Buy Article Permissions and Reprints 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 Authors' Contributions

All authors contributed to the study conception and design. All authors read and approved the final manuscript.

*These authors contributed equally to this work and act as first author.

Publication History

Received: 27 December 2022

Accepted: 14 April 2023

Accepted Manuscript online:
19 April 2023

Article published online:
19 May 2023

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