OMEGA-3 AND OMEGA-6 FATTY ACIDS AND PREMATURE INFANTS

二十二碳六烯酸（DHA，22：6N-3）是神经和 视网膜膜 有限的积累与学习有关， 视力缺陷 DHA由母亲传给胎儿/婴儿 在子宫内最后三个月和牛奶中。 早产儿可能 母亲没有接受任何形式的DHA，DHA储备不足，DHA有限 由亚麻酸合成。 RBC DHA的非生理性下降 除非喂食DHA（人乳、鱼油），否则早产。 脂质 在大学新生中心进行的补充研究 田纳西州的孟菲斯将直接评估的作用， 膜生物化学中含有特定n-6和n-3的脂质，目视检查 敏锐度、识别记忆、粒细胞对刺激的反应和气道 功能 1987年，有195名婴儿属于这一出生体重类别， 从装置中释放了。 一个营养团队确保一致的单位 管理 1)发育不良风险低的早产儿将被 当> 110 kcal/kg/d时，随机接受含和不含DHA的配方奶粉 配方是可以容忍的。 将进行生化和功能随访 至92周，评估血浆和红细胞磷脂脂肪 酸，k生育酚和视黄醇的色谱技术，视黄醇- 入组时放射免疫扩散法测定结合蛋白，40，48，57，69，79 和受孕后92周;视敏度（Teller敏度卡）在40，48， 57、69、79和92周;再认记忆（Fagan婴儿认知测验 功能），以及Bayley精神和身体发育 (MDI逐步回归将包括生化（n = 3） 脂肪酸，视黄醇， - 生育酚、视黄醇结合蛋白）和母体/ 新生儿/围产期变量，例如出生体重， 胎龄 入组、O2、辅助支持、母亲年龄和孕妇。 眼科 筛查将识别患有近视，远视，散光， 妨碍双眼测试的不等长或斜视。 2)大豆 磷脂酰胆碱和降低比例的二十碳五烯酸（EPA，20：5n-3） DHA将被喂养，以及它们对PMN白细胞组成的影响， 功能研究。 3)出生后立即补充n-3对 呼吸功能/生化将在非常小的早产儿中进行研究 婴儿（出生时体重<1000 g）患慢性肺部疾病的风险最高 疾病 他们的n-3状态非常差。 证据表明 多不饱和脂肪酸，尤其是鱼油DNA和EPA， 防止人工通气和吸氧引起的肺损伤 局 静脉脂质和配方中的DHA给药将 出生后48 - 72小时内开始。 1987年，139名新生儿中有77名 (55出生时体重小于1000 g的婴儿从UT存活出院， 孟菲斯新生儿中心

Docosahexaenoic acid (DHA, 22:6N-3) is a major component of neural and retinal membranes. Limited accumulation is associated with learning and visual acuity deficits. DHA is transmitted from mother to the fetus/infant in the last intrauterine trimester and in milk. Premature infants may receive neither form of maternal DHA, have poor DHA stores and limited DHA synthesis from linolenic acid. Nonphysiological declines in RBC DHA occur following early delivery unless DHA is fed (human milk, fish oil). Lipid supplementation studies carried out in the Newborn Center at the University of Tennessee, Memphis will be directed toward assessing the role of specific n-6 and n-3 containing lipids in membrane biochemistry, visual acuity, recognition memory, granulocyte response to stimuli and airway function. In 1987, 195 infants in this birthweight category were discharged live from the unit. A nutrition team assures consistent unit management. 1) Preterm infants at low risk for poor developmental outcomes will be randomized to receive formula with and without DHA when >110 kcal/kg/d from formula is tolerated. Biochemical and functional followup will occur to 92 wks with assessment of plasma and red blood cell phospholipid fatty acids,k tocopherol and retinol by chromatographic techniques, retinol- binding protein by radialimmunodiffusion at enrollment, 40, 48, 57, 69, 79 and 92 wks postconception; visual acuity (Teller acuity cards) at 40, 48, 57, 69, 79 and 92 wks; recognition memory (Fagan infantest for cognitive function) at 69, 79, and 92 wks, and Bayley Mental and Physical Development (MDI/PDI) at 92 wks. Stepwise regression will include biochemical (n-3 fatty acids, retinol, -tocopherol, retinol-binding protein) and maternal/ neonatal/perinatal variables such as birth wt, gestational age, age at enrollment, O2, ventilatory support, maternal age and gravida. Ophthalmic screening will identify infants with myopia, hyperopia, astigmatism, aniosometria or strabismus precluding binocular testing. 2) Soybean phosphatidylcholine and reduced ratios of eicosapentaenoate (EPA, 20:5n-3) to DHA will be fed and their effects on PMN leukocyte composition and function studied. 3) The effect of n-3 supplementation immediately after birth on respiratory function/biochemistry will be studied in very small premature infants (<1000 g birth wt) who are at greatest risk for chronic lung disease. Their n-3 status is very poor. Evidence suggests that polyunsaturated fatty acids, especially fish oil DNA and EPA, could protect against lung damage induced by artificial ventilation and oxygen administration. DHA administration in intravenous lipid and formula will begin within 48-72 hrs after birth. In 1987, 77 of 139 inborn infants (55%^) weighing less than 1000 g at birth were discharged live from the UT, Memphis, Newborn Center.