Prospective Cohort Study Investigating Polyunsaturated Fatty Acids and Chronic Lung Disease in Preterm Infants.

Abstract

Objective: Chronic lung disease (CLD) is a complication of prematurity. Studies examining the effects of long-chain polyunsaturated fatty acids (LC-PUFAs) on CLD are conflicting. This study investigated LC-PUFAs in the red blood cell membrane (RBCM) in preterm infants.

Study design: This prospective observational study included infants with gestational age <32 weeks or birth weight <2 kg and at least one LC-PUFA measurement in the first month of life. Subjects without CLD (CON group) were compared to those with CLD (CLD group) and then by CLD severity.

Results: Seventy infants were included (CON n=29; CLD n=41). Twenty six infants had Grade 1 CLD; 12 had Grade 2 CLD; 3 had Grade 3 CLD. When the CLD group was compared to the CON group, the overall mean (95% confidence interval) RBCM% for linoleic acid (LA) was similar (CLD vs. CON 12.5% [11.7% - 13.4%] vs. 11.2% [10.2 - 12.3%] p=0.06) but the overall mean arachidonic acid (ARA) was lower (17.6% [17.1% - 18.0%] vs. 18.6% [18.1% - 19.2%], p<0.01). During weeks 1-4, LA% was similar, while ARA% was lower in weeks 2 and 3 (18.8% ± 2.2% vs. 20.0% ± 1.5%, p=0.05, 16.8% ± 2.0% vs. 18.3% ± 1.6%, p=0.01). A similar trend was noted when groups were compared by CLD severity. The CLD group had a higher overall mean ∝-linolenic acid (ALA) compared to the CON group (0.4% [0.3% - 0.4%] vs. 0.2% [0.2 % - 0.3%], p<0.01) but no difference in docosahexaenoic acid (DHA) (3.8% [3.4% - 4.1%] vs. 3.8% [3.4% - 4.3%], p=0.80). During weeks 1-4, ALA% was higher during week 1 only (0.4% ± 0.3% vs. 0.2% ± 0.1%, p<0.01), and DHA% was similar for weeks 1-4. Results were similar when groups were compared by CLD severity.

Conclusions: In this study, low ARA status was associated with CLD.