Possible benefit in omega-3 supplementation for extremely preterm infants

Image: PD

1. This systematic review did not find an association between omega-3 fatty acid supplementation and decreased incidence of bronchopulmonary dysplasia (BPD) among neonates.

2. In a subset of extremely premature infants, effects of omega-3 fatty acid supplementation were still non-significant, but trended towards a lower risk of BPD and necrotizing enterocolitis.

Evidence Rating Level: 2 (Good)

Study Rundown: Bronchopulmonary dysplasia (BPD) is a common and significant complication of premature birth, resulting in long-term respiratory difficulties and the need for supplemental oxygen. Long-chain polyunsaturated fatty acids (LCPUFAs), including omega-3 fatty acids, have been previously implicated in inflammatory modulation. Dysregulation in the inflammatory cascade is postulated as a contributor to BPD, and research has indicated that premature infants are LCPUFA-deficient. As such, this systematic review gathered multiple studies analyzing the effects of omega-3 fatty acid supplementation on neonates. Researchers found that omega-3 fatty acid supplementation was not associated with decreased BPD in neonates overall, but may show a benefit for BPD and nectrotizing enterocolitis in extremely premature infants. This systematic review was greatly limited by homogeneity amongst included studies, including a lack of randomized control trials directly comparing supplementation to placebo in extremely premature infants. The review however, indicated no adverse effects to supplementation, and sets up a platform for future trials of LCPUFA supplementation in neonates.

Click to read the study published today in Pediatrics

Relevant Reading: Docosahexaenoic acid status of preterm infants at birth and following feeding with human milk or formula

In-Depth [systematic review]: This systematic review included 18 randomized control trials and 6 observational studies analyzing the effects of omega-3 LCPUFA supplementation in neonates; individual trials comprised of a range of gestational age, omega-3 derivative (fish, algae, eggs), and route of administration in addition to differences in study design. Overall, omega-3 fatty acid supplementation was not associated with a decreased risk of BPD (n = 2809, pooled RR = 0.97, 95% CI: 0.82 – 1.13). In extremely preterm infants ≤ 32 weeks gestational age, effects of omega-3 fatty acid supplementation were still non-significant, but trended towards reduced risk for both BPD (n= 1156, pooled RR = 0.88, 95% CI: 0.74 – 1.05,) and necrotizing enterocolitis (n = 900, pooled RR = 0.50, 95% CI: 0.23 – 1.10).

More from this author: PTSD symptoms in Boston-area youth after marathon bombing, AAP issues update on iodine deficiency and associated pollutants, Duration of post-concussive symptoms identified in pediatric patients, AAP issues new guidelines for freestanding urgent care clinics, Home oxygen therapy for mild bronchiolitis explored

©2012-2014 2minutemedicine.com. All rights reserved. No works may be reproduced without expressed written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors, editors, staff or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT.