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Arachidonic and docosahexaenoic acid supplementation and brain maturation in preterm infants : a double blind RCT

Moltu, Sissel J. (författare)
Department of Neonatal Intensive Care, Oslo University Hospital, Oslo, Norway
Nordvik, Tone (författare)
Department of Neonatal Intensive Care, Oslo University Hospital, Oslo, Norway
Rossholt, Madelaine E. (författare)
Department of Pediatrics and Adolescence Medicine, Oslo University Hospital, Oslo, Norway
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Wendel, Kristina (författare)
Department of Neonatal Intensive Care, Oslo University Hospital, Oslo, Norway
Chawla, Maninder (författare)
Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
Server, Andres (författare)
Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
Gunnarsdottir, Gunnthorunn (författare)
Department of Pediatric Neurology, Oslo University Hospital, Oslo, Norway
Pripp, Are Hugo (författare)
Oslo Centre of Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
Domellöf, Magnus, 1963- (författare)
Umeå universitet,Pediatrik
Bratlie, Marianne (författare)
Department of Pediatrics and Adolescence Medicine, Oslo University Hospital, Oslo, Norway
Aas, Marlen (författare)
Department of Neonatal Intensive Care, Oslo University Hospital, Oslo, Norway
Hüppi, Petra S. (författare)
Department of Woman, Child and Adolescent Medicine, University of Geneva, Geneva, Switzerland
Lapillonne, Alexandre (författare)
Department of Neonatal Intensive Care, APHP Necker-Enfants Malades Hospital, Paris University, Paris, France
Beyer, Mona K. (författare)
Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
Stiris, Tom (författare)
Department of Neonatal Intensive Care, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
Maximov, Ivan I. (författare)
Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
Geier, Oliver (författare)
Department of Physics and Computational Radiology, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
Pfeiffer, Helle (författare)
Department of Neonatal Intensive Care, Oslo University Hospital, Oslo, Norway; Department of Pediatric Neurology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
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 (creator_code:org_t)
Elsevier, 2024
2024
Engelska.
Ingår i: Clinical Nutrition. - : Elsevier. - 0261-5614 .- 1532-1983. ; 43:1, s. 176-186
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • Background: Arachidonic acid (ARA) and docosahexaenoic acid (DHA) are important structural components of neural cellular membranes and possess anti-inflammatory properties. Very preterm infants are deprived of the enhanced placental supply of these fatty acids, but the benefit of postnatal supplementation on brain development is uncertain. The aim of this study was to test the hypothesis that early enteral supplementation with ARA and DHA in preterm infants improves white matter (WM) microstructure assessed by diffusion-weighted MRI at term equivalent age.Methods: In this double-blind, randomized controlled trial, infants born before 29 weeks gestational age were allocated to either 100 mg/kg ARA and 50 mg/kg DHA (ARA:DHA group) or medium chain triglycerides (control). Supplements were started on the second day of life and provided until 36 weeks postmenstrual age. The primary outcome was brain maturation assessed by diffusion tensor imaging (DTI) using Tract-Based Spatial Statistics (TBSS) analysis.Results: We included 120 infants (60 per group) in the trial; mean (range) gestational age was 26+3 (22+6 - 28+6) weeks and postmenstrual age at scan was 41+3 (39+1 - 47+0) weeks. Ninety-two infants underwent MRI imaging, and of these, 90 had successful T1/T2 weighted MR images and 74 had DTI data of acceptable quality. TBSS did not show significant differences in mean or axial diffusivity between the groups, but demonstrated significantly higher fractional anisotropy in several large WM tracts in the ARA:DHA group, including corpus callosum, the anterior and posterior limb of the internal capsula, inferior occipitofrontal fasciculus, uncinate fasciculus, and the inferior longitudinal fasciculus. Radial diffusivity was also significantly lower in several of the same WM tracts in the ARA:DHA group.Conclusion: This study suggests that supplementation with ARA and DHA at doses matching estimated fetal accretion rates improves WM maturation compared to control treatment, but further studies are needed to ascertain any functional benefit.Clinical trial registration: www.clinicaltrials.gov; ID:NCT03555019.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Pediatrik (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Pediatrics (hsv//eng)

Nyckelord

Arachidonic acid
Brain
Docosahexaenoic acid
Fatty acid supplementation
Neurodevelopment
Preterm

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