Journal
JOURNAL OF PARENTERAL AND ENTERAL NUTRITION
Volume 43, Issue 7, Pages 874-882Publisher
WILEY
DOI: 10.1002/jpen.1497
Keywords
omega-3 fatty acids; DHA; neonate; premature infant; preterm; retinopathy; ROP
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Funding
- Consejo Nacional de Ciencia y Tecnologia [Salud-2015-2-261765]
- Instituto Mexicano del Seguro Social [FIS/IMSS/PROT/G15/1462]
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Background Retinopathy of prematurity (ROP) is a disorder of the retina of low-birth-weight preterm infants that potentially leads to blindness. Docosahexaenoic acid (DHA), is protective in experimental models, but its administration as part of parenteral nutrition has shown inconsistent results. We test the effect of enteral DHA to prevent ROP and/or severity and to reduce hospital stay. Methods This was a double-blind parallel clinical trial. Preterm infants (n = 110; 55 per group) with birth weight <1500 g but >= 1000 g were recruited in a neonatal intensive care unit. Infants were randomized to receive 75 mg of DHA/kg/d (DHA group) or high oleic sunflower oil (control group) for 14 days by enteral feeding. The effect of DHA was evaluated on any stage of ROP, severe ROP (stage >= 3) incidence, and hospital stay. Groups were compared with relative risk (RR) and 95% confidence interval (CI), Fisher's exact test, Student's t-test, or Mann-Whitney U-test, as appropriate. Logistic regression was applied to adjust for confounders. Results There was no difference between the DHA and control groups in ROP risk (RR for DHA = 0.79; 95% CI, 0.49-1.27; P = 0.33). However, patients who received DHA showed lower risk for stage 3 ROP (RR for DHA = 0.66; 95% CI, 0.44-0.99; P = 0.03). After adjusting for confounders, this decreased risk remained significant (adjusted odds ratio = 0.10; 95% CI, 0.011-0.886; P = 0.04). Hospital stay was similar between groups. Conclusion Enteral DHA may reduce the incidence of stage 3 ROP.
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