reducing neonatal morbidities in extremely preterm infants.METHODS: Data sources were PubMed, Embase, Center for Reviews and Dissemination, and the Cochrane Register of Controlled Trials. Original studies were selected that included infants born at ,29 weeks' gestation, those published until May 2013, and those that evaluated the relationship between omega-3 LCPUFA supplementation and major adverse neonatal outcomes. Data were extracted on study design and outcome. Effect estimates were pooled. RESULTS:Of the 1876 studies identified, 18 randomized controlled trials (RCTs) and 6 observational studies met the defined criteria. No RCT specifically targeted a population of extremely preterm infants. Based on RCTs, omega-3 LCPUFA was not associated with a decreased risk of bronchopulmonary dysplasia in infants overall (pooled risk ratio [RR] 0.97, 95% confidence interval [CI] 0.82-1.13], 12 studies, n = 2809 infants); however, when considering RCTs that include only infants born at #32 weeks' gestation, a trend toward a reduction in the risk of bronchopulmonary dysplasia (pooled RR 0.88, 95% CI 0.74-1.05, 7 studies, n = 1156 infants) and a reduction in the risk of necrotizing enterocolitis (pooled RR 0.50, 95% CI 0.23-1.10, 5 studies, n = 900 infants) was observed with LCPUFA.CONCLUSIONS: Large-scale interventional studies are required to determine the clinical benefits of omega-3 LCPUFA, specifically in extremely preterm infants, during the neonatal period. Dr Marc conceptualized and designed the protocol, screened the titles and abstracts, and retrieved articles for inclusion and quality, performed the analyses, drafted the initial manuscript, and approved the final manuscript as submitted; Ms Zhang critically reviewed the protocol, screened the titles and abstracts and retrieved articles for inclusion and quality, drafted the tables and figures, and reviewed the final manuscript as submitted; Dr Lavoie screened the articles for quality, revised the manuscript, participated in the redaction of the final manuscript, and reviewed the final manuscript as submitted; Dr Rhainds designed and conducted the systematic database search, reviewed the manuscript, and approved the final manuscript as submitted; and Dr Lacaze-Masmonteil reviewed the manuscript and approved the final manuscript as submitted.www.pediatrics.org/cgi

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Section: Overview Of Included Studiesmentioning

confidence: 99%

Section: Characteristics Of Exposure and Outcomesmentioning

confidence: 99%

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Omega-3 Long-Chain Polyunsaturated Fatty Acids for Extremely Preterm Infants: A Systematic Review

et al. 2014

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“…Supplementation of DHA/AA to premature infants has been associated with positive effects on cognition in several studies. 20,[27][28][29][30][31] Conversely, 2 systematic reviews of supplementation with low-dose long chain polyunsaturated fatty acids (LCPUFAs) revealed no significant effects on cognition. 32,33 Recent systematic reviews request further randomized controlled trials (RCTs) with LCPUFAs and cognitive development in premature infants.…”

Section: What This Study Addsmentioning

confidence: 99%

Long-Chain Polyunsaturated Fatty Acids and Cognition in VLBW Infants at 8 years: an RCT

et al. 2015

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OBJECTIVE: To test the hypothesis that supplementation with the long chain polyunsaturated fatty acids docosahexaenoic acid (DHA) and arachidonic acid (AA) to very low birth weight (VLBW) infants would improve long-term cognitive functions and influence neuroanatomical volumes and cerebral cortex measured by MRI. METHODS:The current study is a follow-up of a randomized, double-blinded, placebo-controlled study of supplementation with high-dose DHA (0.86%) and AA (0.91%) to 129 VLBW infants fed human milk. Ninety-eight children participated at 8 years follow-up and completed a broad battery of cognitive tests. Eighty-one children had cerebral MRI scans of acceptable quality.RESULTS: There were no significant differences between the intervention group and the control group on any of the cognitive measures. Equally, MRI data on segmental brain volumes and cerebral cortex volume, area, and thickness suggested no overall group effect.CONCLUSIONS: This study is the first long-term follow-up of a randomized controlled trial with supplementation of DHA and AA to human milk fed VLBW infants investigating both cognitive functions and brain macrostructure measured by MRI. No cognitive or neuroanatomical effects of the supplementation were detected at 8 years of age.

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“…Анализ результатов этих работ демонстрирует противоречивые результаты. В ряде работ ставится под сомнение необходимость обогащения ДЦПНЖК специализированных смесей для недоношен-ных детей [58,59]. Подчеркивается, что дизайн данных исследований был разноплановым, при этом выборка детей была недостаточна для получения достоверных данных, а состав и дозы добавляемых жирных кислот значительно отличались.…”

Section: обзор литературыunclassified

Long-Chain Polyunsaturated Fatty Acids and Their Role in Children Nourishment

Боровик¹,

Грибакин²,

Скворцова³

et al. 2012

Vopr. sovr. pediatr.

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Несомненным достижением нутрициологии в пос-ледней четверти ХХ в. являются результаты детального изучения роли длинноцепочечных полиненасыщенных жирных кислот (ДЦПНЖК) в питании человека и в осо-бенности их значение в метаболизме и развитии мозга у детей первого года жизни [1,2]. Отправной точкой при проведении исследований в этом направлении послужили данные об их содержании в грудном молоке [3][4][5]. Было установлено, что грудное молоко содержит относительно низкие концентрации короткоцепочечных жирных кислот и в то же время -значительные количе-ства ДЦПНЖК, в частности арахидоновой (АК) и докоза-гексаеновой (ДГК) [6,7].Показано, что содержание АК в грудном молоке составляет 0,3-0,6%, и ее концентрация относительно стабильна в различных регионах мира, причем не имеет тесной связи с питанием матери. Напротив, содержа-ние ДГК варьирует в достаточно широком диапазоне (от 0,1 до 1,0%) и хорошо коррелирует с содержанием этой кислоты в рационе кормящей женщины [8,9].Важно отметить, что содержание ДЦПНЖК в грудном молоке матерей, родивших недоношенных детей, выше, чем в таковом у женщин после срочных родов [10]. Установлено положительное влияние дополнительного введения АК и ДГК в состав детских молочных смесей на когнитивное развитие и остроту зрения у недоношен-ных детей, а также, хотя и в меньшей степени, у детей, родившихся в срок [11].Известно, что для детей первого года жизни харак-терны быстрый рост и развитие. Поэтому их рацион дол-жен включать в оптимальных количествах и сбаланси-рованных соотношениях основные пищевые вещества,

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Improved Cognitive Development Among Preterm Infants Attributable to Early Supplementation of Human Milk With Docosahexaenoic Acid and Arachidonic Acid

Abstract: Supplementation with docosahexaenoic acid and arachidonic acid for very preterm infants fed human milk in the early neonatal period was associated with better recognition memory and higher problem-solving scores at 6 months.

Cited by 218 publications

References 27 publications

Omega-3 Long-Chain Polyunsaturated Fatty Acids for Extremely Preterm Infants: A Systematic Review

Omega-3 Long-Chain Polyunsaturated Fatty Acids for Extremely Preterm Infants: A Systematic Review

Long-Chain Polyunsaturated Fatty Acids and Cognition in VLBW Infants at 8 years: an RCT

Long-Chain Polyunsaturated Fatty Acids and Their Role in Children Nourishment

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