Feeding preterm infants milk with a higher dose of docosahexaenoic acid than that used in current practice does not influence language or behavior in early childhood: a follow-up study of a randomized controlled trial
Feeding preterm infants milk with a higher dose of docosahexaenoic acid than that used in current practice does not influence language or behavior in early childhood: a follow-up study of a randomized controlled trial
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DOI：
10.3945/ajcn.2009.28603
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发表时间：
2010-03-01
影响因子：
7.1
通讯作者：
Makrides, Maria
中科院分区：
文献类型：
--
作者：
Smithers, Lisa G.;Collins, Carmel T.;Makrides, Maria
背景资料：在喂养富含二十二碳六烯酸（DHA）的牛奶后，早产儿的视觉和智力发育得到改善，DHA的含量与胎儿的生长速度相匹配。目的：目的是评估喂养DHA含量高于目前实践中使用的DHA含量的牛奶是否会影响早产儿早期的语言或行为。设计：这是一项对参加DINO（二十二碳六烯酸改善神经发育结果）试验的婴儿亚组的随访研究。在一项双盲随机对照试验中，出生于妊娠< 33周的婴儿被喂食含有1%总脂肪酸的DHA（高DHA组）或约0.3% DHA（对照组）的牛奶，直到达到足月等效年龄。干预对语言、行为和气质的长期影响通过使用26个月校正年龄的麦克阿瑟沟通发展量表（MCDI）、优势和困难问卷（SDQ）和3- 5岁校正年龄的儿童短气质量表（STSC）进行测量。根据词汇产生子量表，高DHA组（308 +/- 179，n = 60）和对照组（316 +/- 192，n = 67）的平均（+/- SD）MCDI评分无显著差异（校正后P = 0.8）。高DHA组和对照组的SDQ和STSC综合评分没有差异[SDQ总难度：高DHA组（10.3 +/- 6.0，n = 61），对照组（9.5 +/- 5.5，n = 64），校正后P = 0.5; STSC评分：较高DHA组（3.1 ± 0.7，n = 61），对照组（3.0 +/- 0.7，n = 64），校正P = 0.3]。在早期评估中，喂养含有3倍标准量DHA的早产儿牛奶不会导致任何有临床意义的语言发育或行为变化。童年.膳食补充DHA的长期影响是否可以检测到仍有待评估。本试验已在澳大利亚和新西兰临床试验注册中心注册，网址为www.anzctr.org.auas12606000327583。美国临床营养杂志2010;91：628-34。
Background: The visual and mental development of preterm infants improved after feeding them milk enriched with docosahexaenoic acid (DHA) in amounts matching the fetal accretion rate.Objective: The objective was to evaluate whether feeding preterm infants milk with a higher DHA content than that used in current practice influences language or behavior in early childhood.Design: This was a follow-up study in a subgroup of infants enrolled in the DINO (Docosahexaenoic acid for the Improvement in Neurodevelopmental Outcome) trial. In a double-blind randomized controlled trial, infants born at < 33 wk of gestation were fed milk containing 1% of total fatty acids as DHA (higher-DHA group) or approximate to 0.3% DHA (control group) until reaching full-term equivalent age. The longer-term effects of the intervention on language, behavior, and temperament were measured by using the MacArthur Communicative Development Inventory (MCDI) at 26-mo corrected age, the Strengths and Difficulties Questionnaire (SDQ), and the Short Temperament Scale for Children (STSC) between 3-and 5-y corrected age.Results: Mean (+/- SD) MCDI scores did not differ significantly (adjusted P = 0.8) between the higher-DHA group (308 +/- 179, n = 60) and the control group (316 +/- 192, n = 67) per the Vocabulary Production subscale. Composite scores on the SDQ and STSC did not differ between the higher-DHA group and the control group [SDQ Total Difficulties: higher-DHA group (10.3 +/- 6.0, n = 61), control group (9.5 +/- 5.5, n = 64), adjusted P = 0.5; STSC score: higher-DHA group (3.1 +/- 0.7, n = 61), control group (3.0 +/- 0.7, n = 64), adjusted P = 0.3].Conclusions: Feeding preterm infants milk containing 3 times the standard amount of DHA did not result in any clinically meaningful change to language development or behavior when assessed in early childhood. Whether longer-term effects of dietary DHA supplementation can be detected remains to be assessed. This trial was registered with the Australia and New Zealand Clinical Trial Registry at www.anzctr.org.auas 12606000327583. Am J Clin Nutr 2010;91:628-34.