Background: Very-low-birth-weight infants are largely dependent on parenteral nutrition after birth. Parenteral nutritionassociated liver disease is often observed in long-term parenteral nutrition with pure soybean oil lipid emulsion. A novel multicomponent lipid emulsion may prevent liver injury, improve growth, and decrease morbidity in preterm infants.

Objective: To compare the effects of a multicomponent lipid emulsion with a conventional pure soybean oil lipid emulsion on the incidence of neonatal cholestasis, neonatal growth, neonatal morbidity, and the biochemical assessment of liver enzymes.

Material and Method: Preterm infants weighing less than 1,250 g were allocated using a double-blind method. Both groups received parenteral nutrition, based on the same protocol. The study group received multicomponent lipid emulsion, while the control group received the standard pure soybean oil lipid emulsion. Serum levels of bilirubin, alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyl transpeptidase (GGT) were measured before enrollment, and at week 1, 2, and 3. Clinical data on neonatal outcomes were collected until the day of discharge.

Results: Each group was comprised of 22 preterm infants. The mean total parenteral nutrition (TPN) days were 12.5±8.1 and 10.5±5.9 in the study group and the control group respectively. There were no significant differences in laboratory parameters, including liver enzymes and GGT between the two groups. The incidence of cholestasis was 4.5% in the study group, and 9% in the control group, which was not statistically significant. No differences were observed in neonatal growth or neonatal morbidity including sepsis, bronchopulmonary dysplasia, retinopathy of prematurity, and necrotizing enterocolitis between the two groups. Eight infants (36%) in the study group experienced growth failure before discharge compared with 12 infants (54%) in the control group.

Conclusion: Multicomponent lipid emulsion appeared to be safe and well tolerated in preterm infants. No beneficial effects on the prevention of liver dysfunction were seen based on the type of lipid emulsion.

Keywords: Preterm, Parenteral nutrition, Cholestasis, Intravenous lipid emulsion, Growth