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

Authors

Sudeepta K. Basu, Neonatology, Children's National Hospital, Washington, DC, USA.
Katherine M. Ottolini, Neonatology, Children's National Hospital, Washington, DC, USA.
Kushal J. Kapse, Developing Brain Institute, Children's National Hospital, Washington, DC, USA.
Julius Ngwa, Developing Brain Institute, Children's National Hospital, Washington, DC, USA.
Steve C. Hui, Developing Brain Institute, Children's National Hospital, Washington, DC, USA.
Nickie Andescavage, Neonatology, Children's National Hospital, Washington, DC, USA.
Jonathan Murnick, The George Washington University School of Medicine, Washington, DC, USA.
Adre J. du Plessis, The George Washington University School of Medicine, Washington, DC, USA.
Catherine Limperopoulos, Developing Brain Institute, Children's National Hospital, Washington, DC, USA. climpero@childrensnational.org.

Document Type

Journal Article

Publication Date

6-23-2025

Journal

Journal of perinatology : official journal of the California Perinatal Association

DOI

10.1038/s41372-025-02336-8

Abstract

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 (H-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 H-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.

APA Citation

Basu, Sudeepta K.; Ottolini, Katherine M.; Kapse, Kushal J.; Ngwa, Julius; Hui, Steve C.; Andescavage, Nickie; Murnick, Jonathan; du Plessis, Adre J.; and Limperopoulos, Catherine, "Early parenteral lipid intake supports cerebellar neurometabolism at term-age in preterm infants" (2025). GW Authored Works. Paper 7381.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/7381

Department

Pediatrics