Effects of a Multicomponent Lipid Emulsion on Brain Volumes in Extremely Low Birth Weight Infants

Simonetta Costa; Carmen Cocca; Gabriella D'Apolito; Antonietta De Gisi; Simona Fattore; Maria L. Tataranno; Manon Benders; Roberta Pastorino; Cesare Colosimo; Giovanni Vento

doi:10.1055/a-2077-2551

American Journal of Perinatology, Table of Contents

Am J Perinatol 2024; 41(S 01): e1813-e1819
DOI: 10.1055/a-2077-2551

Original Article

Effects of a Multicomponent Lipid Emulsion on Brain Volumes in Extremely Low Birth Weight Infants

Authors

Simonetta Costa^*

¹Unit of Neonatology, Department of Woman and Child Health and Public Health, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
Carmen Cocca ^*

¹Unit of Neonatology, Department of Woman and Child Health and Public Health, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
Gabriella D'Apolito

²Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, Diagnostic Imaging Area, Rome, Italy
Antonietta De Gisi

¹Unit of Neonatology, Department of Woman and Child Health and Public Health, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
Simona Fattore

¹Unit of Neonatology, Department of Woman and Child Health and Public Health, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
Maria L. Tataranno

⁴Unit of Neonatology, Wilhemina Children's Hospital University Medical Center, Utrecht, The Netherlands
Manon Benders

⁴Unit of Neonatology, Wilhemina Children's Hospital University Medical Center, Utrecht, The Netherlands
Roberta Pastorino

⁵Department of Woman and Child Health and Public Health, Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

⁶Section of Hygiene, University Department of Life Sciences and Public Health, Catholic University of Sacred Heart, Rome, Italy
Cesare Colosimo

²Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, Diagnostic Imaging Area, Rome, Italy

³Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
Giovanni Vento

¹Unit of Neonatology, Department of Woman and Child Health and Public Health, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

Abstract

Objective During the early weeks of life optimization of nutrition in extremely preterm infants presents a critical opportunity to attenuate the adverse neurological consequences of prematurity and potentially improve neurodevelopmental outcome. We hypothesized that the use of multicomponent lipid emulsion (MLE) in parenteral nutrition (PN) would be related to larger volume of the cerebellum on brain magnetic resonance at term of equivalent age (TEA) in extremely low birth weight (ELBW) infants.

Study Design We analyzed the brain magnetic resonance imaging (MRI) at TEA of a cohort of preterm infants with gestational age ≤28 weeks and/or birth weight <1,000 g randomly assigned in our previous trial to receive an MLE or soybean-based lipid emulsion (SLE). The primary outcome of the study was the cerebellar volume (CeV), valued on MRI acquired at TEA. Secondary outcomes included total brain volume (TBV), supratentorial volume, brainstem volume, and CeV corrected for TBV evaluated on MRI acquired at TEA.

Results MRIs at TEA of 34 infants were then analyzed: 17 in the MLE group and 17 in the SLE group. The postmenstrual age (PMA) at which MRIs were performed were comparable between the two study groups. The CeV as well as the PMA-corrected CeV were significantly higher in the MLE group than in the SLE group. No difference was found among the other brain volumes considered.

Conclusion Our results suggest that the use of MLE in PN could promote CeV growth in ELBW infants, valued with MRI at TEA.

Key Points

Optimization of nutrition in extremely low birthweight infants.
Use of multicomponent lipid emulsions in parenteral nutrition.
Larger cerebellar volume with use of multicomponent lipid emulsion.

Keywords

brain volume - multicomponent lipid emulsion - magnetic resonance imaging - preterm infants

Full Text

References

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