- Title
- Docosahexaenoic acid and bronchopulmonary dysplasia in preterm infants
- Creator
- Collins, Carmel T.; Makrides, Maria; Liley, Helen G.; Opie, Gillian F.; Tan, Kenneth; Lui, Kei; Morris, Scott A.; Stack, Jacqueline; Stark, Michael J.; Chua, Mei-Chien; Jayagobi, Pooja A.; Holberton, James; McPhee, Andrew J.; Bolisetty, Srinivas; Callander, Ian R.; Harris, Deborah L.; Gibson, Robert A.; Sullivan, Thomas R.; Davis, Peter G.; Thio, Marta; Simmer, Karen; Rajadurai, Victor S.; Travadi, Javeed; Berry, Mary J.
- Relation
- NHMRC.1022112 http://purl.org/au-research/grants/nhmrc/1022112
- Relation
- New England Journal of Medicine Vol. 376, Issue 13, p. 1245-1255
- Publisher Link
- http://dx.doi.org/10.1056/NEJMoa1611942
- Publisher
- Massachusetts Medical Society
- Resource Type
- journal article
- Date
- 2017
- Description
- Background: Studies in animals and in humans have suggested that docosahexaenoic acid (DHA), an n-3 long-chain polyunsaturated fatty acid, might reduce the risk of bronchopulmonary dysplasia, but appropriately designed trials are lacking. Methods: We randomly assigned 1273 infants born before 29 weeks of gestation (stratified according to sex, gestational age [ < 27 weeks or 27 to < 29 weeks], and center) within 3 days after their first enteral feeding to receive either an enteral emulsion providing DHA at a dose of 60 mg per kilogram of body weight per day or a control (soy) emulsion without DHA until 36 weeks of postmenstrual age. The primary outcome was bronchopulmonary dysplasia, defined on a physiological basis (with the use of oxygen-saturation monitoring in selected infants), at 36 weeks of postmenstrual age or discharge home, whichever occurred first. Result s: A total of 1205 infants survived to the primary outcome assessment. Of the 592 infants assigned to the DHA group, 291 (49.1% by multiple imputation) were classified as having physiological bronchopulmonary dysplasia, as compared with 269 (43.9%) of the 613 infants assigned to the control group (relative risk adjusted for randomization strata, 1.13; 95% confidence interval [CI], 1.02 to 1.25; P = 0.02). The composite outcome of physiological bronchopulmonary dysplasia or death before 36 weeks of postmenstrual age occurred in 52.3% of the infants in the DHA group and in 46.4% of the infants in the control group (adjusted relative risk, 1.11; 95% CI, 1.00 to 1.23; P = 0.045). There were no significant differences between the two groups in the rates of death or any other neonatal illnesses. Bronchopulmonary dysplasia based on a clinical definition occurred in 53.2% of the infants in the DHA group and in 49.7% of the infants in the control group (P = 0.06). Conclusions: Enteral DHA supplementation at a dose of 60 mg per kilogram pe r day did not result in a lower risk of physiological bronchopulmonary dysplasia than a control emulsion among preterm infants born before 29 weeks of gestation and may have resulted in a greater risk.
- Subject
- docosahexaenoic acid (DHA); bronchopulmonary dysplasia; preterm infants; fatty acids
- Identifier
- http://hdl.handle.net/1959.13/1352806
- Identifier
- uon:30962
- Identifier
- ISSN:0028-4793
- Language
- eng
- Full Text
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