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Neonatal Docosahexaenoic Acid in Preterm Infants and Intelligence at 5 Years

Gould JF, Makrides M, Gibson RA, Sullivan TR, McPhee AJ, Anderson PJ, Best KP, Sharp M, Cheong JLY, Opie GF, Travadi J, Bednarz JM, Davis PG, Simmer K, Doyle LW, Collins CT

The New England journal of medicine · 54 citas

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Cómo se estudió

Diseño
Ensayo controlado aleatorizado (clasificado por nuestro filtro de IA)
Estudiado en
Personas
Resultado principal
Marcadores de salud y funcionamiento

Quién lo pagó

Financiación
Financiado por la industria
Gobierno
National Health and Medical Research Council
Empresa
Nu-Mega Ingredients
Subvenciones
National Health and Medical Research Council (1146806); National Health and Medical Research Council (1022112)

Según 2 financiadores declarados.

Publicación

Publicado
2022-10-26 · N Engl J Med · vol. 387 · número 17 · págs. 1579–1588
Editorial
Massachusetts Medical Society
Citado
63 citas · más que el 98% de estudios similares · 5.9× el promedio de su campo
Impacto
Entre el 10 % más citado de su campo
Referencias
38 trabajos
Acceso
Lectura gratuita
Áreas de investigación
Fatty Acid Research and Health · Infant Nutrition and Health · Infant Development and Preterm Care
Palabras clave
Docosahexaenoic acid, Gestation, Pregnancy, First trimester, Obstetrics, Physiology, Medicine, Brain development, Pediatrics, Biology, Biochemistry, Polyunsaturated fatty acid, Fatty acid, Neuroscience
MeSH
humans, bronchopulmonary dysplasia, docosahexaenoic acids, emulsions, enteral nutrition, follow-up studies, intelligence, cognition, wechsler scales, dietary supplements, child, child, preschool, infant, infant, newborn, infant, premature, australia

16 autores

  • Jacqueline F. Gould🇦🇺South Australian Health and Medical Research Institute; The University of Adelaide
  • Maria Makrides🇦🇺South Australian Health and Medical Research Institute; The University of Adelaide
  • Robert Alan Gibson🇦🇺South Australian Health and Medical Research Institute; The University of Adelaide
  • Thomas Sullivan🇦🇺South Australian Health and Medical Research Institute; The University of Adelaide
  • Andrew J McPhee🇦🇺Women's and Children's Hospital; South Australian Health and Medical Research Institute; The University of Adelaide
  • Peter J. Anderson🇦🇺The University of Melbourne; South Australian Health and Medical Research Institute; Murdoch Children's Research Institute; Monash University
  • Karen P Best🇦🇺South Australian Health and Medical Research Institute; The University of Adelaide
  • Mary Sharp🇦🇺🇺🇸The University of Western Australia; Edward Hospital; South Australian Health and Medical Research Institute; Memorial Hospital
  • Jeanie L.Y. Cheong🇦🇺Royal Women's Hospital; South Australian Health and Medical Research Institute; Murdoch Children's Research Institute
  • Gillian F. Opie🇦🇺Mercy Hospital for Women; South Australian Health and Medical Research Institute
  • Javeed Travadi🇦🇺South Australian Health and Medical Research Institute; John Hunter Children's Hospital
  • Jana Bednarz🇦🇺South Australian Health and Medical Research Institute; The University of Adelaide
  • Peter Graham Davis🇦🇺Royal Women's Hospital; South Australian Health and Medical Research Institute; Murdoch Children's Research Institute
  • Karen Norrie Simmer🇦🇺The University of Western Australia; South Australian Health and Medical Research Institute
  • Lex William Doyle🇦🇺Royal Women's Hospital; South Australian Health and Medical Research Institute; Murdoch Children's Research Institute
  • Carmel T Collins🇦🇺South Australian Health and Medical Research Institute; The University of Adelaide

Resumen

El texto original del estudio, en el idioma en que se publicó.

Background

Docosahexaenoic acid (DHA) is a component of neural tissue. Because its accretion into the brain is greatest during the final trimester of pregnancy, infants born before 29 weeks' gestation do not receive the normal supply of DHA. The effect of this deficiency on subsequent cognitive development is not well understood.

Methods

We assessed general intelligence at 5 years in children who had been enrolled in a trial of neonatal DHA supplementation to prevent bronchopulmonary dysplasia. In the previous trial, infants born before 29 weeks' gestation had been randomly assigned in a 1:1 ratio to receive an enteral emulsion that provided 60 mg of DHA per kilogram of body weight per day or a control emulsion from the first 3 days of enteral feeds until 36 weeks of postmenstrual age or discharge home, whichever occurred first. Children from 5 of the 13 centers in the original trial were invited to undergo assessment with the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) at 5 years of corrected age. The primary outcome was the full-scale intelligence quotient (FSIQ) score. Secondary outcomes included the components of WPPSI.

Results

A total of 1273 infants underwent randomization in the original trial; of the 656 surviving children who had undergone randomization at the centers included in this follow-up study, 480 (73%) had an FSIQ score available - 241 in the DHA group and 239 in the control group. After imputation of missing data, the mean (±SD) FSIQ scores were 95.4±17.3 in the DHA group and 91.9±19.1 in the control group (adjusted difference, 3.45; 95% confidence interval, 0.38 to 6.53; P = 0.03). The results for secondary outcomes generally did not support that obtained for the primary outcome. Adverse events were similar in the two groups.

Conclusions

In infants born before 29 weeks' gestation who had been enrolled in a trial to assess the effect of DHA supplementation on bronchopulmonary dysplasia, the use of an enteral DHA emulsion until 36 weeks of postmenstrual age was associated with modestly higher FSIQ scores at 5 years of age than control feeding. (Funded by the Australian National Health and Medical Research Council and Nu-Mega Ingredients; N3RO Australian New Zealand Clinical Trials Registry number, ACTRN12612000503820.).

Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.

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