ω-3 and ω-6 fatty acid status within a week of birth in a cross-sectional study of very preterm infants

Gibson RA 1 , Bednarz JM 2 , Sullivan TR 2 , Makrides M 3 , McPhee AJ 4 , Davis PG 5 Show all authors , Doyle LW 6 , Cheong JL 6 , Travadi J 7 , Tan K 8 , Morris S 9 , Lui K 10 , Bolisetty S 11 , Stark MJ 12 , Thio M 5 , Harris DL 13 , Stack J 14 , Berry M 15 , Rajadurai V 16 , Chua MC 16 , Jayagobi PA 16 , Sharp M 17 , Opie G 18 , Liley H 19 , Gould JF 20

Affiliations 

  • 1 SAHMRI Women and Kids, South Australian Health and Medical Research Institute, North Adelaide, South Australia, Australia; School of Agriculture, Food and Wine, The University of Adelaide, Glen Osmond, South Australia, Australia
  • 2 SAHMRI Women and Kids, South Australian Health and Medical Research Institute, North Adelaide, South Australia, Australia; School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
  • 3 SAHMRI Women and Kids, South Australian Health and Medical Research Institute, North Adelaide, South Australia, Australia; Discipline of Paediatrics, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
  • 4 SAHMRI Women and Kids, South Australian Health and Medical Research Institute, North Adelaide, South Australia, Australia; Neonatal Medicine, Women's and Children's Hospital, North Adelaide, South Australia, Australia
  • 5 Neonatal Medicine, The Royal Women's Hospital, Parkville, Melbourne, Victoria, Australia
  • 6 Department of Obstetrics and Gynaecology, The Royal Women's Hospital, Parkville, Melbourne, Victoria, Australia
  • 7 Newborn Services, John Hunter Children's Hospital, New Lambton Heights, New South Wales, Australia; Neonatology, Waikato Hospital, Hamilton, North Island, New Zealand
  • 8 Department of Paediatrics, Monash University, Monash Children's Hospital, Clayton, Victoria, Australia
  • 9 Neonatal-Perinatal Medicine, Flinders Medical Centre, Bedford Park, South Australia, Australia
  • 10 School of Clinical Medicine, Discipline of Paediatrics and Child Health, University of New South Wales, Sydney, New South Wales, Australia
  • 11 Newborn Services, Royal Hospital for Women, Randwick, New South Wales, Australia
  • 12 Neonatal Medicine, Women's and Children's Hospital, North Adelaide, South Australia, Australia; Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
  • 13 Neonatology, Waikato Hospital, Hamilton, North Island, New Zealand; School of Nursing, Midwifery and Health Practice, Victoria University of Wellington, Wellington, New Zealand
  • 14 Neonatal Intensive Care Unit, Liverpool Hospital, Liverpool, New South Wales, Australia
  • 15 Department of Paediatrics and Child Health, Wellington Hospital, Wellington, New Zealand
  • 16 Department of Neonatology, KK Women's and Children's Hospital, Singapore, Singapore
  • 17 Neonatal Directorate, King Edward Memorial Hospital, Perth, Western Australia, Australia
  • 18 Neonatal Services, Mercy Hospital for Women, Melbourne, Victoria, Australia
  • 19 Mater Research, Faculty of Medicine, The University of Queensland, South Brisbane, Queensland, Australia
  • 20 SAHMRI Women and Kids, South Australian Health and Medical Research Institute, North Adelaide, South Australia, Australia; Discipline of Paediatrics, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia; School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia. Electronic address: jacqueline.gould@adelaide.edu.au
Am J Clin Nutr, 2025 Aug;122(2):593-600.
PMID: 40754390 DOI: 10.1016/j.ajcnut.2025.05.014

Abstract

BACKGROUND: Concentrations of the long-chain polyunsaturated fatty acids, in particular, the ω-3 (n-3) fatty acid DHA and the ω-6 fatty acid arachidonic acid (AA), decrease in infant blood during the first days after very preterm birth.

OBJECTIVES: This study aimed to explore factors associated with blood DHA and AA concentrations of very preterm infants receiving standard care, in the days following birth.

METHODS: We examined the fatty acid composition of whole blood samples collected on cards at 0-6 d after birth, from a cross-sectional study of 1174 infants born <29 weeks of gestation in Australia, New Zealand, and Singapore.

RESULTS: Considerable variation was observed in the proportions of blood AA (1.4%-18.0%) and DHA (0.4%-5.7%) concentrations. Infant blood DHA status was not associated with gestational age at birth, but AA was lower by 0.11% for each week of gestation (95% CI: -0.07%, 0.15%). There was an inverse relationship between age of sampling after birth and DHA (0.07% lower per day; 95% CI: 0.04%, 0.09%) and AA (0.09% lower; 95% CI: 0.04%, 0.14%). A concomitant positive relationship was observed between days after birth and the fatty acids present in the intravenous lipid emulsion administered: ω-6 linoleic acid (range: 2.1%-35.1%) and ω-9 oleic acid (range: 12.2%-52.9%).

CONCLUSIONS: Preterm infants whose blood was sampled later after birth have lower DHA and AA status relative to those sampled earlier after birth; samples taken at later timepoints are concurrently higher in the fatty acids of linoleic acid and oleic acid, which are the major compositional components of intravenous lipid emulsions routinely administered to preterm infants. The results support calls to develop intravenous feeds closely matching the fatty acid composition of infant blood at birth. The N3RO Trial is registered at the Australian New Zealand Clinical Trial Registry as ACTRN12612000503820 (https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12612000503820).

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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