Early neurological and neurophysiological development of the preterm infant and polyunsaturated fatty acids supply

Objectives: To compare the early neurological maturation of premature newborns (PT) fed breast milk (BM) or a formula containing only 18-carbon polyunsaturated fatty acids (PUFA) (A) or enriched with long chain (LC) PUFA (B). Methods: PT enrolled the 2nd day of enteral feeding (D0) were fed BM (n=15; 4 dropped out) or randomly assigned to A (n=11; 2) or B (n=14; 1) for at least 30 days (D30). Auditory and visual evoked potentials (EPs) and nerve conduction velocity (NCV) and plasma and red blood cell (RBC) phospholipid composition were determined at D0 and D30. No difference was found between groups for the D0–D30 changes in EP parameters. The maturation of motor NCV was slower in the B group than in the two other groups. In plasma, the changes were higher in B than in the BM and A groups for linoleic acid (P<0.05), in BM versus B group for arachidonic acid (P<0.02). In RBC, formula groups displayed higher linoleic acid level than the BM group (P<0.05). No difference was found between groups for the changes in arachidonic and docosahexaenoic acids. Conclusions: A balanced supply of n-6 and n-3 PUFA without addition of LC-PUFA allowed an adequate early maturation of the central nerve system. The effects of LC-PUFA on the maturation of NCV remain to be confirmed.