Fish-Oil Containing Lipid Emulsions Support Brain Growth in Very Preterm Infants

Intravenous lipid emulsions are a cornerstone of nutritional support for very preterm infants. While many neonatal intensive care units have transitioned from soybean oil-only emulsions to fish-oil containing multicomponent lipid emulsions, their effects on neurodevelopment have not been fully evaluated.

In a study of 92 human milk-fed preterm infants (≤32 weeks’ gestation), brain growth and neurobehavior at term-equivalent age were compared between infants receiving soybean oil-only (n=61) versus multicomponent lipid emulsions (n=31). Quantitative magnetic resonance imaging assessed volumetric growth and white matter development, and the Neonatal Intensive Care Unit Network Neurobehavioral Scale evaluated neurobehavioral regulation.

Infants receiving soybean oil-only showed smaller brainstem volumes, less mature white matter diffusivity and fractional anisotropy in the corpus callosum, posterior limbs of the internal capsule and brainstem, and lower quality of movement and increased state-related stress.

However, fish-oil-containing multicomponent lipid emulsions improved regional brain growth, enhanced white matter microstructural organization, and better neurobehavioral regulation, suggesting these emulsions may benefit preterm nutrition.

Reference:

Ottolini KM, Ngwa J, Basu SK, Kapse K, Liggett M, Murnick J, Limperopoulos C, Andescavage N. Brain development using a multicomponent intravenous lipid emulsion in preterm infants. BMC pediatrics. 2024 Dec 30;24(1):847.

https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-024-05330-9