Early parenteral lipid intake supports cerebellar neurometabolism at term-age in preterm infants.

OBJECTIVES

The impact of crucial early parenteral nutrition on neurometabolism of the preterm brain remains unclear. This study characterizes the relationship of parenteral lipid and caloric intake with cerebellar neurometabolites.

METHODS

Very premature infants [born ≤32-week gestational age (GA)] in a prospective observational cohort study underwent a proton magnetic resonance spectroscopy (1H-MRS) acquisition from a cerebellar voxel at term-age. Parenteral lipid and caloric intake (g/kg/d or kcal/kg/d) in the first 4 weeks of life were calculated by chart review.

RESULTS

48 preterm infants born at 28.3 ± 2.4 weeks GA underwent 1H-MRS at 38.9 ± 1.9 weeks postmenstrual age. Cerebellar N-acetylaspartate [NAA] positively correlated with 4-week parenteral lipid (Rho = 0.4, p = 0.005) and caloric (Rho = 0.3, p = 0.047) intake. Glutamate [Glx] demonstrated a positive trend. Adjusted for covariates, 4-week parenteral lipid intake was associated with higher NAA (B coefficient = 0.89, p = 0.003) and Glx (B = 1.72, p = 0.045).

CONCLUSIONS

Parenteral lipid intake is associated with higher cerebellar NAA and Glx concentrations, supporting brain development in preterm infants.