Meta-analysis on the effects of fish oil-based versus soybean oil-based lipid emulsions on neurodevelopment in preterm and very low birth weight infants

WANG Yue; LI Xiangcheng; SONG Meijuan; XU Chi; LIU Lijie; JIA Xiuling

doi:10.11852/zgetbjzz2025-0962

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Chinese Journal of Child Health Care ›› 2026, Vol. 34 ›› Issue (10) : 1151-1157. DOI: 10.11852/zgetbjzz2025-0962

Meta-analysis on the effects of fish oil-based versus soybean oil-based lipid emulsions on neurodevelopment in preterm and very low birth weight infants

WANG Yue, LI Xiangcheng, SONG Meijuan, XU Chi, LIU Lijie, JIA Xiuling

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Abstract

Objective To compare the effects of fish oil-based versus soybean oil-based lipid emulsions on head circumference growth and brain magnetic resonance imaging (MRI) measures in preterm and/or very low birth weight infants, so as to provide evidence for clinical practice. Methods Relevant randomized controlled trials (RCTs) and cohort studies published from database inception to May 2025 were retrieved through PubMed, Embase, the Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang Data. Two reviewers independently screened the literature, extracted data, and assessed study quality. Meta-analyses were performed using RevMan 5.3. Results Nine studies (4 RCTs and 5 cohort studies) were included, involving a total of 1 451 infants. The meta-analysis of two MRI studies showed that, compared with the soybean oil-based lipid emulsion group, the fish oil-containing lipid emulsion group had greater total brain volume (MD=24.61cm³, 95%CI: 6.19-43.02, P=0.009) and brainstem volume (MD=0.70cm³, 95%CI: 0.34-1.06, P<0.001). No statistically significant between-group difference was observed in cerebellar volume (P>0.05). The pooled results of eight studies showed no statistically significant difference in head circumference Z score (HCZ) between the two groups (P>0.05). Conclusions Compared with soybean oil-based lipid emulsions, fish oil-containing lipid emulsions did not significantly improve HCZ in preterm and/or very-low-birth-weight infants. Limited MRI evidence suggested that their use might be associated with greater total brain and brainstem volumes. Given that the MRI analyses included only two studies, with limited sample sizes and heterogeneous comparator formulations, these findings require confirmation in larger, high-quality studies with more homogeneous comparator formulations.

Key words

preterm infants / very low birth weight infant / fish oil-containing lipid emulsion / soybean oil-based lipid emulsion / neurodevelopment / meta-analysis

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WANG Yue, LI Xiangcheng, SONG Meijuan, XU Chi, LIU Lijie, JIA Xiuling. Meta-analysis on the effects of fish oil-based versus soybean oil-based lipid emulsions on neurodevelopment in preterm and very low birth weight infants[J]. Chinese Journal of Child Health Care. 2026, 34(10): 1151-1157 https://doi.org/10.11852/zgetbjzz2025-0962

References

[1] 韩立华,王凯,冯小兰,等.妊娠期和哺乳期母亲膳食营养影响子代骨骼发育的研究进展[J].食品科学,2026,47(3):394-405.
Han LH, Wang K, Feng XL, et al. Recent advances in the effect of maternal dietary nutrition during pregnancy and lactation on offspring bone development[J]. Food Science,2026,47(3):394-405. (in Chinese)
[2] Lodygensky GA, Vasung L, Sizonenko SV, et al. Neuroimaging of cortical development and brain connectivity in human newborns and animal models[J]. J Anat, 2010, 217(4): 418-428.
[3] Ottolini KM, Andescavage N, Keller S, et al. Nutrition and the developing brain: The road to optimizing early neurodevelopment: A systematic review[J]. Pediatr Res, 2020, 87(2): 194-201.
[4] Cheong JLY, Olsen JE, Lee KJ, et al. Temporal trends in neurodevelopmental outcomes to 2 years after extremely preterm birth[J]. JAMA Pediatr, 2021, 175(10): 1035.
[5] Skinner AM, Narchi H. Preterm nutrition and neurodevelopmental outcomes[J]. World J Methodol, 2021, 11(6): 278-293.
[6] Deshpande GC, Cai W. Use of lipids in neonates requiring parenteral nutrition[J]. J Parenter Enteral Nutr, 2020, 44(Suppl 1): 45-54.
[7] Bin-Nun A, Kassirer Y, Mimouni FB, et al. Head circumference growth is enhanced by SMOFlipid in preterm neonates[J]. Am J Perinatol, 2020, 37(11): 1130-1133.
[8] Hill NS, Cormack BE, Little BS, et al. Growth and clinical outcome in very low-birth-weight infants after the introduction of a multicomponent intravenous lipid emulsion[J]. JPEN J Parenter Enteral Nutr, 2020, 44(7): 1318-1327.
[9] Johnson MJ, Lapillonne A, Bronsky J, et al. Research priorities in pediatric parenteral nutrition: A consensus and perspective from ESPGHAN/ESPEN/ESPR/CSPEN[J]. Pediatr Res, 2022, 92(1): 61-70.
[10] Ottolini KM, Ngwa J, Basu SK, et al. Brain development using a multicomponent intravenous lipid emulsion in preterm infants[J]. BMC Pediatr, 2024, 24(1): 847.
[11] Costa S, Cocca C, D'Apolito G, et al. Effects of a multicomponent lipid emulsion on brain volumes in extremely low birth weight infants[J]. Am J Perinatol, 2024, 41(S 01): e1813-e1819.
[12] Binder C, Schned H, Longford N, et al. A mixed-lipid emulsion containing fish oil for the parenteral nutrition of preterm infants: No impact on visual neuronal conduction[J]. Nutrients, 2021, 13(12): 4241.
[13] Biagetti C, Correani A, D'Ascenzo R, et al. Is intravenous fish oil associated with the neurodevelopment of extremely low birth weight preterm infants on parenteral nutrition[J]. Clin Nutr, 2021, 40(5): 2845-2850.
[14] Biagetti C, Correani A, D'Ascenzo R, et al. Does intravenous fish oil affect the growth of extremely low birth weight preterm infants on parenteral nutrition[J]. Clin Nutr, 2019, 38(5): 2319-2324.
[15] Vlaardingerbroek H, Vermeulen MJ, Carnielli VP, et al. Growth and fatty acid profiles of VLBW infants receiving a multicomponent lipid emulsion from birth[J]. J Pediatr Gastroenterol Nutr, 2014, 58(4): 417-427.
[16] Uthaya S, Liu X, Babalis D, et al. Nutritional evaluation and optimisation in neonates: A randomized, double-blind controlled trial of amino acid regimen and intravenous lipid composition in preterm parenteral nutrition[J]. Am J Clin Nutr, 2016, 103(6): 1443-1452.
[17] Costa S, Cocca C, Barone G, et al. Growth of head circumference and body length in preterm infants receiving a multicomponent vs a soybean-based lipid emulsion: A randomized controlled trial[J]. J Parenter Enteral Nutr, 2021, 45(1): 94-101.
[18] Thanhaeuser M, Fuiko R, Oberleitner-Leeb C, et al. A randomized trial of parenteral nutrition using a mixed lipid emulsion containing fish oil in infants of extremely low birth weight: Neurodevelopmental outcome at 12 and 24 months corrected age, a secondary outcome analysis[J]. J Pediatr, 2020, 226: 142-148.e5.
[19] 王娜,李晓莺.早产儿神经发育评估的进展[J].中国儿童保健杂志,2023,31(4):404-407,432.
Wang N, Li XY. Progress in neurodevelopmental assessment of premature infants[J]. Chin J Child Health Care, 2023, 31(4):404-407,432. (in Chinese)
[20] Manuela S, Giovanna V, Silvia V, et al. Fetal dependency on maternal fatty acids: A pilot study in human pregnancies using the natural abundance variation of (13)C[J]. Br J Nutr, 2025, 133(2): 194-201.
[21] 余红,陈晓霞,吴长划,等.早产儿体格生长和神经发育的早期综合干预效果评价[J].预防医学,2022,34(8):771-775.
Yu H, Chen XX, Wu CH, et al. Effect of early comprehensive interventions on physical growth and neurodevelopment among premature infants[J].China Preventive Medicine Journal, 2022, 34(8):771-775.(in Chinese)
[22] Schneider J, Fischer Fumeaux CJ, Duerden EG, et al. Nutrient intake in the first two weeks of life and brain growth in preterm neonates[J]. Pediatrics, 2018, 141(3): e20172169.
[23] Tam EWY, Chau V, Barkovich AJ, et al. Early postnatal docosahexaenoic acid levels and improved preterm brain development[J]. Pediatr Res, 2016, 79(5): 723-730.
[24] Moltu SJ, Nordvik T, Rossholt ME, et al. Arachidonic and docosahexaenoic acid supplementation and brain maturation in preterm infants: A double blind RCT[J]. Clin Nutr, 2024, 43(1): 176-186.
[25] Coviello C, Keunen K, Kersbergen KJ, et al. Effects of early nutrition and growth on brain volumes, white matter microstructure, and neurodevelopmental outcome in preterm newborns[J]. Pediatr Res, 2018, 83(1): 102-110.
[26] Ottolini KM, Andescavage N, Kapse K, et al. Early lipid intake improves cerebellar growth in very low-birth-weight preterm infants[J]. J Parenter Enteral Nutr, 2021, 45(3): 587-595.