Journal Article

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

Chávez-Sánchez, Luis, Bernabe-García, Mariela, Villegas-Silva, Raúl, Rodríguez-Cruz, Maricela, Mateos-Sánchez, Leovigildo, Lara-Flores, Gabriel, Cruz-Reynoso, Leonardo, Aguilera-Joaquín, Augusto, Calder, Philip, Sánchez-García, Luisa

2021

Overview

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.

• Publisher: MDPI AG,MDPI
• Subject: Babies / Baby foods / Blood / body weight / Breastfeeding & lactation / Cancer therapies / Chromatography / Clinical trials / digestive tract / docosahexaenoic acid / Docosahexaenoic Acids - pharmacology / dosage / Double-Blind Method / enteral feeding / Enteral Nutrition / enterocolitis / Enterocolitis, Necrotizing - prevention & control / Enterocolitis, Neonatal necrotizing / Enterocolitis, Pseudomembranous / Erythrocytes - chemistry / Ethylenediaminetetraacetic acid / Fatty acids / Female / Gastrointestinal diseases / Gastrointestinal system / Gestational age / Health aspects / Hospitals / Humans / incidence / Infant, Newborn / Infant, Premature / Infants (Premature) / Inflammatory bowel disease / Male / Mexico / Milk, Human - chemistry / morbidity / Mortality / Necrosis / Neonatal intensive care / Newborn babies / Omega-3 fatty acids / Premature babies / protocols / randomized clinical trials / risk / Software / sunflower oil / United Kingdom / Unsaturated fatty acids / Vegetable oils