The 10-year follow-up of a randomised trial of long-chain polyunsaturated fatty acid supplementation in preterm infants: effects on growth and blood pressure
- Kathy Kennedy1,
- Sarah Ross1,2,
- Elizabeth B Isaacs1,
- Lawrence T Weaver2,
- Atul Singhal1,
- Alan Lucas1,
- Mary S Fewtrell1
- 1MRC Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK
- 2Department of Child Health, University of Glasgow, Glasgow, UK
- Correspondence to Kathy Kennedy, MRC Childhood Nutrition Research Centre, UCL Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK;
Contributors KK provided the main draft of this article and supervised the project, SR collected and analysed the data, EI, AS and AL provided expert advice on the design and interpretation of data, LW was the local investigator in Glasgow and critically revised the article, MSF was the primary investigator who wrote the original protocol providing the original concept and design. All authors contributed to the drafting and revision of this manuscript.
- Accepted 17 February 2010
- Published Online First 1 June 2010
Objective To test the hypothesis that consumption of infant formulas containing long-chain polyunsaturated fatty acids (LCPUFAs) by preterm infants would favourably influence growth, body composition and blood pressure (BP) at age 10 years.
Methods This was a follow-up study of a preterm cohort (<35 weeks and birth weight <2000 g) randomly assigned to unsupplemented or LCPUFA-supplemented formulas to 9 months post term. The setting was a research clinic at Yorkhill Hospital for Sick Children, Glasgow, UK. A total of 107 children aged 9–11 years who participated in the original randomised controlled trial (45% follow-up) took part. Main outcome measures were: (1) anthropometry, (2) body composition and (3) BP.
Results There were no differences in growth or BP between randomised groups for the whole cohort. However, girls who had received LCPUFA-supplemented formula were heavier (42.20 (SD 9.61) vs 36.94 (9.46) kg, p=0.05), had greater skin fold thicknesses (biceps 10.7 (3.3) vs 8.5 (3.6) mm, p=0.03; suprailiac 16.7 (8.2) vs 12.0 (7.5) mm, p=0.03) and higher BP (mean 82.2 (8.4) vs 78.1 (6.2) mm Hg, p=0.04: systolic 111.4 (10.1) vs 105.9 (9.0) mm Hg, p=0.04: diastolic 64.8 (8.4) vs 61.1 (5.4) mm Hg, p=0.05). Differences in weight SD score (0.85 (95% CI 0.13 to 1.58), p=0.02), Ln sum of skin fold thicknesses (0.27 (0.02 to 0.52), p=0.04) and BP (mean 4.6 mm Hg (0.43 to 8.84), p=0.03; systolic 6.1 (0.45 to 11.7), p=0.04) remained after adjustment for prerandomisation confounders. Differences in BP were not significant following adjustment for current weight.
Conclusions Girls born preterm and randomised to LCPUFA-supplemented formula showed increased weight, adiposity and BP at 9–11 years, which might have adverse consequences for later health. No effects were seen in boys. Long-term follow-up of other LCPUFA supplementation trials is required to further investigate this finding.
Competing interests MF, AL and AS have received research funding and performed advisory work for infant feeding manufacturers. LW is a member of the Infant and Toddler Forum, an educational charity funded by Danone. KK, SR and EI have no conflicts of interests to declare.
Ethics approval This study was conducted with the approval of the Yorkhill Royal Hospital for Sick Children local Research Ethics Committee, Glasgow; ref 06/S0708/05 May 06.
Provenance and peer review Not commissioned; externally peer reviewed.