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Omega-3 Long Chain Polyunsaturated Fatty Acid Supplementation for Prevention of Retinopathy of Prematurity in
Salma Afroz1, Md Mahbubul Hoque1
1Department of Pediatrics Bangladesh Shishu Hospital & Institute Dhaka Bangladesh.
Insights
Omega-3 long-chain polyunsaturated fatty acids (LCPUFA) supplementation did not reduce overall retinopathy of prematurity (ROP) incidence in preterm infants. However, it significantly lowered the risk of severe ROP, potentially improving visual outcomes.
Area of Science:
- Neonatology
- Ophthalmology
- Nutritional Science
Background:
- Retinopathy of prematurity (ROP) is a leading cause of blindness in preterm infants.
- Omega-3 long-chain polyunsaturated fatty acids (LCPUFA) possess anti-inflammatory and antiangiogenic properties.
- LCPUFA may mitigate ROP by reducing pathological neovascularization.
Purpose of the Study:
- To evaluate the efficacy of omega-3 LCPUFA supplementation in preventing ROP in Bangladeshi preterm infants.
- To assess the impact of LCPUFA on both overall and severe ROP incidence.
Main Methods:
- A pilot study involving 71 preterm neonates (<34 weeks gestation, <1800g birth weight) was conducted.
- Infants were randomized into an intervention group receiving enteral omega-3 LCPUFA (40 mg/kg/day) and a control group.
- Supplementation continued for 4 weeks from the first enteral feed.
Main Results:
- Overall ROP incidence was similar between groups (37.1% vs. 41.6%, p=0.69).
- Severe ROP incidence was significantly lower in the omega-3 LCPUFA group (23.1% vs. 60%, p=0.049).
- Logistic regression did not find a significant association between LCPUFA supplementation and overall ROP incidence.
Conclusions:
- Omega-3 LCPUFA supplementation may reduce the risk of severe ROP in preterm infants.
- This reduction could decrease the need for invasive treatments and improve long-term visual outcomes.
- The study's limited statistical power necessitates further investigation to confirm these findings.
Background And Aims:
Retinopathy of prematurity (ROP) is a vasoproliferative disorder of the retina affecting preterm infants that potentially leads to blindness. Omega-3 long-chain polyunsaturated fatty acids (LCPUFA) have anti-inflammatory and antiangiogenic effects, thereby reducing pathological neovascularization and preventing the incidence of ROP. This study was done to evaluate the effect of available omega-3 LCPUFA supplementation for the prevention of ROP among Bangladeshi infants.
Methods:
This pilot study was conducted in the Neonatology Department of a tertiary care hospital in Bangladesh from November 2022 to March 2024 among preterm neonates < 34 weeks of gestation with birth weight < 1800 g. Initially, 76 preterm neonates were enrolled in this study. Among them, 71 preterm neonates were randomly allocated to the intervention group and the control group. The intervention group received a cap. omega-3 LCPUFA enterally (40 mg/kg/day). It was added to their enteral feeds within 48 h of the first enteral feed and continued from the starting point to 4 weeks. The control group received no supplementation.
Results:
The incidence of ROP was almost similar between the omega-3 LCPUFA group and the control group (37.1% in the intervention group vs. 41.6% in the control group, p = 0.69). However, severe ROP incidence was significantly reduced in the omega-3 group. Three patients developed severe ROP in the omega-3 LCPUFA group, in contrast to nine patients in the control group (23.1% vs. 60%, p = 0.049). On logistic regression analysis, while considering risk factors for ROP, omega-3 LCPUFA supplementation was not found to have a significant association with the incidence of ROP.
Conclusion:
Omega-3 LCPUFA supplementation does not reduce the overall incidence of ROP; however, it may lower the risk of severe ROP. This reduction in severe ROP cases may help decrease the need for invasive treatments and improve long-term visual outcomes in preterm infants. Nonetheless, the study lacks sufficient statistical power to confirm this conclusively.
