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Essential fatty acid status of the premature infant during short-term fat-free parenteral nutrition.

This study was designed to evaluate the effect of fat-free parenteral nutrition on the essential fatty acid status of a group of stable premature infants during the first 10 days of life. Nine infants had a gestational age of less than 32 weeks (Group 1), and 10 infants, 32-34 weeks (Group 2). Five of nine infants in Group 1 and two of 10 infants in Group 2 developed essential fatty acid deficiency (EFAD) (triene/tetraene ratio greater than 0.4). In three infants, EFAD was present by 5 days of age; and in four, between 5 and 10 days of age. The difference in frequency of EFAD between Groups 1 and 2 is statistically significant (p less than 0.05). The development of EFAD as a function of postnatal age could be predicted using a simple regression, y = -0.14 + 0.07x (r = 0.64, p less than 0.0001), where y represents the triene/tetraene ratio and x the postnatal age in days. We conclude that (a) EFAD may develop rapidly in the premature infant; (b) the more immature the infant, the greater the risk of EFAD; (c) the degree of EFAD increases with the duration of fat-free parenteral nutrition.