Docosahexaenoic acid supplementation of preterm infants and parent-reported symptoms of allergic disease at 7 years corrected age: Follow-up of a randomized controlled trial

Anoja W. Gunaratne, Maria Makrides, Carmel T. Collins, Robert A. Gibson, Andrew J. McPhee, Thomas R. Sullivan, Jacqueline F. Gould, Tim J. Green, Lex W. Doyle, Peter G. Davis, Noel P. French, Paul B. Colditz, Karen Simmer, Scott A. Morris, Karen P. Best

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Docosahexaenoic acid (DHA, 22:6n-3) supplementation in the prenatal period is associated with a reduction in the incidence of some symptoms of allergic disease. Infants born preterm are at increased risk of allergic disease, but it is unknown if DHA supplementation reduces the risk of childhood allergies. Objectives: The aim of this study was to determine if supplementation of infants born at >33 wk gestation with high-DHA compared with standard-DHA enteral feeds decreases the incidence and severity of parent-reported allergic disease symptoms at a corrected age (CA) of 7 y. Methods: This study was a follow-up of an Australian multicenter randomized controlled trial. Infants were given high-DHA (-1% total fatty acids) or standard-DHA (-0.3% total fatty acids) enteral feeds from 2-4 d of postnatal age until 40 wk postmenstrual age. Parent-reported incidence of respiratory allergic disease symptoms including wheeze and rhinitis at 7 y CA were the main outcomes. Other outcomes included the incidence of eczema symptoms; severity of any symptoms; and the incidence of wheeze, rhinitis, rhinoconjunctivitis, and eczema from birth to 7 y CA. Results: Data were available for 569 of 657 (87%) children originally randomized. Symptoms of wheeze or rhinitis at 7 y CA did not differ between high-and standard-DHA groups [wheeze: RR: 1.10; 95% CI: 0.73, 1.65; P = 0.66; rhinitis: RR: 1.09; 95% CI: 0.81, 1.46; P = 0.59]. There was no difference in other allergic disease symptoms at 7 y CA or in the severity of symptoms. Parent-reported symptoms of wheeze, rhinitis, rhinoconjunctivitis, or eczema from birth to 7 y CA did not differ between the groups. Conclusions: High-dose DHA supplementation of infants born at >33 wk gestation did not alter allergic disease symptoms or severity at 7 y CA, or from birth to 7 y CA compared with standard-dose DHA.

Original languageEnglish
Pages (from-to)1600-1610
Number of pages11
JournalAmerican Journal of Clinical Nutrition
Volume109
Issue number6
DOIs
Publication statusPublished - 1 Jun 2019

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Docosahexaenoic Acids
Premature Infants
Rhinitis
Randomized Controlled Trials
Eczema
Incidence
Parturition
Small Intestine
Fatty Acids
Pregnancy
Hypersensitivity

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Gunaratne, Anoja W. ; Makrides, Maria ; Collins, Carmel T. ; Gibson, Robert A. ; McPhee, Andrew J. ; Sullivan, Thomas R. ; Gould, Jacqueline F. ; Green, Tim J. ; Doyle, Lex W. ; Davis, Peter G. ; French, Noel P. ; Colditz, Paul B. ; Simmer, Karen ; Morris, Scott A. ; Best, Karen P. / Docosahexaenoic acid supplementation of preterm infants and parent-reported symptoms of allergic disease at 7 years corrected age : Follow-up of a randomized controlled trial. In: American Journal of Clinical Nutrition. 2019 ; Vol. 109, No. 6. pp. 1600-1610.
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title = "Docosahexaenoic acid supplementation of preterm infants and parent-reported symptoms of allergic disease at 7 years corrected age: Follow-up of a randomized controlled trial",
abstract = "Background: Docosahexaenoic acid (DHA, 22:6n-3) supplementation in the prenatal period is associated with a reduction in the incidence of some symptoms of allergic disease. Infants born preterm are at increased risk of allergic disease, but it is unknown if DHA supplementation reduces the risk of childhood allergies. Objectives: The aim of this study was to determine if supplementation of infants born at >33 wk gestation with high-DHA compared with standard-DHA enteral feeds decreases the incidence and severity of parent-reported allergic disease symptoms at a corrected age (CA) of 7 y. Methods: This study was a follow-up of an Australian multicenter randomized controlled trial. Infants were given high-DHA (-1{\%} total fatty acids) or standard-DHA (-0.3{\%} total fatty acids) enteral feeds from 2-4 d of postnatal age until 40 wk postmenstrual age. Parent-reported incidence of respiratory allergic disease symptoms including wheeze and rhinitis at 7 y CA were the main outcomes. Other outcomes included the incidence of eczema symptoms; severity of any symptoms; and the incidence of wheeze, rhinitis, rhinoconjunctivitis, and eczema from birth to 7 y CA. Results: Data were available for 569 of 657 (87{\%}) children originally randomized. Symptoms of wheeze or rhinitis at 7 y CA did not differ between high-and standard-DHA groups [wheeze: RR: 1.10; 95{\%} CI: 0.73, 1.65; P = 0.66; rhinitis: RR: 1.09; 95{\%} CI: 0.81, 1.46; P = 0.59]. There was no difference in other allergic disease symptoms at 7 y CA or in the severity of symptoms. Parent-reported symptoms of wheeze, rhinitis, rhinoconjunctivitis, or eczema from birth to 7 y CA did not differ between the groups. Conclusions: High-dose DHA supplementation of infants born at >33 wk gestation did not alter allergic disease symptoms or severity at 7 y CA, or from birth to 7 y CA compared with standard-dose DHA.",
keywords = "?-3 Long-Chain Polyunsaturated Fatty Acids, Allergic Disease, Docosahexaenoic Acid, Prematurity, Preterm Infant",
author = "Gunaratne, {Anoja W.} and Maria Makrides and Collins, {Carmel T.} and Gibson, {Robert A.} and McPhee, {Andrew J.} and Sullivan, {Thomas R.} and Gould, {Jacqueline F.} and Green, {Tim J.} and Doyle, {Lex W.} and Davis, {Peter G.} and French, {Noel P.} and Colditz, {Paul B.} and Karen Simmer and Morris, {Scott A.} and Best, {Karen P.}",
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doi = "10.1093/ajcn/nqz010",
language = "English",
volume = "109",
pages = "1600--1610",
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Gunaratne, AW, Makrides, M, Collins, CT, Gibson, RA, McPhee, AJ, Sullivan, TR, Gould, JF, Green, TJ, Doyle, LW, Davis, PG, French, NP, Colditz, PB, Simmer, K, Morris, SA & Best, KP 2019, 'Docosahexaenoic acid supplementation of preterm infants and parent-reported symptoms of allergic disease at 7 years corrected age: Follow-up of a randomized controlled trial' American Journal of Clinical Nutrition, vol. 109, no. 6, pp. 1600-1610. https://doi.org/10.1093/ajcn/nqz010

Docosahexaenoic acid supplementation of preterm infants and parent-reported symptoms of allergic disease at 7 years corrected age : Follow-up of a randomized controlled trial. / Gunaratne, Anoja W.; Makrides, Maria; Collins, Carmel T.; Gibson, Robert A.; McPhee, Andrew J.; Sullivan, Thomas R.; Gould, Jacqueline F.; Green, Tim J.; Doyle, Lex W.; Davis, Peter G.; French, Noel P.; Colditz, Paul B.; Simmer, Karen; Morris, Scott A.; Best, Karen P.

In: American Journal of Clinical Nutrition, Vol. 109, No. 6, 01.06.2019, p. 1600-1610.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Docosahexaenoic acid supplementation of preterm infants and parent-reported symptoms of allergic disease at 7 years corrected age

T2 - Follow-up of a randomized controlled trial

AU - Gunaratne, Anoja W.

AU - Makrides, Maria

AU - Collins, Carmel T.

AU - Gibson, Robert A.

AU - McPhee, Andrew J.

AU - Sullivan, Thomas R.

AU - Gould, Jacqueline F.

AU - Green, Tim J.

AU - Doyle, Lex W.

AU - Davis, Peter G.

AU - French, Noel P.

AU - Colditz, Paul B.

AU - Simmer, Karen

AU - Morris, Scott A.

AU - Best, Karen P.

PY - 2019/6/1

Y1 - 2019/6/1

N2 - Background: Docosahexaenoic acid (DHA, 22:6n-3) supplementation in the prenatal period is associated with a reduction in the incidence of some symptoms of allergic disease. Infants born preterm are at increased risk of allergic disease, but it is unknown if DHA supplementation reduces the risk of childhood allergies. Objectives: The aim of this study was to determine if supplementation of infants born at >33 wk gestation with high-DHA compared with standard-DHA enteral feeds decreases the incidence and severity of parent-reported allergic disease symptoms at a corrected age (CA) of 7 y. Methods: This study was a follow-up of an Australian multicenter randomized controlled trial. Infants were given high-DHA (-1% total fatty acids) or standard-DHA (-0.3% total fatty acids) enteral feeds from 2-4 d of postnatal age until 40 wk postmenstrual age. Parent-reported incidence of respiratory allergic disease symptoms including wheeze and rhinitis at 7 y CA were the main outcomes. Other outcomes included the incidence of eczema symptoms; severity of any symptoms; and the incidence of wheeze, rhinitis, rhinoconjunctivitis, and eczema from birth to 7 y CA. Results: Data were available for 569 of 657 (87%) children originally randomized. Symptoms of wheeze or rhinitis at 7 y CA did not differ between high-and standard-DHA groups [wheeze: RR: 1.10; 95% CI: 0.73, 1.65; P = 0.66; rhinitis: RR: 1.09; 95% CI: 0.81, 1.46; P = 0.59]. There was no difference in other allergic disease symptoms at 7 y CA or in the severity of symptoms. Parent-reported symptoms of wheeze, rhinitis, rhinoconjunctivitis, or eczema from birth to 7 y CA did not differ between the groups. Conclusions: High-dose DHA supplementation of infants born at >33 wk gestation did not alter allergic disease symptoms or severity at 7 y CA, or from birth to 7 y CA compared with standard-dose DHA.

AB - Background: Docosahexaenoic acid (DHA, 22:6n-3) supplementation in the prenatal period is associated with a reduction in the incidence of some symptoms of allergic disease. Infants born preterm are at increased risk of allergic disease, but it is unknown if DHA supplementation reduces the risk of childhood allergies. Objectives: The aim of this study was to determine if supplementation of infants born at >33 wk gestation with high-DHA compared with standard-DHA enteral feeds decreases the incidence and severity of parent-reported allergic disease symptoms at a corrected age (CA) of 7 y. Methods: This study was a follow-up of an Australian multicenter randomized controlled trial. Infants were given high-DHA (-1% total fatty acids) or standard-DHA (-0.3% total fatty acids) enteral feeds from 2-4 d of postnatal age until 40 wk postmenstrual age. Parent-reported incidence of respiratory allergic disease symptoms including wheeze and rhinitis at 7 y CA were the main outcomes. Other outcomes included the incidence of eczema symptoms; severity of any symptoms; and the incidence of wheeze, rhinitis, rhinoconjunctivitis, and eczema from birth to 7 y CA. Results: Data were available for 569 of 657 (87%) children originally randomized. Symptoms of wheeze or rhinitis at 7 y CA did not differ between high-and standard-DHA groups [wheeze: RR: 1.10; 95% CI: 0.73, 1.65; P = 0.66; rhinitis: RR: 1.09; 95% CI: 0.81, 1.46; P = 0.59]. There was no difference in other allergic disease symptoms at 7 y CA or in the severity of symptoms. Parent-reported symptoms of wheeze, rhinitis, rhinoconjunctivitis, or eczema from birth to 7 y CA did not differ between the groups. Conclusions: High-dose DHA supplementation of infants born at >33 wk gestation did not alter allergic disease symptoms or severity at 7 y CA, or from birth to 7 y CA compared with standard-dose DHA.

KW - ?-3 Long-Chain Polyunsaturated Fatty Acids

KW - Allergic Disease

KW - Docosahexaenoic Acid

KW - Prematurity

KW - Preterm Infant

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U2 - 10.1093/ajcn/nqz010

DO - 10.1093/ajcn/nqz010

M3 - Article

VL - 109

SP - 1600

EP - 1610

JO - The American Journal of Clinical Nutrition

JF - The American Journal of Clinical Nutrition

SN - 0002-9165

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