Lung function in preterm infants at 3 months corrected age after neonatal LC-PUFA supplementation

Objective: To test the hypothesis that long-chain polyunsaturated fatty acid (LC-PUFA) supplementation improves lung function at 3 months corrected age (CA) compared with standard treatment in very preterm infants. We also aimed to investigate the association between bronchopulmonary dysplasia (BPD), longitudinal growth, and lung function at 3 months CA.Methods: A secondary analysis from the ImNuT trial, in which 121 infants with gestational age <29 weeks were randomized to a daily supplement with arachidonic acid (ARA) and docosahexaenoic acid (DHA) (ARA:DHA group) or MCT-oil (control group) from birth up to 36 weeks postmenstrual age (PMA). Lung function was assessed at 3 months CA by tidal flow volume loops and the outcomes were the ratio of time to peak tidal expiratory flow to expiratory time (t(PTEF) /t(E) ) and tidal volume (V-T ) per body weight (mL/kg).Results: Thirty-nine infants in the ARA:DHA group versus 51 in the control group had a successful lung function test. There was no mean difference (MD) in t(PTEF) /t(E) ratio (MD: 0.01, 95% confidence interval [CI]: -0.04 to 0.05; p = .77) or V-T (MD: 0.09 mL/kg, 95% CI: -0.79 to 0.62; p = .81) between the study groups. The multivariable regression model showed that BPD was associated with t(PTEF) /t(E) ratio <= 0.25 (p = .03) and that an increase in z score for length after 36 weeks PMA correlated positively with V-T (mL/kg) (p = .03).Conclusion: Neonatal LC-PUFA supplementation did not improve lung function at 3 months CA in very preterm infants. BPD was independently associated with reduced lung function, while improved linear growth correlated with higher tidal volumes.

Automated summary

This study aimed to test the hypothesis that long-chain polyunsaturated fatty acid (LC-PUFA) supplementation improves lung function in very preterm infants at 3 months corrected age. The results showed that LC-PUFA supplementation did not improve lung function at 3 months CA, and bronchopulmonary dysplasia (BPD) was independently associated with reduced lung function while improved linear growth correlated with higher tidal volumes.