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Carnitine synthesis requires gamma-butyl betaine hydroxylase, and premature infants have a limited capacity to synthesize L-carnitine themselves, having only 1215% of the synthesis ability of adults (3335)

F., Krams M., et al

However, we used leave-one-out sensitivity analysis under a conservative random-effects model to assess the possibility of some bias such as unclear double-randomization or large unbalanced dropout

Preterm infants are not efficient in their energy use, a poor exogenous nutrient supply during the first few days of life may not only lead to extrauterine growth retardation in newborns, but it may also increase their susceptibility to infectious diseases and organ function damage (80)