Serum docosahexaenoic acid levels are associated with brain volumes in extremely preterm born infants,Pediatric Research

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Serum docosahexaenoic acid levels are associated with brain volumes in extremely preterm born infants
Pediatric Research ( IF 3.1 ) Pub Date : 2021-08-14 , DOI: 10.1038/s41390-021-01645-w
Lisa M Hortensius _{1,

2} , William Hellström ₃ , Karin Sävman _{3,

4} , Rolf A Heckemann ₅ , Isabella M Björkman-Burtscher ₆ , Floris Groenendaal _{1,

2} , Mats X Andersson ₇ , Anders K Nilsson ₈ , Maria Luisa Tataranno _{1,

2} , Ruurd M van Elburg _{1,

9} , Ann Hellström ₈ , Manon J N L Benders _{1,

2}

Affiliation

Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands.
Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Region Västra Götaland, Department of Neonatology, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
Department of Medical Radiation Sciences, Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Radiology, Clinical Sciences, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden.
Department of Biology and Environmental Sciences, The Faculty of Science, University of Gothenburg, Gothenburg, Sweden.
Section for Ophthalmology, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Emma Children's Hospital, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

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.

中文翻译：

血清二十二碳六烯酸水平与极早产儿的脑容量相关

背景

二十二碳六烯酸 (DHA) 和花生四烯酸 (AA) 对胎儿大脑的生长和发育很重要。我们的目的是评估极早产儿血清 DHA 和 AA 水平与脑容量之间的关联。

方法

纳入了 2013-2015 年胎龄 <28 周出生的婴儿，该队列来自一项比较两种肠外脂肪乳剂的随机对照试验（n = 90）。在出生后第 1、7、14 和 28 天测量血清 DHA 和 AA 水平，并计算曲线下面积。磁共振 (MR) 成像在足月等效年龄 ( n = 66) 进行，并自动生成六个大脑区域的体积。

结果

MR 图像质量评估和曲线下面积计算后，纳入 48 名婴儿（胎龄平均 [SD] 25.5 [1.4] 周）。DHA 水平与全脑 ( B = 7.966, p = 0.012)、皮质灰质 ( B = 3.653, p = 0.036)、深部灰质 ( B = 0.439, p = 0.014)、小脑 ( B = 0.932, p = 0.003）和白质体积（B = 3.373，p = 0.022）。AA 水平与脑容量无关。