DHA & Eye Health: Can It Help Premature Babies?
Quick Summary: A new study found that giving premature babies a special supplement with DHA and another fatty acid called AA (arachidonic acid) helped protect their eyes. Babies who got the supplement had a much lower risk of a serious eye problem called retinopathy of prematurity (ROP).
What Is Retinopathy of Prematurity (ROP)?
ROP is a potentially blinding eye disease that affects premature babies. It happens when the blood vessels in the baby's retina (the back of the eye) don't develop properly.
How DHA and AA Help Baby Eyes
This research looked at whether giving very premature babies DHA (docosahexaenoic acid) and AA (arachidonic acid) could help prevent ROP. These are important fats that babies get from their mothers during pregnancy.
What The Research Found
The study showed that babies who received a daily supplement of DHA and AA had a 50% lower chance of developing severe ROP compared to babies who didn't get the supplement. The babies who got the supplement also had higher levels of DHA and AA in their blood.
Study Details
- Who was studied: 206 premature babies born before 28 weeks of pregnancy.
- How long: From birth until they reached 40 weeks after their due date.
- What they took: Babies received a special oil supplement containing DHA and AA, given through a feeding tube or by mouth.
What This Means For You
If you have a premature baby, this research suggests that DHA and AA supplements might help protect their eyes. Talk to your baby's doctor about this study and whether a supplement might be right for your baby.
Study Limitations
- The study was done in Sweden, so the results might be different in other places.
- The study only looked at the short-term effects, not how the supplements might affect the babies later in life.
- The study didn't show that the supplements helped with other health problems common in premature babies.
Technical Analysis Details
Key Findings
The study found that enteral supplementation with arachidonic acid (AA, 100 mg/kg/day) and docosahexaenoic acid (DHA, 50 mg/kg/day) from birth to 40 weeks’ postmenstrual age reduced the incidence of severe retinopathy of prematurity (ROP) in extremely preterm infants by 50% compared to standard care. Supplemented infants had significantly higher serum phospholipid levels of both fatty acids. No differences were observed in secondary outcomes like bronchopulmonary dysplasia, intraventricular hemorrhage, sepsis, or mortality.
Study Design
This was a multicenter, randomized clinical trial conducted at three Swedish university hospitals (December 2016–December 2019). A total of 206 infants born at <28 weeks’ gestation were included (mean gestational age: 25.5 weeks; 57% male). Participants were randomized to receive AA:DHA supplementation or standard care. Outcomes were analyzed using intention-to-treat and per-protocol methods.
Dosage & Administration
Infants received an enteral oil providing AA (100 mg/kg/day) and DHA (50 mg/kg/day) via nasogastric tube or oral administration within 3 days of birth. Supplementation continued until 40 weeks’ postmenstrual age.
Results & Efficacy
- Primary Outcome: Severe ROP (stage 3/type 1) occurred in 15.8% (16/101) of the AA:DHA group vs. 33.3% (35/105) in the control group (adjusted relative risk: 0.50; 95% CI: 0.28–0.91; P = 0.02).
- Serum Levels: AA and DHA fractions in serum phospholipids were significantly higher in the supplemented group (mean difference: +0.82 mol%; 95% CI: 0.46–1.18) vs. controls (+0.13 mol%; 95% CI: 0.01–0.24).
- Secondary Outcomes: No significant differences in bronchopulmonary dysplasia (47.5% vs. 45.7%), intraventricular hemorrhage (42.6% vs. 40.0%), sepsis (41.6% vs. 50.5%), serious adverse events (25.7% vs. 24.8%), or mortality (15.8% vs. 12.3%) between groups.
Limitations
- Generalizability: Conducted in Sweden with a standardized neonatal care protocol; results may not apply to other populations or settings.
- Sample Size: 206 infants provided sufficient power for the primary outcome but limited ability to detect differences in secondary outcomes.
- Blinding: While ophthalmologists were masked, other outcomes (e.g., sepsis, mortality) relied on unblinded clinical assessments.
- Long-Term Effects: No follow-up beyond 40 weeks’ postmenstrual age to assess developmental or growth impacts.
- Dosage Ratio: The fixed 2:1 AA:DHA ratio may not optimize efficacy, as individual requirements for these fatty acids could vary.
Clinical Relevance
For extremely preterm infants (<28 weeks’ gestation), early enteral supplementation with AA and DHA may halve the risk of severe ROP, a leading cause of childhood blindness. However, the lack of significant effects on other morbidities (e.g., sepsis, mortality) and the absence of long-term safety data suggest cautious implementation. Clinicians should consider this intervention as a potential adjunct to standard ROP prevention strategies, particularly in settings with similar neonatal care practices to Sweden. Further research is needed to validate these findings in diverse populations and determine optimal dosing.
Source: ClinicalTrials.gov Identifier NCT03201588.
Original Study Reference
Effect of Enteral Lipid Supplement on Severe Retinopathy of Prematurity: A Randomized Clinical Trial.
Source: PubMed
Published: 2021
📄 Read Full Study (PMID: 33523106)
