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In The Journal of pediatrics ; h5-index 69.0

OBJECTIVE : To evaluate the impact of a parenteral lipid emulsion containing fish oil compared with a soybean-oil based lipid emulsion on the cognitive outcome and behavior of preschool children with extremely low birth weight (ELBW) .

STUDY DESIGN : This was a retrospective secondary outcome analysis of a randomized controlled trial performed between 06/2012 and 06/2015. Infants with ELBW received either a mixed (soybean oil, medium chain triglycerides, olive oil, fish oil) or a soybean oil-based lipid emulsion for parenteral nutrition. Data from the Kaufman Assessment Battery for Children II (KABC-II), the Child Behavior Checklist 1.5-5 (CBCL 1.5-5), and anthropometry were collected from medical charts at 5.6 years of age.

RESULTS : At discharge, 206 of the 230 study participants were eligible. At 5 years, 6 months of age, data of 153 of 206 (74%) infants was available for analysis. There were no significant differences in KABC-II scores for Sequential/Gsm, Simultaneous/Gv, Learning/Glr, and Mental Processing Index (mixed lipid: median 97.5 [IQR 23.5]; soybean oil: median 96 [IQR 19.5], p=.43) or CBCL 1.5-5 scores for internalizing problems, externalizing problems, or total problems (mixed lipid: median 37 [IQR 12.3]; soybean oil: median 37 [IQR 13.5], p=.54). A Random Forest machine learning regression analysis did not show an effect of type of lipid emulsion on cognitive and behavioral outcome.

DISCUSSION : Parenteral nutrition using a mixed lipid emulsion containing fish oil did not affect neurodevelopment and had no impact on child behavior of infants with extremely low birth weights at preschool age.

Thanhaeuser Margarita, Steyrl David, Fuiko Renate, Brandstaetter Sophia, Binder Christoph, Thajer Alexandra, Huber-Dangl Mercedes, Haiden Nadja, Berger Angelika, Repa Andreas


fish oil, neurodevelopmental outcome, parenteral nutrition, premature infant