Growth of Head Circumference and Body Length in Preterm Infants Receiving a Multicomponent vs a Soybean‐Based Lipid Emulsion: A Randomized Controlled Trial. Issue 1 (10th August 2020)

• Record Type: Journal Article
• Authors: Costa, Simonetta; Cocca, Carmen; Barone, Giovanni; Catenazzi, Piero; Gallini, Francesca; Maggio, Luca; Fusco, Francesca Paola; Vento, Giovanni
• Is Part Of: JPEN, Journal of parenteral and enteral nutrition. Volume 45:Issue 1(2021)
• Page Start: 94
• Page End: 101
• Publication Date: 2020-08-10
• Subjects: improvement of head growth circumference -- multicomponent lipid emulsions -- parenteral nutrition–associated cholestasis -- very low‐birth‐weight infants; Parenteral feeding -- Periodicals; Enteral feeding -- Periodicals; 615.85484
• DOI: 10.1002/jpen.1968
• Languages: English
• ISSNs: 0148-6071

Abstract

Abstract: Background: The growth of very low‐birth‐weight (VLBW) infants relies, to a large extent, on parenteral nutrition (PN) during the early weeks of life. Despite the parenteral nutrients supply, extrauterine growth restriction remains the main concern for these infants. A parenteral multicomponent lipid emulsion (MLE) might improve growth and neurological outcomes, delivering fats for brain growth that the traditional soybean‐based lipid emulsion (SLE) fails to provide. We hypothesize that the use of an MLE in PN may reduce the loss of head circumference (HC) z ‐score from birth to 36 weeks' postmenstrual age (PMA) or at discharge compared with the use of an SLE in VLBW infants. Methods: Infants with BW ≤1250 g, without malformations or chromosomal abnormalities, were randomly assigned to receive an MLE or an SLE. The primary outcome was the change in HC z ‐score (HC Δ z ‐score) from birth to 36 weeks' PMA or at discharge. Secondary outcomes included the change in weight and length z ‐score (W Δ z ‐score and L Δ z ‐score) as well as incidence of late‐onset sepsis and PN‐associated cholestasis (PNAC). Results: Of the 128 infants randomized, 51 infants in the MLE group and 50 infants in the SLE group were analyzed. The MLE was significantly associated with a decreased loss in HC and length z ‐scores from birth to 36 weeks' PMA or at discharge. Conclusions: This is the first randomized controlled trial providing the evidence that an MLE is associated with improved HC growth in comparison with a pure SLE.