Fish oil-containing multicomponent lipid emulsion vs soy-based lipid emulsion and neurodevelopmental outcomes of children born < 29 weeks’ gestation

• Published in: Journal of perinatology Vol. 40; no. 11; pp. 1712 - 1718
• Main Authors: Torgalkar, Ranjit, Shah, Jyotsna, Dave, Shruti, Yang, Junmin, Ostad, Nastaran, Kotsopoulos, Kirsten, Unger, Sharon, Kelly, Edmond, Shah, Prakesh S.
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01-11-2020; Nature Publishing Group
• Subjects: 692/308/409; 692/499; 692/700/1720; 692/700/459; Children; Comparative analysis; Fish oils; Gestation; Lipids; Medicine; Medicine & Public Health; Mortality; Neurodevelopmental disorders; Olive oil; Pediatric Surgery; Pediatrics; Pregnancy; Premature birth; Steroid hormones; Steroids; Triglycerides
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/s41372-020-0710-5

Objective
To compare neurodevelopmental outcomes of extremely preterm children who received soy-medium chain triglycerides-olive-fish oil-containing lipid emulsion (SMOF-LE) vs soy-based LE.
Study design
We conducted a pre-post comparative cohort study of children born < 29 weeks’ gestation who received 
>
 7 days of LE. Outcomes were mortality/significant neurodevelopmental impairment (NDI), mortality/any NDI, significant NDI, any NDI, and individual components of NDI.
Results
Among children with follow-up data (Intralipid:
n
 = 340/442, 77%; SMOF-LE:
n
 = 214/286, 75%), baseline characteristics were comparable except for postnatal steroids. There was no significant difference in death/significant NDI between groups. Adjusted odds of death/any NDI [0.68 (95% CI 0.48, 0.97)], any NDI [0.64 (95% CI 0.44, 0.93)] and Bayley-III language score < 85 and <70 were significantly lower in the SMOF-LE group.
Conclusions
In extremely preterm children, a change from soy-based LE to SMOF-LE was not associated with deleterious effect on neurodevelopmental outcomes and may have been associated with some improvement.