EFFECT OF α-LINOLENIC ACID (ALA) INTAKE DURING EARLY LIFE ON NEURODEVELOPMENTAL STATUS OF PRETERM INFANTS: ▴ 1915

Docosahexaenoic acid (DHA; 22:6ω3) and arachidonic acid (AA; 20:4ω6), present in human milk but not in most infant formulas, are essential components of the structural lipids of brain and retinal cell membranes. More optimal indices of neurodevelopmental status have been reported in breast vs formula fed infants. To determine if intake of ALA, the precursor of DHA, affects neurodevelopmental outcome, the Bayley Scales of Infant Development, Second Edition (MDI, PDI), the Clinical Linguistic and Auditory Milestone Scale (CLAMS), the Clinical Adaptive Test (CAT), and the Gross Motor section of the Revised Gesell Developmental Inventory (GM) were administered at 12 to 15 months corrected age to 23 preterm infants fed formulas with either 1% or 3.2% of fat as ALA from shortly after birth to 56 weeks post-menstrual age (PMA). In general, DHA content of plasma phospholipids (PL) was higher and AA content was lower at 56 weeks PMA in infants who received the highest LNA intake. The group which received the highest LNA intake, in contrast to term infants fed the same ALA intakes, scored lower on every neurodevelopmental measure (PDI, 16 points; MDI, 8 points; CLAMS, 5 points; CAT, 10 points; GM, 11 points), but only the difference in PDI score was statistically significant (p <0.01). Across groups, after controlling for differences in birth weights and early clinical events, there were positive correlations between plasma PL content of AA at 56 weeks PMA and both PDI (p = 0.011; r² = 46%) and GM (p = 0.047, r² = 28%) scores. Total plasma PL content of ω6 fatty acids at 56 weeks PMA also correlated positively with PDI (p = 0.002; r² = 55%) and GM (p = 0.045; r² 28%) scores. Plasma PL content of both DHA (p = 0.023; r² = 33%) and total ω3 fatty acids (p = 0.030; r² = 31%) at 56 weeks PMA correlated positively with CLAMS scores. These data suggest that ω6 fatty acid status at 56 weeks PMA may be associated with enhanced motor outcome, and ω3 fatty acid status at 56 weeks PMA with enhanced language outcome in preterm infants.