Essential Fatty Acid Supplementation and Early Inflammation in Preterm Infants: Secondary Analysis of a Randomized Clinical Trial.


Journal

Neonatology
ISSN: 1661-7819
Titre abrégé: Neonatology
Pays: Switzerland
ID NLM: 101286577

Informations de publication

Date de publication:
2023
Historique:
received: 24 01 2023
accepted: 06 03 2023
medline: 22 8 2023
pubmed: 1 5 2023
entrez: 30 4 2023
Statut: ppublish

Résumé

Postnatal inflammation is associated with increased mortality and adverse outcomes in preterm infants. The essential fatty acids arachidonic acid (ARA) and docosahexaenoic acid (DHA) are precursors of lipid mediators with a key role in resolving inflammation. Our aim was to investigate the effect of ARA and DHA supplementation on systemic inflammation in very preterm infants and to identify clinical factors associated with early inflammation. Secondary analysis of data from a randomized clinical trial (ImNuT study). Infants with gestational age (GA) less than 29 weeks were randomized to receive a daily enteral supplement with ARA 100 mg/kg and DHA 50 mg/kg (ARA:DHA group) or MCT oil (control group) from the second day of life to 36 weeks postmenstrual age. ARA, DHA, and four proinflammatory cytokines (IL-1β, IL-6, IL-8, and TNF-α) were analyzed in repeated dried blood samples from birth to day 28 and the area under the curve (AUC) for each variable was calculated. The intention to treat population included 120 infants with mean (SD) GA 26.4 (1.7). The ARA:DHA group had significantly lower IL-6 levels from day 3 to day 28 compared to the control group, mean difference AUC log10 (95% CI): 0.16 (0.03-0.30) pg/mL, p = 0.018. There was no correlation between ARA or DHA blood concentrations and cytokine levels. Having a low gestational age was independently associated with increased levels of all cytokines during the first 4 weeks of life. Enhanced supplementation with ARA and DHA may modulate inflammation in very preterm infants.

Identifiants

pubmed: 37121228
pii: 000530129
doi: 10.1159/000530129
pmc: PMC10614433
doi:

Substances chimiques

Interleukin-6 0
Docosahexaenoic Acids 25167-62-8
Arachidonic Acid 27YG812J1I
Cytokines 0

Types de publication

Randomized Controlled Trial Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

465-472

Informations de copyright

© 2023 The Author(s). Published by S. Karger AG, Basel.

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Auteurs

Kristina Wendel (K)

Department of Neonatal Intensive Care, Oslo University Hospital, Oslo, Norway.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

Gunnthorunn Gunnarsdottir (G)

Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Department of Pediatric Neurology, Oslo University Hospital, Oslo, Norway.

Marlen Fossan Aas (M)

Department of Neonatal Intensive Care, Oslo University Hospital, Oslo, Norway.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

Åsbjørn Schumacher Westvik (ÅS)

Department of Neonatal Intensive Care, Oslo University Hospital, Oslo, Norway.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

Are Hugo Pripp (AH)

Oslo Centre of Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway.

Drude Fugelseth (D)

Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

Tom Stiris (T)

Department of Neonatal Intensive Care, Oslo University Hospital, Oslo, Norway.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

Sissel Jennifer Moltu (SJ)

Department of Neonatal Intensive Care, Oslo University Hospital, Oslo, Norway.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

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