Respiratory hospitalisation of infants supplemented with docosahexaenoic acid as preterm neonates

Authors

  • Kerryn Atwell,

    1. Neonatal Medicine, Women's and Children's Hospital, North Adelaide
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  • Carmel T Collins,

    1. Women's and Children's Health Research Institute, Women's and Children's Hospital, North Adelaide
    2. School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, South Australia, Australia
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  • Thomas R Sullivan,

    1. School of Population Health and Clinical Practice, University of Adelaide, Adelaide, South Australia, Australia
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  • Philip Ryan,

    1. School of Population Health and Clinical Practice, University of Adelaide, Adelaide, South Australia, Australia
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  • Robert A Gibson,

    1. Women's and Children's Health Research Institute, Women's and Children's Hospital, North Adelaide
    2. School of Agriculture, Food and Wine, University of Adelaide, Adelaide, South Australia, Australia
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  • Maria Makrides,

    1. Women's and Children's Health Research Institute, Women's and Children's Hospital, North Adelaide
    2. School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, South Australia, Australia
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  • Andrew J McPhee

    Corresponding author
    1. School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, South Australia, Australia
    • Neonatal Medicine, Women's and Children's Hospital, North Adelaide
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  • Declaration of conflict of interest: None declared.
  • This trial has been registered with the Australian and New Zealand Clinical Trial Registry (http://www.anzctr.org.au) (identifier ACTRN12606000327583).

Correspondence: Dr Andrew J McPhee, Department of Neonatal Medicine, Women's and Children's Hospital, 72 King William Road, North Adelaide, SA 5006, Australia. Fax: +08 8161 7645; email: andrew.mcphee@health.sa.gov.au

Abstract

Aim

To determine the effect of neonatal docosahexaenoic acid (DHA) supplementation in preterm infants on later respiratory-related hospitalisations.

Methods

We enrolled 657 infants in a multicentre, randomised, controlled trial designed to study the long-term efficacy of higher dose dietary DHA in infants born <33 weeks' gestation. Treatment was with high DHA (∼1%) compared with standard DHA (∼0.3%) in breast milk or formula, given from the first week of life to term equivalent. Parent-reported hospital admissions to 18 months corrected age were recorded. The proportion of children hospitalised for lower respiratory tract (LRT) conditions and the mean number of hospitalisations per infant were determined.

Results

Twenty-three per cent (154/657) of infants were hospitalised for LRT conditions. Seventy-three per cent (173/238) of admissions were for bronchiolitis. There was no significant effect of higher DHA on the proportion of infants admitted for LRT conditions (high DHA 22% vs. standard DHA 25%, adjusted relative risk 0.92, 95% confidence interval (CI) 0.68–1.24, P = 0.57) or in the mean number of admissions per infant (high DHA 0.34, standard DHA 0.38, adjusted ratio of means 0.91, 95% CI 0.63–1.32, P = 0.62). The sexes responded differently to treatment (interaction P = 0.046), with reduced admissions in boys given high DHA, but this was not statistically significant (high DHA 19%, standard DHA 28%, adjusted relative risk 0.69, 95% CI 0.46–1.04, P = 0.08).

Conclusions

Hospitalisation for LRT problems in the first 18 months for preterm infants was not reduced by neonatal supplementation with 1% DHA.

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