Fatty Acid Composition of Plasma and Red Blood Cell Phospholipids in Preterm Infants from 2 Weeks to 6 Months Postpartum

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Abstract
The purpose of this study was to follow the long-chain polyunsaturated fatty acid (LCP) status in initially human milk-fed preterm infants from 2 weeks to 6 months postpartum. Twenty-two infants aged 27–33 weeks of gestation at birth who had a birthweight of 710–2525 g were fed human milk for ≥4 weeks. After discharge from the hospital, they were either human milk-fed or formula-fed according to their mothers' decision: 10 were fully breast-fed for 6 months and 12 were formula-fed after discharge at 1–2 months. The formula fat contained 20% 18:2n-6 and 3% 18:3n-3 but was devoid of long-chain polyunsaturated fatty acids (LCP). Blood samples were taken at 2 weeks, 3 months, and 6 months postpartum. Percentage fatty acid compositions in red blood cell (RBC) and plasma total phospholipids were analyzed by capillary gas liquid chromatography. In formula-fed infants, the change from human milk to formula resulted in a significant rise in plasma and RBC l8:2n-6 and 18:3n-3 and a decrease in plasma 20:4n-6. Interestingly, RBC20:4n-6 remained constant in both groups, even after 4–5 months of formula feeding. In the formula-fed group, RBC 22:5n-6 showed an increasing trend. The largest changes were seen in 22:6n-3; in the formula-fed group, il decreased in both plasma and RBC, whereas in the human milk-fed group, it showed an increasing trend. At 6 month, RBC 22:6n-3 was twice as high in the human milk-fed group [7.70% (95% CI 6.17–9.22)] than in the formula-fed group [3.80% (3.36–4.24)]. The relative birthweight correlated positively with RBC 20:4n-6 and 22:6n-3 in both groups at 3 months. In conclusion, in initially human milk-fed preterm infants, formula feeding resulted in a rapid and significant decrease in plasma and RBC 22:6n-3 and plasma 20:4n-6 but not in RBC 20:4n-6. Relative birthweight was associated with RBC 20:4n-6 and 22:6n-3 levels up to 3 months, showing the importance of intrauterine nutrition on LCP status.

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