Docosahexaenoic acid supplementation of preterm infants and parent-reported symptoms of allergic disease at 7 years corrected age: follow-up of a randomized controlled trial

Anoja W Gunaratne; Maria Makrides; Carmel T Collins; Robert A Gibson; Andrew J McPhee; Thomas R Sullivan; Jacqueline F Gould; Tim J Green; Lex W Doyle; Peter G Davis; Noel P French; Paul B Colditz; Karen Simmer; Scott A Morris; Karen P Best

doi:10.1093/ajcn/nqz010

Docosahexaenoic acid supplementation of preterm infants and parent-reported symptoms of allergic disease at 7 years corrected age: follow-up of a randomized controlled trial

Am J Clin Nutr. 2019 Jun 1;109(6):1600-1610. doi: 10.1093/ajcn/nqz010.

Authors

Anoja W Gunaratne^{1

2}, Maria Makrides^{1

2}, Carmel T Collins^{1

2}, Robert A Gibson^{1

3}, Andrew J McPhee^{1

4}, Thomas R Sullivan⁵, Jacqueline F Gould^{1

2}, Tim J Green^{1

2}, Lex W Doyle^{6

7

8}, Peter G Davis^{6

8}, Noel P French^{9

10}, Paul B Colditz¹¹, Karen Simmer^{9

10}, Scott A Morris¹², Karen P Best^{1

2}

Affiliations

¹ Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.
² Adelaide Medical School.
³ School of Agriculture, Food and Wine.
⁴ Department of Neonatal Medicine, Women's and Children's Hospital, North Adelaide, South Australia, Australia.
⁵ School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia.
⁶ Clinical Sciences, The Murdoch Children's Research Institute, Parkville, Victoria, Australia.
⁷ Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Parkville, Victoria, Australia.
⁸ Department of Obstetrics and Gynaecology, The Royal Women's Hospital, Parkville, Victoria, Australia.
⁹ Centre of Neonatal Research and Education, The University of Western Australia, Perth, Western Australia, Australia.
¹⁰ King Edward Memorial Hospital and Princess Margaret Hospital for Children, Subiaco, Western Australia, Australia.
¹¹ Perinatal Research Centre, University of Queensland Centre for Clinical Research, The University of Queensland, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
¹² Department of Neonatal Perinatal Medicine, Flinders Medical Centre and College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.

PMID: 31070712
DOI: 10.1093/ajcn/nqz010

Abstract

Background: Docosahexaenoic acid (DHA, 22:6n-3) supplementation in the prenatal period is associated with a reduction in the incidence of some symptoms of allergic disease. Infants born preterm are at increased risk of allergic disease, but it is unknown if DHA supplementation reduces the risk of childhood allergies.

Objectives: The aim of this study was to determine if supplementation of infants born at <33 wk gestation with high-DHA compared with standard-DHA enteral feeds decreases the incidence and severity of parent-reported allergic disease symptoms at a corrected age (CA) of 7 y.

Methods: This study was a follow-up of an Australian multicenter randomized controlled trial. Infants were given high-DHA (∼1% total fatty acids) or standard-DHA (∼0.3% total fatty acids) enteral feeds from 2-4 d of postnatal age until 40 wk postmenstrual age. Parent-reported incidence of respiratory allergic disease symptoms including wheeze and rhinitis at 7 y CA were the main outcomes. Other outcomes included the incidence of eczema symptoms; severity of any symptoms; and the incidence of wheeze, rhinitis, rhinoconjunctivitis, and eczema from birth to 7 y CA.

Results: Data were available for 569 of 657 (87%) children originally randomized. Symptoms of wheeze or rhinitis at 7 y CA did not differ between high- and standard-DHA groups [wheeze: RR: 1.10; 95% CI: 0.73, 1.65; P = 0.66; rhinitis: RR: 1.09; 95% CI: 0.81, 1.46; P = 0.59]. There was no difference in other allergic disease symptoms at 7 y CA or in the severity of symptoms. Parent-reported symptoms of wheeze, rhinitis, rhinoconjunctivitis, or eczema from birth to 7 y CA did not differ between the groups.

Conclusions: High-dose DHA supplementation of infants born at <33 wk gestation did not alter allergic disease symptoms or severity at 7 y CA, or from birth to 7 y CA compared with standard-dose DHA. This trial was registered with the Australian New Zealand Clinical Trials Registry as ANZCTR 12606000327583 (http://www.anzctr.org.au).

Keywords: allergic disease; docosahexaenoic acid; prematurity; preterm infant; ω-3 long-chain polyunsaturated fatty acids.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Australia
Child
Child, Preschool
Dietary Supplements / analysis
Docosahexaenoic Acids / administration & dosage*
Female
Follow-Up Studies
Humans
Hypersensitivity / immunology
Hypersensitivity / prevention & control*
Infant
Infant, Newborn
Infant, Newborn, Diseases / immunology
Infant, Newborn, Diseases / prevention & control*
Infant, Premature / immunology*
Male
Parents
Prenatal Care

Substances

Docosahexaenoic Acids