Enteral Docosahexaenoic Acid and Retinopathy of Prematurity: A Randomized Clinical Trial

Area of Science:

• Neonatal ophthalmology
• Nutritional science
• Clinical research

Background:

• Retinopathy of prematurity (ROP) is a leading cause of blindness in low-birth-weight preterm infants.
• Docosahexaenoic acid (DHA) shows promise in experimental models, but clinical results from parenteral nutrition are inconsistent.
• The efficacy of enteral DHA for ROP prevention and severity reduction requires further investigation.

Purpose of the Study:

• To evaluate the effect of enteral docosahexaenoic acid (DHA) on the incidence and severity of retinopathy of prematurity (ROP).
• To assess the impact of enteral DHA on hospital stay duration in preterm infants.
• To determine if enteral DHA administration can prevent or reduce ROP severity in high-risk neonates.

Main Methods:

• A double-blind, parallel clinical trial involving 110 preterm infants (birth weight 1000-1500 g) was conducted.
• Infants received either 75 mg/kg/d of enteral DHA or a high oleic sunflower oil placebo for 14 days.
• Outcomes included any ROP, severe ROP (stage ≥3) incidence, and hospital stay, with statistical comparisons using relative risk and logistic regression.

Main Results:

• No significant difference in overall ROP risk was observed between the DHA and control groups (RR 0.79, P=0.33).
• Enteral DHA significantly reduced the risk of severe ROP (stage 3) (RR 0.66, P=0.03), a finding that remained significant after adjusting for confounders (aOR 0.10, P=0.04).
• Hospital stay duration was comparable between the groups.

Conclusions:

• Enteral DHA supplementation may be beneficial in reducing the incidence of severe retinopathy of prematurity (stage 3) in preterm infants.
• Further research is warranted to confirm these findings and optimize DHA administration protocols.
• The study highlights a potential targeted nutritional strategy for mitigating severe ROP outcomes.