Smoking and alcohol use during pregnancy affects preterm infants' docosahexaenoic acid (DHA) status

This study investigated the effect of alcohol consumption and smoking during pregnancy on the fatty acid composition of the infants. A total of 40 very-low-birth-weight (VLBW) infants, weighing between 750 and 1500g, were enrolled in the study after being hospitalized and ventilated for respiratory distress syndrome (RDS). Maternal and infant demographic information was recorded. Questions regarding maternal smoking (none, <10 and ≥10 cigarettes/d) and alcohol consumption (none, occasionally, moderate and severe) were recorded. Erythrocyte membrane (EMB; n = 40) total fatty acid analyses were performed at birth (baseline) and on days 14 and 28 postnatally. During pregnancy, 42% of mothers consumed alcohol and 50% smoked. At birth, infants of mothers who smoked and consumed alcohol during pregnancy, had significantly higher blood docosahexaenoic acid (DHA; p < 0.05) than infants of mothers who abstained from both alcohol and smoking. The consequences of this finding remain unknown.Articl

Plasma cholesterol and triglycéride profiles and prevalence of essential fatty acid deficiency in very-low-birth-weight infants infused with a 10% or 20% lipid emulsion

ArticleThe original publication is available at http://www.samj.org.zaObjective. To compare the cholesterol and triglycéride levels obtained in very-low-birth-weight (VLBW) infants infused with 10% or 20% Lipovenous (Intramed) or 10% or 20% Intralipid (Pharmacia) and to determine the effect on the triene/tetraene ratio (TTR). Design. A double-blind randomly controlled study. Setting. The study was undertaken in the neonatal wards of Tygerberg Hospital. Study subjects. Forty VLBW infants were randomly assigned to four groups of 10 each, who were to receive either 10% or 20% Lipovenous or 10% or 20% Intralipid from day 3 to 9 of life. Outcome measures. Plasma cholesterol and triglycéride concentrations were determined on days 3, 6 and 9 of life. Essential fatty acid deficiency was confirmed when the TTR was > 0.2. Results. Although no significant differences in the mean cholesterol levels on day 6 and 9 were noted between infants receiving either Lipovenous or Intralipid, the cholesterol levels of the infants treated with the 10% fat emulsions were significantly higher than those receiving the 20% emulsions. The plasma triglycéride levels increased over time, and this was not influenced by either the type or fat concentration of the lipid emulsion. The mean plasma triglycéride levels, however, remained well below the accepted normal level of 150 mg/dl during the study period. Nine infants (23%) had TTRs > 0.2 on day 3 but these normalised over the 6 days of parenteral fat administration. Conclusions. Fat should be added to the diets of VLBW infants before day 3 of life. Given the significantly higher mean plasma cholesterol levels in the infants treated with the 10% lipid emulsions, we suggest that a 20% emulsion be used in parenteral nutrition in VLBW infants.Publisher’s versio