Premature infants are particularly vulnerable to nutritional deficiency because of their limited adipose tissue mass and immaturity in many metabolic and physiologic pathways at birth. In addition, the growth of dendritic arbors and peak formation of synapses, which are enriched in Docosahexaenoic acid-DHA, extends from about 34 weeks of gestation through 24 months after birth, during which time new connections form at rates up to almost 40,000 synapses/s.
Reduced accretion of Docosahexaenoic acid -DHA in the retina and brain during development results in decreased Electroretinogram responses, decreased performance in behaviour tests of learning, exploratory activity and auditory brainstem evoked potential responses, and changes in dopamine and Serotonin metabolism
Clinical trials have also noted higher growth in preterm infant fed with formula containing arachidonic acid – AA and Docosahexaenoic acid – DHA the fetus and preterm infant are capable of forming Docosahexaenoic acid – DHA from linoleic acid, but this capacity is low, and preformed Docosahexaenoic acid – DHA is much more efficient in supporting the accretion of DHA in developing brain and other organs than its precursor linoleic acid. Plasma fatty acid transport in the fetus is distinctly different from that afterbirth, with a relative enrichment of arachidonic acid – AA and Docosahexaenoic acid – DHA.