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Docosahexaenoic Acid and Arachidonic Acid Levels Are Associated with Early Systemic Inflammation in Extremely Preterm
Ann Hellström1, William Hellström2, Gunnel Hellgren1,3
1Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, 40530 Gothenburg, Sweden.
Insights
Lower docosahexaenoic acid (DHA) levels at birth are linked to early inflammation in extremely preterm infants. Arachidonic acid (AA) levels showed no significant association with early inflammation.
Area of Science:
- Neonatal Medicine
- Nutritional Biochemistry
- Inflammation Research
Background:
- Fetal and early postnatal inflammation are linked to increased morbidity in extremely preterm infants.
- Docosahexaenoic acid (DHA) and arachidonic acid (AA) are critical fatty acids with potential immunomodulatory roles.
Purpose of the Study:
- To investigate the association between postpartum levels of DHA and AA and early systemic inflammation in extremely preterm infants.
- To determine if cord blood and early postnatal serum levels of DHA and AA correlate with inflammatory markers.
Main Methods:
- A cohort of 90 extremely preterm infants was studied.
- Serum levels of DHA and AA were measured in cord blood, on postnatal day 1, and postnatal day 7.
- Early systemic inflammation was defined by elevated C-reactive protein (CRP) and/or interleukin-6 (IL-6) within 72 hours of birth, with or without positive blood culture.
Main Results:
- Infants with early systemic inflammation had significantly lower median serum DHA levels on postnatal day 1 compared to those without inflammation (0.5 mol% lower, P = 0.006).
- Serum AA levels did not differ significantly between infants with and without signs of inflammation.
- In cord blood, lower serum levels of both DHA (r = -0.40, P = 0.010) and AA (r = -0.54, P < 0.001) correlated with higher IL-6 levels.
Conclusions:
- Serum DHA levels at birth are associated with the early postnatal inflammatory response in extremely preterm infants.
- DHA status may play a role in modulating inflammation in this vulnerable population.
- Further research is warranted to explore the therapeutic potential of DHA supplementation.
Abstract:
Fetal and early postnatal inflammation have been associated with increased morbidity in extremely preterm infants. This study aimed to demonstrate if postpartum levels of docosahexaenoic acid (DHA) and arachidonic acid (AA) were associated with early inflammation. In a cohort of 90 extremely preterm infants, DHA and AA in cord blood, on the first postnatal day and on postnatal day 7 were examined in relation to early systemic inflammation, defined as elevated C-reactive protein (CRP) and/or interleukin-6 (IL-6) within 72 h from birth, with or without positive blood culture. Median serum level of DHA was 0.5 mol% (95% CI (confidence interval) 0.2-0.9, P = 0.006) lower than the first postnatal day in infants with early systemic inflammation, compared to infants without signs of inflammation, whereas levels of AA were not statistically different between infants with and without signs of inflammation. In cord blood, lower serum levels of both DHA (correlation coefficient -0.40; P = 0.010) and AA (correlation coefficient -0.54; p < 0.001) correlated with higher levels of IL-6. Levels of DHA or AA did not differ between infants with and without histological signs of chorioamnionitis or fetal inflammation. In conclusion, serum levels of DHA at birth were associated with the inflammatory response during the early postnatal period in extremely preterm infants.
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