Docosahexaenoic Acid and Bronchopulmonary Dysplasia in Preterm Infants

Carmel T. Collins, Maria Makrides, Andrew J. McPhee, Thomas R. Sullivan, Peter G. Davis, Marta Thio, Karen Simmer, Victor S. Rajadurai, Javeed Travadi, Mary J. Berry, Helen G. Liley, Gillian F. Opie, Kenneth Tan, Kei Lui, Scott A. Morris, Jacqueline Stack, Michael J. Stark, Mei-Chien Chua, Pooja A. Jayagobi, James HolbertonSrinivas Bolisetty, Ian R. Callander, Deborah L. Harris, Robert A. Gibson

    Research output: Contribution to journalArticlepeer-review

    75 Citations (Scopus)

    Abstract

    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 [

    RESULTS

    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 per 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.

    Original languageEnglish
    Pages (from-to)1244-1254
    Number of pages11
    JournalThe New England Journal of Medicine
    Volume376
    Issue number13
    DOIs
    Publication statusPublished - 30 Mar 2017

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