Long-Chain Polyunsaturated Fatty Acids in Breast-Milk and Erythrocytes and Neurodevelopmental Outcomes in Danish Late-Preterm Infants

Long-chain polyunsaturated fatty acids (LCPUFAs) play specific roles during the perinatal period and are very important nutrients to consider. The possible effects of LCPUFAs, particularly docosahexaenoic acid (DHA), on various clinical outcomes of preterm infants are discussed in this paper. Since DHA accumulates in the central nervous system during development, a lot of attention has focused on the effects of DHA on neurodevelopment. Experimental studies as well as recent clinical trials show that providing larger amounts of DHA than currently and routinely provided is associated with better neurological outcomes at 18 months to 2 years. This early advantage, however, does not seem to translate into detectable change in visual and neurodevelopmental outcomes or behavior when assessed in childhood. There is growing evidence that, in addition to effects on development, omega-3 LCPUFAs may reduce the incidence or severity of neonatal morbidities by affecting different steps of the immune and anti-inflammatory response. Studies in preterm infants suggest that the omega-3 LCPUFAs may play a significant role by reducing the risk of bronchopulmonary dysplasia, necrotizing enterocolitis and possibly retinopathy of prematurity and sepsis. Overall, evidence is increasing to support the benefits of high-dose DHA for various health outcomes of preterm infants. These findings are of major clinical relevance mainly because infants born preterm are at particularly high risk for a nutritional deficit in omega-3 fatty acids, predisposing to adverse neonatal outcomes. Further studies are warranted to address these issues as well as to more precisely determine the LCPUFA requirement in order to favor the best possible outcomes of preterm infants.

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Intestinal absorption of long-chain polyunsaturated fatty acids in preterm infants fed breast milk or formula

American Journal of Clinical Nutrition ◽

10.1093/ajcn/67.1.97 ◽

1998 ◽

Vol 67 (1) ◽

pp. 97-103 ◽

Cited By ~ 100

Author(s):

V P Carnielli ◽

G Verlato ◽

F Pederzini ◽

I Luijendijk ◽

A Boerlage ◽

...

Keyword(s):

Fatty Acids ◽

Breast Milk ◽

Polyunsaturated Fatty Acids ◽

Intestinal Absorption ◽

Preterm Infants ◽

Long Chain

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Neurodevelopmental Outcomes at 18 Months of Corrected Age for Late Preterm Infants Born at 34 and 35 Gestational Weeks

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18020640 ◽

2021 ◽

Vol 18 (2) ◽

pp. 640 ◽

Cited By ~ 1

Author(s):

Ruka Nakasone ◽

Kazumichi Fujioka ◽

Yuki Kyono ◽

Asumi Yoshida ◽

Takumi Kido ◽

...

Keyword(s):

Preterm Infants ◽

Late Preterm ◽

Psychomotor Development ◽

Youden Index ◽

Chromosomal Anomalies ◽

Clinical Factors ◽

Neurodevelopmental Outcomes ◽

Late Preterm Infants ◽

Significant Difference ◽

Severe Hyperbilirubinemia

To date, the difference in neurodevelopmental outcomes between late preterm infants (LPI) born at 34 and 35 gestational weeks (LPI-34 and LPI-35, respectively) has not been elucidated. This retrospective study aimed to evaluate neurodevelopmental outcomes at 18 months of corrected age for LPI-34 and LPI-35, and to elucidate factors predicting neurodevelopmental impairment (NDI). Records of all LPI-34 (n = 93) and LPI-35 (n = 121) admitted to our facility from 2013 to 2017 were reviewed. Patients with congenital or chromosomal anomalies, severe neonatal asphyxia, and without developmental quotient (DQ) data were excluded. Psychomotor development was assessed as a DQ using the Kyoto Scale of Psychological Development at 18 months of corrected age. NDI was defined as DQ < 80 or when severe neurodevelopmental problems made neurodevelopmental assessment impossible. We compared the clinical characteristics and DQ values between LPI-34 (n = 62) and LPI-35 (n = 73). To elucidate the factors predicting NDI at 18 months of corrected age, we compared clinical factors between the NDI (n = 17) and non-NDI (n = 118) groups. No significant difference was observed in DQ values at 18 months of corrected age between the groups in each area and overall. Among clinical factors, male sex, intraventricular hemorrhage (IVH), hyperbilirubinemia, and severe hyperbilirubinemia had a higher prevalence in the NDI group than in the non-NDI group, and IVH and/or severe hyperbilirubinemia showed the highest Youden Index values for predicting NDI. Based on the results of this study, we can conclude that no significant difference in neurodevelopmental outcomes at 18 months of corrected age was observed between LPI-34 and LPI-35. Patients with severe hyperbilirubinemia and/or IVH should be considered to be at high risk for developing NDI.

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Visfatin levels in healthy preterm infants are independently associated with high-density lipoprotein cholesterol levels and dietary long-chain polyunsaturated fatty acids

Clinical Biochemistry ◽

10.1016/j.clinbiochem.2011.03.086 ◽

2011 ◽

Vol 44 (7) ◽

pp. 536

Author(s):

A. Margeli ◽

H. Mandyla ◽

A. Kappis ◽

I. Papassotiriou ◽

T. Siahanidou

Keyword(s):

Fatty Acids ◽

Polyunsaturated Fatty Acids ◽

High Density Lipoprotein ◽

Preterm Infants ◽

High Density Lipoprotein Cholesterol ◽

Density Lipoprotein ◽

High Density ◽

Lipoprotein Cholesterol ◽

Cholesterol Levels ◽

Long Chain

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Intermittent Kangaroo Mother Care and the Practice of Breastfeeding Late Preterm Infants: Results from Four Hospitals in Different Provinces of China

10.21203/rs.2.18645/v2 ◽

2020 ◽

Author(s):

Bo Zhang ◽

Zhiying Duan ◽

Yingxi Zhao ◽

Sarah Williams ◽

Stephen Wall ◽

...

Keyword(s):

Breast Milk ◽

Preterm Infants ◽

Exclusive Breastfeeding ◽

Kangaroo Mother Care ◽

Late Preterm ◽

Feeding Practice ◽

Late Preterm Infants ◽

Breastfeeding Rate ◽

Milk Feeding

Abstract Background China has an extremely low exclusive breastfeeding rate. Kangaroo mother care (KMC) has been shown to increase the exclusive breastfeeding rate among infants born extremely or very preterm. However, there is limited evidence surrounding intermittent KMC and exclusive breastfeeding in late preterm infants. In our study we investigated the association between the provision of intermittent KMC and breastfeeding practice for late preterm infants in four hospitals in different provinces of China. Methods Intermittent KMC was recommended to the mothers of all preterm infants admitted to the postnatal wards of participating hospitals between March 2018 and March 2019. Those who agreed to practice KMC were enrolled in the “KMC group”, those who did not were enrolled in the “No KMC group”. Basic maternal socio-demographic information was collected, feeding practice; outcome and method, were recorded daily whilst in hospital. A follow-up survey of feeding practice was conducted 42 days after discharge. Calculations for feeding practice were performed separately for both groups. Logistics regression was used to analyze the association between KMC and feeding outcome and method, adjusting for socio-demographic covariates. Results Among the 844 mothers participating in the study, 627 (74.3%) chose to perform KMC. More of the mothers who provided KMC were exclusively breast milk feeding their infants in the 24 hours before hospital discharge (54.6%) and at follow-up (57.3%), compared to mothers who did not provide KMC (34.6% at discharge and 33.2% at follow-up,). Mothers in the KMC group were more likely to be breastfeeding (method) than mothers in the No KMC group (65.3% vs. 52.1% at discharge, and 83.1% vs. 67.3% at follow up). Logistic regression indicated that compared with the No KMC group, mothers who provided KMC were twice as likely to be exclusively breast milk feeding their infants at discharge (OR=2.15 (1.53-3.02)), use breastfeeding method at discharge as opposed to other means such as bottle or cup feeding (OR=1.61 (1.15-2.25)), be exclusive breast milk feeding at follow-up (OR=2.55 (1.81-3.61)), and use breastfeeding method at follow-up (OR=2.09 (1.44-3.02)). Conclusions Intermittent KMC was associated with a nearly doubled increase in exclusive breast milk feeding (outcome) and breastfeeding (method) at both discharge and 42 days after discharge for late preterm infants. This is especially important in China where exclusive breastfeeding rates are low, intermittent KMC provides a feasible means to increase the likelihood of these vulnerable infants receiving the benefits of exclusive breastmilk.

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