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Thanhaeuser M, Fuiko R, Oberleitner-Leeb C, Brandstaetter S, et al. A randomized trial of parenteral nutrition using a mixed lipid emulsion containing fish oil in infants of extremely low birth weight: Neurodevelopmental outcome at 12 and 24 months corrected age, a secondary outcome analysis. J Pediatr. 2020 Jun 23. pii: S0022-3476(20)30759.

Objective: To examine whether parenteral nutrition using a mixed lipid emulsion containing fish oil improves the neurodevelopmental outcomes of extremely low birth weight (ELBW) infants.

Study design: The study is a secondary outcome analysis of a double-blind randomized trial of 230 ELBW infants performed at a single level IV neonatal care unit (Medical University Vienna; 06/2012-06/2015). Participants received either a mixed lipid emulsion composed of soybean oil, medium chain triglycerides, olive oil, and fish oil, or a soybean oil-based lipid emulsion for parenteral nutrition. Neurodevelopment of study participants was assessed at 12 and 24 months corrected age (08/2013-10/2017) using the Bayley Scales of Infant-Toddler Development, Third edition.

Results: At discharge, 206/230 study participants were eligible. At 12 and 24 months corrected age, 174 out of 206 (85%) and 164 out of 206 (80%) infants were evaluated. At 12 months, there was no significant difference (median [interquartile range]) in cognitive (mixed lipid: 95 [85-101], soybean oil: 95 [85-100]; P=.71), language (mixed lipid: 86 [77-94], soybean oil: 89 [79-94]; P=.48) or motor scores (mixed lipid: 88 [76-94], soybean oil: 88 [79-94]; P=.69). At 24 months, there was again no significant difference in cognitive (mixed lipid: 95 [80-105], soybean oil: 95 [90-105]; P=.17), language (mixed lipid: 89 [75-97], soybean oil 89 [77-100]; P=.54) and motor scores (mixed lipid: 94 [82-103], soybean oil: 94 [85-103]; P=.53).

Conclusion: Parenteral nutrition using a mixed lipid emulsion containing fish oil did not improve neurodevelopment of ELBW infants at 12 and 24 months corrected age.

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