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Enteral docosahexaenoic acid and retinopathy of prematurity: a randomized clinical trial

Enteral docosahexaenoic acid and retinopathy of prematurity: a randomized clinical trial
Enteral docosahexaenoic acid and retinopathy of prematurity: a randomized clinical trial
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.
0148-6071
874-882
Bernabe García, Mariela
0874ce55-deb3-46ef-9b81-d2cea7bd99cc
Villegas-Silva, Raúl
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Villavicencio-Torres, Astrid
9a93dc52-3198-42da-9eb7-d6e02bac1ecf
Calder, Philip
1797e54f-378e-4dcb-80a4-3e30018f07a6
Rodríguez-Cruz, Maricela
f79b9cb0-404f-447d-a3bc-538eb31a4787
Maldonado-Hernándeza, Jorge
50443f44-9e5c-47a0-ba4b-9e3b9ee71cb3
Macías-Loaiza, Denisse
e386031c-c960-4d8f-b2e1-424efe826efd
López-Alarcón, Mardia
df42c486-0d17-4162-bccb-a8f9447a43c8
Inda-Icaza, Patricia
55f3b522-e19b-4a2e-9702-dc1480a3f2fa
Cruz-Reynoso, Leonardo
e30264c8-2eab-4732-8a55-28f1c26aaab5
Bernabe García, Mariela
0874ce55-deb3-46ef-9b81-d2cea7bd99cc
Villegas-Silva, Raúl
0ab9f4a2-d58d-4215-b0c0-17e321a8089b
Villavicencio-Torres, Astrid
9a93dc52-3198-42da-9eb7-d6e02bac1ecf
Calder, Philip
1797e54f-378e-4dcb-80a4-3e30018f07a6
Rodríguez-Cruz, Maricela
f79b9cb0-404f-447d-a3bc-538eb31a4787
Maldonado-Hernándeza, Jorge
50443f44-9e5c-47a0-ba4b-9e3b9ee71cb3
Macías-Loaiza, Denisse
e386031c-c960-4d8f-b2e1-424efe826efd
López-Alarcón, Mardia
df42c486-0d17-4162-bccb-a8f9447a43c8
Inda-Icaza, Patricia
55f3b522-e19b-4a2e-9702-dc1480a3f2fa
Cruz-Reynoso, Leonardo
e30264c8-2eab-4732-8a55-28f1c26aaab5

Bernabe García, Mariela, Villegas-Silva, Raúl, Villavicencio-Torres, Astrid, Calder, Philip, Rodríguez-Cruz, Maricela, Maldonado-Hernándeza, Jorge, Macías-Loaiza, Denisse, López-Alarcón, Mardia, Inda-Icaza, Patricia and Cruz-Reynoso, Leonardo (2019) Enteral docosahexaenoic acid and retinopathy of prematurity: a randomized clinical trial. Journal of Parenteral and Enteral Nutrition, 43 (7), 874-882. (doi:10.1002/jpen.1497).

Record type: Article

Abstract

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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Manucript DHA & ROP JPEN 2018-08-240.R1 - Accepted Manuscript
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Fig.1: CONSORT Flow Diagram JPEN 2018-08-240 - Accepted Manuscript
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Tables: DHA & ROP JPEN 2018-08-240.R1 - Accepted Manuscript
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More information

Accepted/In Press date: 1 December 2018
e-pub ahead of print date: 6 January 2019
Published date: 1 September 2019

Identifiers

Local EPrints ID: 426848
URI: http://eprints.soton.ac.uk/id/eprint/426848
ISSN: 0148-6071
PURE UUID: 9f9c9755-24cf-4a52-896d-2c78329a0d0a
ORCID for Philip Calder: ORCID iD orcid.org/0000-0002-6038-710X

Catalogue record

Date deposited: 13 Dec 2018 17:30
Last modified: 26 Nov 2021 05:12

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Contributors

Author: Mariela Bernabe García
Author: Raúl Villegas-Silva
Author: Astrid Villavicencio-Torres
Author: Philip Calder ORCID iD
Author: Maricela Rodríguez-Cruz
Author: Jorge Maldonado-Hernándeza
Author: Denisse Macías-Loaiza
Author: Mardia López-Alarcón
Author: Patricia Inda-Icaza
Author: Leonardo Cruz-Reynoso

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