Effect of arachidonic and docosahexaenoic acid supplementation on respiratory outcomes and neonatal morbidities in preterm infants. Issue 1 (January 2023)

• Record Type: Journal Article
• Authors: Wendel, Kristina; Aas, Marlen Fossan; Gunnarsdottir, Gunnthorunn; Rossholt, Madelaine Eloranta; Bratlie, Marianne; Nordvik, Tone; Landsend, Erlend Christoffer Sommer; Fugelseth, Drude; Domellöf, Magnus; Pripp, Are Hugo; Stiris, Tom; Moltu, Sissel Jennifer
• Is Part Of: Clinical nutrition. Volume 42:Issue 1(2023)
• Page Start: 22
• Page End: 28
• Publication Date: 2023-01
• Subjects: Preterm -- Fatty acid supplementation -- Arachidonic acid -- Docosahexaenoic acid -- Bronchopulmonary dysplasia -- Neonatal morbidities; ARA Arachidonic acid -- BPD Bronchopulmonary dysplasia -- CPAP continuous positive airway pressure -- CRIB Clinical Risk Index for Babies -- DHA Docosahexaenoic acid -- DMC Data Monitoring Committee -- FA Fatty acid -- GA Gestational age -- HR Hazard ratio -- IVH Intraventricular hemorrhage -- LCPUFA Long-chain polyunsaturated fatty acid -- LOS Late-onset septicemia -- MRI Magnetic Resonance Imaging -- MCT Medium chain triglycerides -- MD Mean difference -- NEC Necrotizing enterocolitis -- PDA Patent ductus arteriosus -- PMA Postmenstrual age -- PVL Periventricular leukomalacia -- ROP Retinopathy of prematurity -- RR Respiratory rate or Risk ratio -- TPTEF/Te ratio Time to peak tidal expiratory flow as a ratio of expiratory time -- Vt Tidal volume; Critically ill -- Nutrition -- Periodicals; Diet therapy -- Periodicals; Parenteral feeding -- Periodicals; Enteral feeding -- Periodicals; Enteral Nutrition -- Periodicals; Parenteral Nutrition -- Periodicals; Metabolism -- Periodicals; Diétothérapie -- Périodiques; Alimentation parentérale -- Périodiques; Alimentation entérale -- Périodiques; Nutrition -- Périodiques; Diet therapy; Enteral feeding; Nutrition; Parenteral feeding; Electronic journals; Periodicals; Electronic journals; 615.854
• DOI: 10.1016/j.clnu.2022.11.012
• Languages: English
• ISSNs: 0261-5614

Abstract

Summary: Background & aims: Studies have suggested that supplementation with docosahexaenoic acid (DHA) to preterm infants might be associated with an increased risk of bronchopulmonary dysplasia (BPD). Our aim was to investigate the effect of enteral supplementation with arachidonic acid (ARA) and DHA on short-term respiratory outcomes and neonatal morbidities in very preterm infants. Methods: This is a secondary analysis of data from the ImNuT (Immature, Nutrition Therapy) study, a randomized double blind clinical trial. Infants with gestational age less than 29 weeks were randomized to receive a daily enteral supplement with ARA 100 mg/kg and DHA 50 mg/kg (intervention) or medium chain triglycerides (MCT) oil (control), from second day of life to 36 weeks postmenstrual age. Study outcomes included duration of respiratory support, incidence of BPD and other major morbidities associated with preterm birth. Results: 120 infants with mean (SD) gestational age 26.4 (1.7) weeks were randomized and allocated to either the intervention or control group. Supplementation with ARA and DHA led to a significant reduction in number of days with respiratory support (mean (95% CI) 63.4 (56.6–71.3) vs 80.6 (72.4–88.8); p = 0.03) and a lower oxygen demand (FiO2 ) (mean (95% CI) 0.26 (0.25–0.28) vs 0.29 (0.27–0.30); p = 0.03) compared to control treatment. There were no clinically important differences in incidence of BPD and other major morbidities between the treatment groups. Conclusions: Supplementation with ARA and DHA to preterm infants was safe and might have a beneficial effect on respiratory outcomes. Clinical trial registration: The trial has been registered in www.clinicaltrials.gov, ID: NCT03555019.