Neurodevelopmental outcomes of preterm infants fed high-dose docosahexaenoic acid: A randomized controlled trial

Makrides, Maria, Gibson, Robert A., McPhee, Andrew J., Collins, Carmel T., Davis, Peter G., Doyle, Lex W., Simmer, Karen, Colditz, Paul B., Morris, Scott, Smithers, Lisa G., Willson, Kristyn and Ryan, Philip (2009) Neurodevelopmental outcomes of preterm infants fed high-dose docosahexaenoic acid: A randomized controlled trial. JAMA - Journal of the American Medical Association, 301 2: 175-182. doi:10.1001/jama.2008.945


Author Makrides, Maria
Gibson, Robert A.
McPhee, Andrew J.
Collins, Carmel T.
Davis, Peter G.
Doyle, Lex W.
Simmer, Karen
Colditz, Paul B.
Morris, Scott
Smithers, Lisa G.
Willson, Kristyn
Ryan, Philip
Title Neurodevelopmental outcomes of preterm infants fed high-dose docosahexaenoic acid: A randomized controlled trial
Journal name JAMA - Journal of the American Medical Association   Check publisher's open access policy
ISSN 0098-7484
1538-3598
Publication date 2009-01-14
Sub-type Article (original research)
DOI 10.1001/jama.2008.945
Open Access Status DOI
Volume 301
Issue 2
Start page 175
End page 182
Total pages 8
Place of publication Chicago, IL, United States
Publisher American Medical Association
Language eng
Subject 11 Medical and Health Sciences
Formatted abstract
Context Uncertainty exists about the benefit of dietary docosahexaenoic acid (DHA) on the neurodevelopment of preterm infants.

Objective
To determine the effect of meeting the estimated DHA requirement of preterm infants on neurodevelopment at 18 months’ corrected age.

Design, Setting, and Participants
Randomized, double-blind controlled trial enrolling infants born at less than 33 weeks’ gestation from April 2001 to October 2005 at 5 Australian tertiary hospitals, with follow-up to 18 months.

Intervention
High-DHA (approximately 1% total fatty acids) enteral feeds compared with standard DHA (approximately 0.3% total fatty acids) from day 2 to 4 of life until term corrected age.

Main Outcome
Measures Bayley Mental Development Index (MDI) at 18 months’ corrected age. A priori subgroup analyses were conducted based on randomization strata (sex and birth weight _1250 g vs _1250 g).

Results Of the 657 infants enrolled, 93.5% completed the 18-month follow-up. Bayley MDI scores did not differ between the high- and standard-DHA groups (mean difference, 1.9; 95% confidence interval [CI], −1.0 to 4.7). The MDI among girls fed the high-DHA diet was higher than girls fed standard DHA in unadjusted and adjusted analyses (unadjusted mean difference, 4.7; 95% CI, 0.5-8.8; adjusted mean difference, 4.5; 95% CI, 0.5-8.5). The MDI among boys did not differ between groups. For infants born weighing less than 1250 g, the MDI in the high-DHA group was higher than with standard DHA in the unadjusted comparison (mean difference, 4.7; 95% CI, 0.2-9.2) but did not reach statistical significance following adjustment for gestational age, sex, maternal education, and birth order (mean difference, 3.8; 95% CI, −0.5 to 8.0). The MDI among infants born weighing at least 1250 g did not differ between groups.

Conclusion
A DHA dose of approximately 1% total fatty acids in early life did not increase MDI scores of preterm infants overall born earlier than 33 weeks but did improve the MDI scores of girls.
Keyword polyunsaturated fatty-acids
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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Created: Thu, 03 Sep 2009, 09:06:19 EST by Mr Andrew Martlew on behalf of School of Medicine