Efficacy of Docosahexaenoic Acid for the Prevention of Necrotizing Enterocolitis in Preterm Infants: A Randomized Clinical Trial

Nutrients

Raúl Villegas-Silva¹  PhilipC. Calder²  AugustoR. Aguilera-Joaquín³  Leonardo Cruz-Reynoso³  Luisa Sánchez-García³  Gabriel Lara-Flores⁴  Leovigildo Mateos-Sánchez⁴  Luis Chávez-Sánchez⁵  Maricela Rodríguez-Cruz⁶  Mariela Bernabe-García⁶ 

[1]Neonatología, Hospital Infantil de México Federico Gómez, México City 06720, Mexico

[2]School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK

[3]Unidad de Cuidados Intensivos Neonatales, UMAE Hospital de Gineco-Obstetricia No.3, CMN La Raza, Instituto Mexicano del Seguro Social, México City 02990, Mexico

[4]Unidad de Cuidados Intensivos Neonatales, UMAE Hospital de Gineco-Obstetricia N° 4 “Luis Castelazo Ayala”, Instituto Mexicano del Seguro Social, México City 01090, Mexico

[5]Unidad de Investigación Médica en Inmunología, UMAE Hospital de Pediatría, CMN Siglo XXI, Instituto Mexicano del Seguro Social, México City 06720, Mexico

[6]Unidad de Investigación Médica en Nutrición, UMAE Hospital de Pediatría, CMN Siglo XXI, Instituto Mexicano del Seguro Social, México City 06720, Mexico

关键词: very low birth weight;    infant;    prematurity;    necrotizing enterocolitis;    inflammation;    DHA;   

DOI  :  10.3390/nu13020648

来源: DOAJ

【 摘 要 】

Necrotizing enterocolitis (NEC) is an inflammatory bowel disease and a leading cause of morbidity and mortality in preterm infants. In this study, a randomized double-blind parallel-group (1:1) trial was carried out in two neonatal intensive care units of two tertiary hospitals. Two hundred and twenty-five preterm newborns with an expected functional gastrointestinal tract were recruited and received an enteral dose of 75 mg of docosahexaenoic acid (DHA)/kg body weight or high-oleic sunflower oil daily for 14 days from the first enteral feed after birth. Confirmed NEC was evaluated with Bell’s scale from stage ≥ IIa. Two hundred and fourteen randomized infants were analyzed in terms of the intent-to-treat (DHA-group: n = 105; control-group: n = 109); data for two hundred infants were analysed per protocol. Confirmed NEC was lower in infants from the DHA-group compared with the control-group (0/100 vs. 7/100; p = 0.007), with RR = 0.93 (95% CI 0.881 to 0.981), risk difference = −7%, (95% CI −12.00 to −1.99), and number needed-to-treat = 15 (95% CI 8.3 to 50). Intent-to-treat analysis showed a lower level of treatment failure in the DHA-group compared with the control-group (6/105 (6%) vs. 16/109 (15%); p = 0.03, RR = 0.905, (95% CI 0.826 to 0.991)). The results after multivariate-regression analysis remained significant. Adverse events (apart from the incidence of NEC) were not different between groups. A daily dose of DHA for 14 days starting with the first enteral feed may prevent NEC in preterm infants.

【 授权许可】

Unknown