Beyond building better brains: bridging the docosahexaenoic acid (DHA) gap of prematurity.
Beyond building better brains: bridging the docosahexaenoic acid (DHA) gap of prematurity.
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DOI：
10.1038/jp.2014.195
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发表时间：
2015-01
影响因子：
2.9
通讯作者：
Baack, M. L.
中科院分区：
文献类型：
--
作者：
Harris, W. S.;Baack, M. L.
长链多不饱和脂肪酸（LCPUFA）包括二十二碳六烯酸（DHA），是正常视力和神经发育所必需的。DHA在子宫内的积累主要发生在怀孕的最后三个月，以支持快速生长和大脑发育。在这个过程完成之前出生的早产儿相对缺乏这种必需脂肪酸。极低出生体重（VLBW）婴儿由于从前体脂肪酸的无效转化、较低的脂肪储存以及出生后DHA的营养供应有限而在很长一段时间内保持缺乏。除了长期的视觉和神经发育风险外，VLBW婴儿还具有早产特有疾病的显著发病率和死亡率，包括支气管肺发育不良（BPD）、坏死性小肠结肠炎（NEC）和早产儿视网膜病变（ROP）。越来越多的证据表明，DHA对这些疾病具有保护作用。本文的目的是确定早产儿的独特需求，审查目前对婴儿提供LCPUFA的建议，并讨论通过产后补充克服DHA缺乏症的注意事项和创新方法，长期目标是改善这一高危人群的发病率和死亡率。
Long chain polyunsaturated fatty acids (LCPUFA) including docosahexaenoic acid (DHA), are essential for normal vision and neurodevelopment. DHA accretion in utero occurs primarily in the last trimester of pregnancy to support rapid growth and brain development. Premature infants, born before this process is complete, are relatively deficient in this essential fatty acid. Very low birth weight (VLBW) infants remain deficient for a long period of time due to ineffective conversion from precursor fatty acids, lower fat stores, and a limited nutritional provision of DHA after birth. In addition to long- term visual and neurodevelopmental risks, VLBW infants have significant morbidity and mortality from diseases specific to premature birth, including bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), and retinopathy of prematurity (ROP). There is increasing evidence that DHA has protective benefits against these disease states. The aim of this article is to identify the unique needs of premature infants, review the current recommendations for LCPUFA provision in infants, and discuss the caveats and innovative new ways to overcome the DHA deficiency through postnatal supplementation, with the long term goal of improving morbidity and mortality in this at risk population.
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