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. 2024 Oct 29;24(1):686.
doi: 10.1186/s12887-024-05153-8.

Association between SMOFlipid and impaired brain development on term-equivalent age brain magnetic resonance imaging in very preterm infants

Mountasser M Al-Mouqdad  1 , Belal Alshaikh  2 , Haider H Sumaily  3 , Nabeel A Alodhaidan  3 , Latifah AlMahmoud  3 , Ameen A Almotiri  3 , Mousa A Alkhourmi  4 , Mazen M Abounassif  5 , Ahmed F Beh  5 , Mashael A Alawad  6 , Amani A Albraiki  7 , Aziza A Alqarni  7 , Maha R Al-Anazi  7 , Nadia A Basodan  7 , Fuddah M Assiri  7 , Suzan S Asfour  8
Affiliations

Association between SMOFlipid and impaired brain development on term-equivalent age brain magnetic resonance imaging in very preterm infants

Mountasser M Al-Mouqdad et al. BMC Pediatr. .

Abstract

Soybean oil, medium-chain triglycerides, olive oil, and fish oil (SMOFlipid) is used without evidence of benefits. We investigated the relationship between lipid emulsions and brain injury in term-equivalent age magnetic resonance imaging (MRI) in 148 very preterm infants with a birth weight of < 1500 g at ≤ 32 gestational weeks in a neonatal intensive care unit. Infants who received soybean-based lipid emulsions between January 2015 and December 2018 were compared with those who received SMOFlipids between January 2019 and December 2022. A negative binomial generalized linear model was applied for bivariate analysis. Modified log-Poisson regression with generalized linear models and a robust variance estimator (Huber-White) were applied to adjust for potential confounders. The Kidokoro score was used to determine if lipid emulsion type would affect brain morphology and growth at term-equivalent age. Eighty-six (58.9%) received SMOFlipid. SMOFlipid was associated with lower focal signal abnormality, myelination delay, increased extracerebral space, and cerebellar volume reduction (P = 0.02, P = 0.007, P = 0.01, P = 0.02, respectively). SMOFlipidis are associated with brain insult, especially in white matter, cortical gray matter, and the cerebellum. Well-designed studies are needed to investigate the effect of lipid emulsions on the central nervous system.

Keywords: Brain morphology; Growth; Lipid emulsion; Magnetic resonance imaging; Parenteral nutrition; Premature infant.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of patient selection. GA gestational age, MRI magnetic resonance imaging
See this image and copyright information in PMC

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