Enteral supplementation with arachidonic and docosahexaenoic acid and pulmonary outcome in extremely preterm infants
Wackernagel, Dirk ; Nilsson, Anders K. ; Sjöbom, Ulrika ; Hellström, Ann LU ; Klevebro, Susanna and Hansen-Pupp, Ingrid LU
(2024)
In Prostaglandins Leukotrienes and Essential Fatty Acids
201.
- Abstract
Enteral supplementation with arachidonic acid (AA) and docosahexaenoic acid (DHA) in extremely preterm infants has shown beneficial effects on retinopathy of prematurity and pulmonary outcome whereas exclusive DHA supplementation has been associated with increased pulmonary morbidity. This secondary analysis evaluates pulmonary outcome in 204 extremely preterm infants, randomized to receive AA (100 mg/kg/day) and DHA (50 mg/kg/day) enterally from birth until term age or standard care. Pulmonary morbidity was primarily assessed based on severity of bronchopulmonary dysplasia (BPD). Serum levels of AA and DHA during the first 28 days were analysed in relation to BPD. Supplementation with AA:DHA was not associated with increased BPD... (More)
Enteral supplementation with arachidonic acid (AA) and docosahexaenoic acid (DHA) in extremely preterm infants has shown beneficial effects on retinopathy of prematurity and pulmonary outcome whereas exclusive DHA supplementation has been associated with increased pulmonary morbidity. This secondary analysis evaluates pulmonary outcome in 204 extremely preterm infants, randomized to receive AA (100 mg/kg/day) and DHA (50 mg/kg/day) enterally from birth until term age or standard care. Pulmonary morbidity was primarily assessed based on severity of bronchopulmonary dysplasia (BPD). Serum levels of AA and DHA during the first 28 days were analysed in relation to BPD. Supplementation with AA:DHA was not associated with increased BPD severity, adjusted OR 1.48 (95 % CI 0.85–2.61), nor with increased need for respiratory support at post menstrual age 36 weeks or duration of oxygen supplementation. Every 1 % increase in AA was associated with a reduction of BPD severity, adjusted OR 0.73 (95 % CI 0.58–0.92). In conclusion, in this study, with limited statistical power, enteral supplementation with AA:DHA was not associated with an increased risk of pulmonary morbidity, but higher levels of AA were associated with less severe BPD. Whether AA or the combination of AA and DHA have beneficial roles in the immature lung needs further research.
(Less)
- author
- Wackernagel, Dirk
; Nilsson, Anders K.
; Sjöbom, Ulrika
; Hellström, Ann
LU
; Klevebro, Susanna
and Hansen-Pupp, Ingrid
LU
- organization
- publishing date
- 2024-02
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Arachidonic acid, Bronchopulmonary dysplasia, Docosahexaenoic acid, Infants, Preterm, Pulmonary outcome
- in
- Prostaglandins Leukotrienes and Essential Fatty Acids
- volume
- 201
- article number
- 102613
- publisher
- Elsevier
- external identifiers
-
- pmid:38377640
- scopus:85185597088
- ISSN
- 0952-3278
- DOI
- 10.1016/j.plefa.2024.102613
- language
- English
- LU publication?
- yes
- id
- de822ed3-d913-46b1-a46f-87baa356ff63
- date added to LUP
- 2024-03-25 15:25:01
- date last changed
- 2024-04-22 20:28:16
@article{de822ed3-d913-46b1-a46f-87baa356ff63,
abstract = {{<p>Enteral supplementation with arachidonic acid (AA) and docosahexaenoic acid (DHA) in extremely preterm infants has shown beneficial effects on retinopathy of prematurity and pulmonary outcome whereas exclusive DHA supplementation has been associated with increased pulmonary morbidity. This secondary analysis evaluates pulmonary outcome in 204 extremely preterm infants, randomized to receive AA (100 mg/kg/day) and DHA (50 mg/kg/day) enterally from birth until term age or standard care. Pulmonary morbidity was primarily assessed based on severity of bronchopulmonary dysplasia (BPD). Serum levels of AA and DHA during the first 28 days were analysed in relation to BPD. Supplementation with AA:DHA was not associated with increased BPD severity, adjusted OR 1.48 (95 % CI 0.85–2.61), nor with increased need for respiratory support at post menstrual age 36 weeks or duration of oxygen supplementation. Every 1 % increase in AA was associated with a reduction of BPD severity, adjusted OR 0.73 (95 % CI 0.58–0.92). In conclusion, in this study, with limited statistical power, enteral supplementation with AA:DHA was not associated with an increased risk of pulmonary morbidity, but higher levels of AA were associated with less severe BPD. Whether AA or the combination of AA and DHA have beneficial roles in the immature lung needs further research.</p>}},
author = {{Wackernagel, Dirk and Nilsson, Anders K. and Sjöbom, Ulrika and Hellström, Ann and Klevebro, Susanna and Hansen-Pupp, Ingrid}},
issn = {{0952-3278}},
keywords = {{Arachidonic acid; Bronchopulmonary dysplasia; Docosahexaenoic acid; Infants; Preterm; Pulmonary outcome}},
language = {{eng}},
publisher = {{Elsevier}},
series = {{Prostaglandins Leukotrienes and Essential Fatty Acids}},
title = {{Enteral supplementation with arachidonic and docosahexaenoic acid and pulmonary outcome in extremely preterm infants}},
url = {{http://dx.doi.org/10.1016/j.plefa.2024.102613}},
doi = {{10.1016/j.plefa.2024.102613}},
volume = {{201}},
year = {{2024}},
}