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

Autor: Leonardo Cruz-Reynoso, Luis Chávez-Sánchez, Mariela Bernabe-García, Gabriel Lara-Flores, Augusto R Aguilera-Joaquín, Leovigildo Mateos-Sánchez, Raúl Villegas-Silva, Philip C. Calder, Maricela Rodríguez-Cruz, Luisa Sánchez-García
Rok vydání: 2021
Předmět:
Male
medicine.medical_specialty
Erythrocytes
Neonatal intensive care unit
Docosahexaenoic Acids
very low birth weight
lcsh:TX341-641
Gastroenterology
Enteral administration
Inflammatory bowel disease
Article
law.invention
03 medical and health sciences
Enteral Nutrition
0302 clinical medicine
Double-Blind Method
Randomized controlled trial
Enterocolitis
Necrotizing
law
030225 pediatrics
Internal medicine
Intensive care
medicine
Humans
030212 general & internal medicine
Adverse effect
necrotizing enterocolitis
Nutrition and Dietetics
Milk
Human
business.industry
Incidence (epidemiology)
prematurity
Infant
Newborn
n-3 fatty acids
medicine.disease
infant
neonatal intensive care unit
hospital stay
DHA
inflammation
Necrotizing enterocolitis
Female
omega-3
business
lcsh:Nutrition. Foods and food supply
Infant
Premature
Food Science
Zdroj: Nutrients
Volume 13
Issue 2
Nutrients, Vol 13, Iss 648, p 648 (2021)
ISSN: 2072-6643
Popis: 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.
Databáze: OpenAIRE
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