van Wezel-Meijler G, van der Knaap M S, Huisman J, Jonkman E J, Valk J, Lafeber H N
Department of Paediatrics, Free University Medical Centre, Amsterdam, The Netherlands.
Acta Paediatr. 2002;91(9):942-50. doi: 10.1080/080352502760272632.
To study the influence of dietary-supplied long-chain polyunsaturated fatty acids on structural brain maturation in preterm infants and to investigate parameters of functional brain development, relating them to structural maturation. Other studies have suggested that dietary supplementation of long-chain polyunsaturated fatty acids in preterm infants may enhance their visual development. The influence on structural brain development has never been evaluated.
In a prospective, double-blind study, 42 formula-fed premature infants were randomized to be fed either a standard preterm formula without long-chain polyunsaturated fatty acids or an identical formula supplemented with docosahexaenoic acid (0.015 g/100 ml) and arachidonic acid (0.031 g/100 ml). Infants with significant cerebral damage, retinopathy, chronic disease or feeding problems were excluded. Follow-up was focused on assessment of cerebral myelination by MRI. Psychomotor, mental and visual development was analysed and flash-visual evoked potentials were recorded.
It was found that progress of myelination, mental and motor development and latencies of visual evoked potentials were not positively influenced by supplementation of long-chain polyunsaturated fatty acids. At each test age, visual acuity was slightly better in the supplemented infants than in the non-supplemented infants, but the difference never reached significance level
Supplementation of long-chain polyunsaturated fatty acids did not have a demonstrable positive influence on structural brain maturation. Related to this finding, in this small cohort of preterm infants without significant neurological damage, sample size being restricted by strict inclusion criteria and MRI procedures, no significant positive effects were found on psychomotor, mental and visual development.
研究膳食中提供的长链多不饱和脂肪酸对早产儿脑结构成熟的影响,并调查脑功能发育参数,将其与结构成熟相关联。其他研究表明,对早产儿进行长链多不饱和脂肪酸的膳食补充可能会促进其视觉发育。但对脑结构发育的影响从未得到评估。
在一项前瞻性双盲研究中,42名配方奶喂养的早产儿被随机分为两组,一组喂食不含长链多不饱和脂肪酸的标准早产儿配方奶,另一组喂食添加了二十二碳六烯酸(0.015 g/100 ml)和花生四烯酸(0.031 g/100 ml)的相同配方奶。患有严重脑损伤、视网膜病变、慢性病或喂养问题的婴儿被排除在外。随访重点是通过MRI评估脑髓鞘形成。分析了精神运动、智力和视觉发育情况,并记录了闪光视觉诱发电位。
发现补充长链多不饱和脂肪酸对髓鞘形成进程、智力和运动发育以及视觉诱发电位的潜伏期没有积极影响。在每个测试年龄,补充组婴儿的视力略优于未补充组婴儿,但差异从未达到显著水平。
补充长链多不饱和脂肪酸对脑结构成熟没有明显的积极影响。基于这一发现,在这个没有严重神经损伤的小队列早产儿中,由于严格的纳入标准和MRI程序限制了样本量,在精神运动、智力和视觉发育方面未发现显著的积极影响。