Mariela Bernabe-García1, Raúl Villegas-Silva2, Astrid Villavicencio-Torres3, Philip C Calder4,5, Maricela Rodríguez-Cruz1, Jorge Maldonado-Hernández1, Denisse Macías-Loaiza1, Mardia López-Alarcón1, Patricia Inda-Icaza6, Leonardo Cruz-Reynoso7. 1. Unidad de Investigación Médica en Nutrición, Hospital de Pediatría, Centro Médico Nacional, Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México. 2. Neonatología, Hospital Infantil de México Federico Gómez, México City, México. 3. Oftalmología Pediátrica, General Hospital, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Ciudad de México, México. 4. Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK. 5. National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton National Health Service Foundation Trust and University of Southampton, Southampton, UK. 6. Nutrición, Universidad Anáhuac México, Campus Norte, Huixquilucan, Estado de México, México. 7. División de Pediatría, Hospital de Gineco-Obstetricia No.3, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Ciudad de México, México.
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.
RCT Entities:
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 oleicsunflower 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.
Authors: Menaka C Thounaojam; Ravirajsinh N Jadeja; Shubhra Rajpurohit; Diana R Gutsaeva; Brian K Stansfield; Pamela M Martin; Manuela Bartoli Journal: J Clin Med Date: 2020-06-19 Impact factor: 4.241
Authors: Ann Hellström; William Hellström; Gunnel Hellgren; Lois E H Smith; Henri Puttonen; Ing-Marie Fyhr; Karin Sävman; Anders K Nilsson; Susanna Klevebro Journal: Nutrients Date: 2020-07-05 Impact factor: 5.717
Authors: Mariela Bernabe-García; Philip C Calder; Raúl Villegas-Silva; Maricela Rodríguez-Cruz; Luis Chávez-Sánchez; Leonardo Cruz-Reynoso; Leovigildo Mateos-Sánchez; Gabriel Lara-Flores; Augusto R Aguilera-Joaquín; Luisa Sánchez-García Journal: Nutrients Date: 2021-02-17 Impact factor: 5.717
Authors: Ann Hellström; Aldina Pivodic; Lotta Gränse; Pia Lundgren; Ulrika Sjöbom; Anders K Nilsson; Helena Söderling; Anna-Lena Hård; Lois E H Smith; Chatarina Alice Löfqvist Journal: JAMA Netw Open Date: 2021-10-01
Authors: Joselyn M Adams; Christina J Valentine; Rebekah A Karns; Lynette K Rogers; Masahiko Murase; Grace N Fowler; Laurie A Nommsen-Rivers Journal: J Nutr Date: 2022-06-09 Impact factor: 4.687