ARA and DHA may improve brain maturation in immature infants, Finds study

The study is published in the BMC Pediatrics.

Improvements in neonatal care have led to rising survival rates of extremely premature born infants. However, the rate of severe medical disabilities increases significantly with decreasing GA and preventive measures to reduce neurodevelopmental sequelae, postnatal growth failure and inflammatory mediated diseases are most wanted. ARA and DHA are considered essential during early development and studies suggest that supplementation with ARA and DHA has structural effects on brain growth and maturation and reduce severity of BPD, ROP, NEC and WMI by affecting the immune response.

Current nutritional management of infants born very preterm results in significant deficiency of the essential fatty acids (FAs) arachidonic acid (ARA) and docosahexaenoic acid (DHA). The impact of this deficit on brain maturation and inflammation mediated neonatal morbidities are unknown.

Therefore, Kristina Wendel and associates from the Department of Neonatal Intensive Care, Oslo University Hospital, Oslo, Norway conducted the study with the to determine whether early supply of ARA and DHA improves brain maturation and neonatal outcomes in infants born before 29 weeks of gestation.

A total of 12o infants born at Oslo University Hospital were eligible to participate in this double-blind randomized controlled trial. Study participants are randomized to receive an enteral FA supplement of either 0.4 ml/kg MCT-oil™ (medium chain triglycerides) or 0.4 ml/kg Formulaid™ (100 mg/kg of ARA and 50 mg/kg of DHA). The FA supplement was given from the second day of life to 36 weeks' postmenstrual age (PMA).

The primary outcome was brain maturation assessed by Magnetic Resonance Imaging (MRI) at term equivalent age. Secondary outcomes included quality of growth, incidence of neonatal morbidities, cardiovascular health and neuro-development.

The results showed that the supplementation of ARA and DHA has the potential to improve brain maturation and reduce inflammation related diseases. However, the authors further added that this study is expected to provide valuable information for future nutritional guidelines for preterm infants.