Cimatti Anna Giulia, Martini Silvia, Munarini Alessandra, Zioutas Maximilano, Vitali Francesca, Aceti Arianna, Mantovani Vilma, Faldella Giacomo, Corvaglia Luigi
Neonatal Intensive Care Unit, S. Orsola-Malpighi University Hospital, Bologna, Italy.
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Front Pediatr. 2018 Dec 20;6:407. doi: 10.3389/fped.2018.00407. eCollection 2018.
Docosahexaenoic acid (DHA) is a major constituent of neuronal and retinal membranes and plays a crucial role in brain and visual development within the first months of life. Dietary intakes are fundamental to provide neonates with adequate DHA supply; hence, maternal supplementation might represent a useful strategy to implement DHA contents in breast milk (BM), with possible benefits on neonatal neurodevelopment. is a small crustacean rich in highly available phospholipid-bound DHA. This pilot study aimed to evaluate whether maternal supplementation with krill oil during breastfeeding increases long-chain polyunsaturated fatty acids (LCPUFAs) BM contents. Mothers of infants admitted to the Neonatal Intensive Care Unit were enrolled in this open, randomized-controlled study between 4 and 6 weeks after delivery and randomly allocated in 2 groups. Group 1 received an oral krill oil-based supplement providing 250 mg/day of DHA and 70 mg/day of eicosapentaenoic acid (EPA) for 30 days; group 2 served as control. BM samples from both groups were collected at baseline (T0) and day 30 (T1) and underwent a qualitative analysis of LCPUFAs composition by gas chromatography/mass spectrometry. Sixteen breastfeeding women were included. Of these, 8 received krill-oil supplementation and 8 were randomized to the control group. Baseline percentage values of DHA (%DHA), arachidonic acid (%AA), and EPA (%EPA) did not differ between groups. A significant increase in %DHA (T0: median 0.23% [IQR 0.19;0.38], T1:0.42% [0.32;0.49], 0.012) and %EPA (T0: median 0.10% [IQR 0.04;0.11], T1:0.11% [0.04;0.15], 0.036) and a significant reduction in %AA (T0: median 0.48% [IQR 0.42;0.75], T1:0.43% [0.38;0.61], 0.017) between T0 and T1 occurred in Group 1, whereas no difference was seen in Group 2. Consistently, a significant between-group difference was observed in percentage changes from baseline of DHA (Δ%DHA, group 1: median 64.2% [IQR 27.5;134.6], group 2: -7.8% [-12.1;-3.13], 0.025) and EPA (Δ%EPA, group 1: median 39% [IQR 15.7;73.4]; group 2: -25.62% [-32.7;-3.4], 0.035). Oral krill oil supplementation effectively increases DHA and EPA contents in BM. Potential benefits of this strategy on brain and visual development in breastfed preterm neonates deserve further evaluation in targeted studies. : www.ClinicalTrials.gov, identifier NCT03583502.
二十二碳六烯酸（DHA）是神经元和视网膜膜的主要成分，在生命的最初几个月对大脑和视觉发育起着至关重要的作用。饮食摄入对于为新生儿提供充足的DHA供应至关重要；因此，母体补充可能是一种增加母乳（BM）中DHA含量的有用策略，可能对新生儿神经发育有益。磷虾是一种富含高可用性磷脂结合DHA的小型甲壳类动物。这项初步研究旨在评估母乳喂养期间母体补充磷虾油是否会增加长链多不饱和脂肪酸（LCPUFAs）的母乳含量。入住新生儿重症监护病房的婴儿的母亲在分娩后4至6周被纳入这项开放、随机对照研究，并随机分为两组。第1组接受基于磷虾油的口服补充剂，每天提供250毫克DHA和70毫克二十碳五烯酸（EPA），持续30天；第2组作为对照组。两组的母乳样本在基线（T0）和第30天（T1）采集，并通过气相色谱/质谱法对LCPUFAs组成进行定性分析。纳入了16名母乳喂养的女性。其中，8名接受磷虾油补充，8名随机分配到对照组。两组之间DHA（%DHA）、花生四烯酸（%AA）和EPA（%EPA）的基线百分比值没有差异。第1组在T0和T1之间%DHA（T0：中位数0.23%[四分位间距0.19；0.38]，T1：0.42%[0.32；0.49]，P = 0.012）和%EPA（T0：中位数0.10%[四分位间距0.04；0.11]，T1：0.11%[0.04；0.15]，P = 0.036）显著增加，%AA显著降低（T0：中位数0.48%[四分位间距0.42；0.75]，T1：0.43%[0.38；0.61]，P = 0.017），而第2组未见差异。同样，在DHA（Δ%DHA，第1组：中位数64.2%[四分位间距27.5；134.6]，第2组：-7.8%[-12.1；-3.13]，P = 0.025）和EPA（Δ%EPA，第1组：中位数39%[四分位间距15.7；73.4]；第2组：-25.62%[-32.7；-3.4]，P = 0.035）的基线百分比变化方面观察到显著的组间差异。口服磷虾油补充剂可有效增加母乳中的DHA和EPA含量。这种策略对母乳喂养的早产新生儿大脑和视觉发育的潜在益处值得在针对性研究中进一步评估。试验注册：www.ClinicalTrials.gov，标识符NCT03583502。
