Long-chain polyunsaturated fatty acids in breast-milk and erythrocytes and neurodevelopmental outcomes in Danish late-preterm infants

Background: The supply of long-chain polyunsaturated fatty acids (LC-PUFA) during pregnancy and early lactation has been shown to affect cognitive development in preterm infants, but the effect on early neurodevelopment of late-preterm infants has not yet been examined. Aim: To examine the fatty acid composition of late-preterm human milk and identify possible associations between infant LC-PUFA status and perinatal as well as 1-year neurobehavioral outcomes. Methods: Mother’s milk and erythrocytes (RBC) were sampled from 53 Danish late-preterm infants (33-36 weeks of gestation) 1 week and 1 month after delivery, and 3 months corrected age. Fatty acid composition was determined by gas-liquid chromatography. Neurodevelopmental outcomes were assessed by the Nicu Network Neurobehavioral Scale (NNNS) at 1 week and 1 month and the Bayley Scales (BSID-III) at 1 year corrected age. Results: We found that breast-milk content of arachidonic acid (AA) and docosahexaenoic acid (DHA) was similar to reported fatty acid compositions of term human milk. Infant RBC-AA decreased from 1 week to 1 month of age and the size of the decrease was associated with better NNNS-scores at 1 month, specifically on regulation (p=0.03). Infant RBC-AA at 1 month was also associated with a lower 1-year corrected age BSID-III score of receptive language (p=0.05) and fine motor development (p=0.03). Infant RBC-DHA did not ecrease significantly after delivery and was not associated with any of the developmental outcomes. Conclusion: Breast-milk LC-PUFA content was reflected in the RBC LC-PUFA status of the infant. Early RBC-AA status was associated with both early and long-term neurobehavioral development, but not in a consistent way.