Fatty acid supplement may reduce EP infant retinopathy

Published: 9-Feb-2021

Every year, approximately a thousand extremely premature (EP) babies in Sweden are screened for ROP. Four of ten born before 30 weeks’ gestation suffer from the disease to some degree

A study led at the University of Gothenburg has suggested a fatty acid supplement can halve the rate of retinopathy in extremely premature babies.

The study, published in JAMA Pediatrics, documents a fall in retinopathy of prematurity (ROP) among extremely premature infants (born before 28 weeks’ gestation), whose retinal blood vessels are not fully developed. The condition can cause visual impairment and, at worst, blindness after retinal detachment.

The study included 206 babies in the neonatal wards at the university hospitals in Gothenburg, Lund, and Stockholm over three years, 2016–19.

Roughly half of these newborns were given prophylactic nutritional supplements, orally, with the omega-3 fatty acid DHA (50 mg per day and kilogram of body weight), combined with the omega-6 fatty acid arachidonic acid (twice as much). The latter fatty acid is not included in the supplements routinely administered to EP babies immediately after birth.

In the group of EP infants given the fatty acid supplement, 16 of 101 or 15.8% had severe ROP. The corresponding proportion in the control group was 33%, at 35 of 105.

In adults, high levels of omega-6 fatty acids are associated with inflammation and cardiovascular disease. In the fetal period, arachidonic acid is a building block for cell membranes and acts as signalling molecules between cells. The omega-3 fatty acid DHA is a vital component for blood vessels and nerve tissue.

The research group has shown the connection between ROP and low arachidonic acid levels in EP babies’ blood. Administering arachidonic acid as a supplement has reportedly been a topic of debate, and further clinical studies on how to devise an optimal mix of fatty acids have been called for.

“In our study, we’re taking a step toward answering that question by showing such a distinct reduction in one of the severe neurovascular complications that can arise after extremely preterm birth,” Hellström says.

Other results in the study showed no significant differences between the two groups in terms of the incidence of the lung disease bronchopulmonary dysplasia, or in the degree of intraventricular cerebral hemorrhage, which is also common in EP infants. Sepsis occurred in slightly fewer of those who received the fatty acid supplement: 42 of 101 babies, against 53 of 105 in the control group.

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