Mireille Guillot1, Anne Synnes2, Etienne Pronovost1, Mosarrat Qureshi3, Thierry Daboval4, Georges Caouette1, François Olivier5, Julie Bartholomew6, Ibrahim Mohamed7, Edith Massé8, Jehier Afifi9, Leonora Hendson10, Brigitte Lemyre4, Thuy Mai Luu7, Lannae Strueby11, Zenon Cieslak12, Kamran Yusuf10, Gustavo Pelligra13, Thierry Ducruet14, Aissatou Bintou Khairy Thilor Ndiaye1, Georgina Angoa1, Thibaut Sériès15, Bruno Piedboeuf1, Anne Monique Nuyt7, William Fraser16, Benoît Mâsse14,17, Thierry Lacaze-Masmonteil10, Pascal M Lavoie2, Isabelle Marc1. 1. Faculty of Medicine, Department of Pediatrics, Centre Hospitalier Universitaire de Québec-Université Laval, Québec City, Quebec, Canada. 2. Department of Pediatrics, Division of Neonatology, University of British Columbia, Vancouver, British Columbia, Canada. 3. Division of Neonatology, Royal Alexandra Hospital, Edmonton, Alberta, Canada. 4. Department of Pediatrics, Division of Neonatology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada. 5. Division of Neonatology, Montreal Children's Hospital, and. 6. Department of Neonatology, Jewish General Hospital, McGill University, Montréal, Quebec, Canada. 7. Department of Pediatrics, Université de Montréal, Centre Hospitalier Universitaire Sainte-Justine, Montréal, Quebec, Canada. 8. Department of Pediatrics, Université de Sherbrooke, Hôpital Fleurimont, Sherbrooke, Quebec, Canada. 9. Department of Pediatrics, Dalhousie University, Halifax, Novia Scotia, Canada. 10. Department of Pediatrics, Section of Neonatology, Cumming School of Medicine, University of Calgary, Alberta, Calgary, Canada. 11. Department of Pediatrics, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. 12. Department of Pediatrics, Royal Columbian Hospital, New Westminster, British Columbia Canada. 13. Department of Maternity Care & Pediatrics, Victoria General Hospital, Island Health, Victoria, British Columbia, Canada. 14. Unité de Recherche Clinique Appliquée, Centre Hospitalier Universitaire Sainte-Justine, Montréal, Quebec, Canada. 15. School of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada. 16. Department of Obstetrics and Gynecology, Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec Canada. 17. School of Public Health, Université de Montréal, Montréal, Quebec, Canada.
Abstract
OBJECTIVES: To determine whether maternal supplementation with high-dose docosahexaenoic acid (DHA) in breastfed, very preterm neonates improves neurodevelopmental outcomes at 18 to 22 months' corrected age (CA). METHODS: Planned follow-up of a randomized, double-blind, placebo-controlled, multicenter trial to compare neurodevelopmental outcomes in breastfed, preterm neonates born before 29 weeks' gestational age (GA). Lactating mothers were randomized to receive either DHA-rich algae oil or a placebo within 72 hours of delivery until 36 weeks' postmenstrual age. Neurodevelopmental outcomes were assessed with the Bayley Scales of Infant and Toddler Development third edition (Bayley-III) at 18 to 22 months' CA. Planned subgroup analyses were conducted for GA (<27 vs ≥27 weeks' gestation) and sex. RESULTS: Among the 528 children enrolled, 457 (86.6%) had outcomes available at 18 to 22 months' CA (DHA, N = 234, placebo, N = 223). The mean differences in Bayley-III between children in the DHA and placebo groups were -0.07 (95% confidence interval [CI] -3.23 to 3.10, P = .97) for cognitive score, 2.36 (95% CI -1.14 to 5.87, P = .19) for language score, and 1.10 (95% CI -2.01 to 4.20, P = .49) for motor score. The association between treatment and the Bayley-III language score was modified by GA at birth (interaction P = .07). Neonates born <27 weeks' gestation exposed to DHA performed better on the Bayley-III language score, compared with the placebo group (mean difference 5.06, 95% CI 0.08-10.03, P = .05). There was no interaction between treatment group and sex. CONCLUSIONS: Maternal DHA supplementation did not improve neurodevelopmental outcomes at 18 to 22 months' CA in breastfed, preterm neonates, but subgroup analyses suggested a potential benefit for language in preterm neonates born before 27 weeks' GA.
OBJECTIVES: To determine whether maternal supplementation with high-dose docosahexaenoic acid (DHA) in breastfed, very preterm neonates improves neurodevelopmental outcomes at 18 to 22 months' corrected age (CA). METHODS: Planned follow-up of a randomized, double-blind, placebo-controlled, multicenter trial to compare neurodevelopmental outcomes in breastfed, preterm neonates born before 29 weeks' gestational age (GA). Lactating mothers were randomized to receive either DHA-rich algae oil or a placebo within 72 hours of delivery until 36 weeks' postmenstrual age. Neurodevelopmental outcomes were assessed with the Bayley Scales of Infant and Toddler Development third edition (Bayley-III) at 18 to 22 months' CA. Planned subgroup analyses were conducted for GA (<27 vs ≥27 weeks' gestation) and sex. RESULTS: Among the 528 children enrolled, 457 (86.6%) had outcomes available at 18 to 22 months' CA (DHA, N = 234, placebo, N = 223). The mean differences in Bayley-III between children in the DHA and placebo groups were -0.07 (95% confidence interval [CI] -3.23 to 3.10, P = .97) for cognitive score, 2.36 (95% CI -1.14 to 5.87, P = .19) for language score, and 1.10 (95% CI -2.01 to 4.20, P = .49) for motor score. The association between treatment and the Bayley-III language score was modified by GA at birth (interaction P = .07). Neonates born <27 weeks' gestation exposed to DHA performed better on the Bayley-III language score, compared with the placebo group (mean difference 5.06, 95% CI 0.08-10.03, P = .05). There was no interaction between treatment group and sex. CONCLUSIONS: Maternal DHA supplementation did not improve neurodevelopmental outcomes at 18 to 22 months' CA in breastfed, preterm neonates, but subgroup analyses suggested a potential benefit for language in preterm neonates born before 27 weeks' GA.
Authors: Suzan S Asfour; Belal Alshaikh; Latifah AlMahmoud; Haider H Sumaily; Nabeel A Alodhaidan; Mousa Alkhourmi; Hissah A Abahussain; Thanaa M Khalil; Bushra A Albeshri; Aroub A Alhamidi; Maha R Al-Anazi; Raneem S Asfour; Mountasser M Al-Mouqdad Journal: Nutrients Date: 2022-09-23 Impact factor: 6.706