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Efficacy of Docosahexaenoic Acid for the Prevention of Necrotizing Enterocolitis in Preterm Infants: A Randomized Clinical Trial

Necrotizing enterocolitis (NEC) is an inflammatory bowel disease and a leading cause of morbidity and mortality in preterm infants. In this study, a randomized double-blind parallel-group (1:1) trial was carried out in two neonatal intensive care units of two tertiary hospitals. Two hundred and twen...

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Autores principales: Bernabe-García, Mariela, Calder, Philip C., Villegas-Silva, Raúl, Rodríguez-Cruz, Maricela, Chávez-Sánchez, Luis, Cruz-Reynoso, Leonardo, Mateos-Sánchez, Leovigildo, Lara-Flores, Gabriel, Aguilera-Joaquín, Augusto R., Sánchez-García, Luisa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7922869/
https://www.ncbi.nlm.nih.gov/pubmed/33671220
http://dx.doi.org/10.3390/nu13020648
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author Bernabe-García, Mariela
Calder, Philip C.
Villegas-Silva, Raúl
Rodríguez-Cruz, Maricela
Chávez-Sánchez, Luis
Cruz-Reynoso, Leonardo
Mateos-Sánchez, Leovigildo
Lara-Flores, Gabriel
Aguilera-Joaquín, Augusto R.
Sánchez-García, Luisa
author_facet Bernabe-García, Mariela
Calder, Philip C.
Villegas-Silva, Raúl
Rodríguez-Cruz, Maricela
Chávez-Sánchez, Luis
Cruz-Reynoso, Leonardo
Mateos-Sánchez, Leovigildo
Lara-Flores, Gabriel
Aguilera-Joaquín, Augusto R.
Sánchez-García, Luisa
author_sort Bernabe-García, Mariela
collection PubMed
description Necrotizing enterocolitis (NEC) is an inflammatory bowel disease and a leading cause of morbidity and mortality in preterm infants. In this study, a randomized double-blind parallel-group (1:1) trial was carried out in two neonatal intensive care units of two tertiary hospitals. Two hundred and twenty-five preterm newborns with an expected functional gastrointestinal tract were recruited and received an enteral dose of 75 mg of docosahexaenoic acid (DHA)/kg body weight or high-oleic sunflower oil daily for 14 days from the first enteral feed after birth. Confirmed NEC was evaluated with Bell’s scale from stage ≥ IIa. Two hundred and fourteen randomized infants were analyzed in terms of the intent-to-treat (DHA-group: n = 105; control-group: n = 109); data for two hundred infants were analysed per protocol. Confirmed NEC was lower in infants from the DHA-group compared with the control-group (0/100 vs. 7/100; p = 0.007), with RR = 0.93 (95% CI 0.881 to 0.981), risk difference = −7%, (95% CI −12.00 to −1.99), and number needed-to-treat = 15 (95% CI 8.3 to 50). Intent-to-treat analysis showed a lower level of treatment failure in the DHA-group compared with the control-group (6/105 (6%) vs. 16/109 (15%); p = 0.03, RR = 0.905, (95% CI 0.826 to 0.991)). The results after multivariate-regression analysis remained significant. Adverse events (apart from the incidence of NEC) were not different between groups. A daily dose of DHA for 14 days starting with the first enteral feed may prevent NEC in preterm infants.
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spelling pubmed-79228692021-03-03 Efficacy of Docosahexaenoic Acid for the Prevention of Necrotizing Enterocolitis in Preterm Infants: A Randomized Clinical Trial Bernabe-García, Mariela Calder, Philip C. Villegas-Silva, Raúl Rodríguez-Cruz, Maricela Chávez-Sánchez, Luis Cruz-Reynoso, Leonardo Mateos-Sánchez, Leovigildo Lara-Flores, Gabriel Aguilera-Joaquín, Augusto R. Sánchez-García, Luisa Nutrients Article Necrotizing enterocolitis (NEC) is an inflammatory bowel disease and a leading cause of morbidity and mortality in preterm infants. In this study, a randomized double-blind parallel-group (1:1) trial was carried out in two neonatal intensive care units of two tertiary hospitals. Two hundred and twenty-five preterm newborns with an expected functional gastrointestinal tract were recruited and received an enteral dose of 75 mg of docosahexaenoic acid (DHA)/kg body weight or high-oleic sunflower oil daily for 14 days from the first enteral feed after birth. Confirmed NEC was evaluated with Bell’s scale from stage ≥ IIa. Two hundred and fourteen randomized infants were analyzed in terms of the intent-to-treat (DHA-group: n = 105; control-group: n = 109); data for two hundred infants were analysed per protocol. Confirmed NEC was lower in infants from the DHA-group compared with the control-group (0/100 vs. 7/100; p = 0.007), with RR = 0.93 (95% CI 0.881 to 0.981), risk difference = −7%, (95% CI −12.00 to −1.99), and number needed-to-treat = 15 (95% CI 8.3 to 50). Intent-to-treat analysis showed a lower level of treatment failure in the DHA-group compared with the control-group (6/105 (6%) vs. 16/109 (15%); p = 0.03, RR = 0.905, (95% CI 0.826 to 0.991)). The results after multivariate-regression analysis remained significant. Adverse events (apart from the incidence of NEC) were not different between groups. A daily dose of DHA for 14 days starting with the first enteral feed may prevent NEC in preterm infants. MDPI 2021-02-17 /pmc/articles/PMC7922869/ /pubmed/33671220 http://dx.doi.org/10.3390/nu13020648 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bernabe-García, Mariela
Calder, Philip C.
Villegas-Silva, Raúl
Rodríguez-Cruz, Maricela
Chávez-Sánchez, Luis
Cruz-Reynoso, Leonardo
Mateos-Sánchez, Leovigildo
Lara-Flores, Gabriel
Aguilera-Joaquín, Augusto R.
Sánchez-García, Luisa
Efficacy of Docosahexaenoic Acid for the Prevention of Necrotizing Enterocolitis in Preterm Infants: A Randomized Clinical Trial
title Efficacy of Docosahexaenoic Acid for the Prevention of Necrotizing Enterocolitis in Preterm Infants: A Randomized Clinical Trial
title_full Efficacy of Docosahexaenoic Acid for the Prevention of Necrotizing Enterocolitis in Preterm Infants: A Randomized Clinical Trial
title_fullStr Efficacy of Docosahexaenoic Acid for the Prevention of Necrotizing Enterocolitis in Preterm Infants: A Randomized Clinical Trial
title_full_unstemmed Efficacy of Docosahexaenoic Acid for the Prevention of Necrotizing Enterocolitis in Preterm Infants: A Randomized Clinical Trial
title_short Efficacy of Docosahexaenoic Acid for the Prevention of Necrotizing Enterocolitis in Preterm Infants: A Randomized Clinical Trial
title_sort efficacy of docosahexaenoic acid for the prevention of necrotizing enterocolitis in preterm infants: a randomized clinical trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7922869/
https://www.ncbi.nlm.nih.gov/pubmed/33671220
http://dx.doi.org/10.3390/nu13020648
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