Association of Docosahexaenoic Acid and Arachidonic Acid Serum Levels With Retinopathy of Prematurity in Preterm Infants
Hellström A, Pivodic A, Gränse L, Lundgren P, Sjöbom U, Nilsson AK, Söderling H, Hård AL, Smith LEH, Löfqvist CA
JAMA network open · 55 citations
How it was studied
- Design
- Cohort study (indexed by PubMed)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
Who paid for it
- Funding
- Independent funding
- Government
- National Eye Institute
- Government
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
- Government
- NICHD NIH HHS
- Government
- NEI NIH HHS
- Grants
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (P50‐HD105351); National Eye Institute (R01EY017017); Eunice Kennedy Shriver National Institute of Child Health and Human Development (U54HD090255); National Eye Institute (R01 EY030904)
Based on 4 listed funder(s).
Publication
- Published
- 2021-10-14 · JAMA Netw Open · vol. 4 · issue 10 · p. e2128771
- Publisher
- American Medical Association
- Cited
- 63 citations · more than 97% of similar papers · 6.1× the field average
- Impact
- Top 10% most cited in its field
- References
- 46 works
- Access
- Open access (journal) · CC-BY
- Research areas
- Retinopathy of Prematurity Studies · Fatty Acid Research and Health · Neonatal Respiratory Health Research
- Keywords
- Retinopathy of prematurity, Docosahexaenoic acid, Arachidonic acid, Association (psychology), Medicine, Internal medicine, Gestational age, Biology, Psychology, Biochemistry, Fatty acid, Pregnancy, Polyunsaturated fatty acid, Genetics
- MeSH
- humans, retinopathy of prematurity, docosahexaenoic acids, arachidonic acid, logistic models, odds ratio, cohort studies, gestational age, infant, infant, newborn, infant, premature, sweden, female, male
10 authors
From SE, US
- Ann HellströmUniversity of Gothenburg
- Aldina PivodicUniversity of Gothenburg
- Lotta GränseLund University; Skåne University Hospital
- Pia LundgrenÖrebro University; University of Gothenburg
- Ulrika SjöbomUniversity of Gothenburg
- Anders NilssonUniversity of Gothenburg
Abstract
Importance
Supplementing preterm infants with long-chain polyunsaturated fatty acids (LC-PUFA) has been inconsistent in reducing the severity and incidence of retinopathy of prematurity (ROP). Furthermore, few studies have measured the long-term serum lipid levels after supplementation.
Objective
To assess whether ROP severity is associated with serum levels of LC-PUFA, especially docosahexaenoic acid (DHA) and arachidonic acid (AA), during the first 28 postnatal days.
Design, setting, and participants
This cohort study analyzed the Mega Donna Mega study, a randomized clinical trial that provided enteral fatty acid supplementation at 3 neonatal intensive care units in Sweden. Infants included in this cohort study were born at a gestational age of less than 28 weeks between December 20, 2016, and August 6, 2019.
Main outcomes and measures
Severity of ROP was classified as no ROP, mild or moderate ROP (stage 1-2), or severe ROP (stage 3 and type 1). Serum phospholipid fatty acids were measured through gas chromatography-mass spectrometry. Ordinal logistic regression, with a description of unadjusted odds ratio (OR) as well as gestational age- and birth weight-adjusted ORs and 95% CIs, was used. Areas under the curve were used to calculate mean daily levels of fatty acids during postnatal days 1 to 28. Blood samples were obtained at the postnatal ages of 1, 3, 7, 14, and 28 days.
Results
A total of 175 infants were included in analysis. Of these infants, 99 were boys (56.6%); the median (IQR) gestational age was 25 weeks 5 days (24 weeks 3 days to 26 weeks 6 days), and the median (IQR) birth weight was 785 (650-945) grams. A higher DHA proportion was seen in infants with no ROP compared with those with mild or moderate ROP or severe ROP (OR per 0.5-molar percentage increase, 0.49 [95% CI, 0.36-0.68]; gestational age- and birth weight-adjusted OR, 0.66 [95% CI, 0.46-0.93]). The corresponding adjusted OR for AA levels per 1-molar percentage increase was 0.83 (95% CI, 0.66-1.05). The association between DHA levels and ROP severity appeared only in infants with sufficient AA levels, suggesting that a mean daily minimum level of 7.8 to 8.3 molar percentage of AA was necessary for a detectable association between DHA level and less severe ROP.
Conclusions and relevance
This cohort study found that higher mean daily serum levels of DHA during the first 28 postnatal days were associated with less severe ROP even after adjustment for known risk factors, but only in infants with sufficiently high AA levels. Further studies are needed to identify LC-PUFA supplementation strategies that may prevent ROP and other morbidities.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
Community trust
Loading…
How much do you trust this study's findings?
Comments
Sign in to rate, comment on or flag this study.Sign inSomething wrong here?
Flag this study if its information, labels or funding look wrong. An editor reviews every flag.
Sign in to rate, comment on or flag this study.Sign inEducational information about published research. Not medical advice, and not a recommendation to start or stop anything.