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Pediatrics. 2014 Jul;134(1):120-34. doi: 10.1542/peds.2014-0459. Epub 2014 Jun 9.

Omega-3 long-chain polyunsaturated fatty acids for extremely preterm infants: a systematic review.

Author information

1
Department of Pediatrics, Centre Mère-Enfant, and.
2
Department of Pediatrics, Children's and Women's Health Centre, University of British Columbia, Vancouver, Canada; and.
3
Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa University, Ottawa, Canada.
4
Health Technology Assessment Unit, CHU de Quebec, Laval University, Quebec, Canada;
5
Department of Pediatrics, Centre Mère-Enfant, and isabelle.marc@crchul.ulaval.ca.

Abstract

BACKGROUND AND OBJECTIVE:

Omega-3 long chain polyunsaturated fatty acid (LCPUFA) exposure can be associated with reduced neonatal morbidities. We systematically review the evidence for the benefits of omega-3 LCPUFAs for reducing neonatal morbidities in extremely preterm infants.

METHODS:

Data sources were PubMed, Embase, Center for Reviews and Dissemination, and the Cochrane Register of Controlled Trials. Original studies were selected that included infants born at <29 weeks' gestation, those published until May 2013, and those that evaluated the relationship between omega-3 LCPUFA supplementation and major adverse neonatal outcomes. Data were extracted on study design and outcome. Effect estimates were pooled.

RESULTS:

Of the 1876 studies identified, 18 randomized controlled trials (RCTs) and 6 observational studies met the defined criteria. No RCT specifically targeted a population of extremely preterm infants. Based on RCTs, omega-3 LCPUFA was not associated with a decreased risk of bronchopulmonary dysplasia in infants overall (pooled risk ratio [RR] 0.97, 95% confidence interval [CI] 0.82-1.13], 12 studies, n = 2809 infants); however, when considering RCTs that include only infants born at ≤32 weeks' gestation, a trend toward a reduction in the risk of bronchopulmonary dysplasia (pooled RR 0.88, 95% CI 0.74-1.05, 7 studies, n = 1156 infants) and a reduction in the risk of necrotizing enterocolitis (pooled RR 0.50, 95% CI 0.23-1.10, 5 studies, n = 900 infants) was observed with LCPUFA.

CONCLUSIONS:

Large-scale interventional studies are required to determine the clinical benefits of omega-3 LCPUFA, specifically in extremely preterm infants, during the neonatal period.

KEYWORDS:

fatty acids; infants; neonatal; omega-3; preterm; systematic review

PMID:
24913791
DOI:
10.1542/peds.2014-0459
[Indexed for MEDLINE]
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