Docosahexaenoic acid (DHA) is a major type of omega-3 (n-3) long-chain polyunsaturated fatty acid found in the brain, which is crucial for the growth of neurons and neurogenesis. During pregnancy, DHA is transferred from the mother to the fetus in the last trimester. However, premature infants miss out on this important transfer of DHA, which increases their risk of developmental delays compared to infants born at full term.
A recent study published in the Journal of JAMA Pediatrics, led by the University of Adelaide, Australia, found that supplementing premature infants born before 29 weeks of gestation with DHA did not have any impact on their behavioral functioning later in life.
Gould et.al. conducted a randomized clinical trial with preterm infants and included children from 10 Australian participating centers. The study, conducted between June 2012 and September 2015, included infants born at <29 weeks of gestation, excluding those with additional fatty acid supplementation or major congenital or chromosomal abnormalities. The follow-up took place from August 2018 to May 2021, and parents of surviving children who had not withdrawn from the original trial were invited to complete questionnaires when the child turned 5 years of corrected age.
In this study, infants born before 29 weeks were randomly assigned to receive daily enteral emulsions providing 60 mg/kg/d of DHA (n=361) or a soy-oil emulsion (n=370) from within the first three days of enteral feeding until 36 weeks’ postmenstrual age or discharge home. The primary outcome data were available for 731 children (76% of 958 surviving eligible children; 361 in the intervention group and 370 in the control group). Following imputation for missing data, the mean Total Difficulties score was the same in both groups. The intervention group (n = 465) had a mean (SD) score of 11.8 (6.3), while the control group (n = 493) had a mean (SD) score of 11.8 (6.0). The mean difference adjusted for sex, gestational age stratum, and hospital was 0.01, with a 95% CI of −0.87 to 0.89 and a P-value of 0.98. There was no evidence for differences between the groups in any secondary outcomes of behavior, executive functioning, or health.
A previous study by Makrides et.al. also concluded that a DHA dose of approximately in early life did not increase Mental Development Index (MDI) scores of preterm infants overall born earlier than 33 weeks.
The study findings contribute significantly to the existing knowledge regarding the impact of DHA on long-term behavioral outcomes in preterm infants. These results underscore the importance of ongoing research efforts in this domain to validate and further understand the potential effects of interventions involving DHA supplementation.
References
- Gould JF, Roberts RM, Anderson PJ, Makrides M, Sullivan TR, Gibson RA, et al. High-Dose Docosahexaenoic Acid in Newborns Born at Less Than 29 Weeks’ Gestation and Behavior at Age 5 Years: Follow-Up of a Randomized Clinical Trial. JAMA Pediatrics [Internet]. 2023 Nov 20.
- Makrides M, Gibson RA, McPhee AJ, Collins CT, Davis PG, Doyle LW, et al. Neurodevelopmental Outcomes of Preterm Infants Fed High-Dose Docosahexaenoic Acid: A Randomized Controlled Trial. JAMA. 2009 Jan 14;301(2):175–82.