Article

AIM: To investigate whether neonates at risk for neurodevelopmental impairment
have improved neurodevelopment after docosahexaenoic acid, choline, and
uridine-5-monophosphate supplementation versus controls. METHOD: Recruitment was
from UK neonatal units.
Eligible for inclusion were infants born at less than 31
weeks' gestation with a weight less than the ninth centile; infants born at less
than 31 weeks' gestation with a grade II or higher intraventricular
haemorrhage/preterm white matter injury; infants born between 31 weeks' and 40
weeks' gestation plus 28 days with a grade II or higher intraventricular
haemorrhage/preterm white matter injury, moderate or severe hypoxic-ischaemic
encephalopathy, or defined neuroimaging abnormalities. Treatment/control
supplementation was for 2 years (double-blind, randomized, controlled design).
Infants were stratified according to sex, gestation, and brain injury severity.
Primary outcome was cognitive composite score (CCS) of the Bayley Scales of
Infant Development, Third Edition (Bayley-III at 24mo). Secondary outcomes were
language composite score (LCS) of the Bayley-III, motor composite score (MCS) of
the Bayley-III, and Vineland Adaptive Behaviour Scales, Second Edition (VABS-II)
score. RESULTS: Sixty-two neonates were recruited, 59 were randomized (34 males,
25 females). Fifty-three started supplementation. Most families found
supplementation acceptable. The treatment group CCS-Bayley-III scores were
non-significantly higher than controls (mean score difference at 24mo: 9.0; 95%
confidence interval -0.2 to 18.2). Language and VABS-II scores, but not motor
score, were non-significantly higher in the treatment group. INTERPRETATION: Most
families found supplementation feasible. Improved neurodevelopmental outcomes in
the treatment group were not statistically significant. A larger multicentre
trial exploration is warranted. Dietary supplementation of
neonates at risk of neurodevelopmental impairment is feasible. No statistically
significant neurodevelopmental advantages were identified for the treatment group
compared to controls. Treatment group cognitive and language advantage are of a
clinically meaningful magnitude.
CI - (c) 2018 Mac Keith Press.

Langue : ANGLAIS