MSC ulaval Centre Hospitalier Universitaire de Quebec- Universite Laval, Université Laval Québec, Quebec, Canada
Background: Very preterm infants are at increased risk of low growth and delayed development. Docosahexaenoic acid (DHA), an omega-3 polyunsaturated fatty acid, could influence growth either directly or by reducing complications related to prematurity.
Objective: To evaluate whether breast milk of mothers receiving a DHA supplementation could improve infant’s growth in the neonatal period.
Design/Methods: This study was a pre-specified secondary outcome of a randomized placebo-controlled clinical trial conducted in 16 Canadian neonatal intensive care units (2015-2018; NCT02371460). Mothers who delivered before 29 weeks of gestation and decided to breastfeed their infant were given 1.2g of DHA daily or a placebo within 72 hours of delivery to 36 weeks’ postmenstrual age (PMA). Infant’s weight, length and head circumference were measured at least once a week from birth to 36 weeks PMA. Analyses were performed using a linear regression model with generalized estimating equations on: 1) Profiles of weight, length and head circumference (birth to 36 weeks’ PMA); 2) Weight velocity (birth to 36 weeks’ PMA); 3) Weight at 36 weeks’ PMA. Interactions of treatment with sex, gestational age and DHA-rich intravenous lipid were also tested.
Results: 461 mothers and their 528 infants (DHA, N=273; Placebo, N=255) were included with mean of gestational age 26.5 weeks [SD=1.6]; 275 (52.1%) males; mean birthweight 895g [SD=240]. DHA interaction with sex was significant on weight profile (interaction P<0.001), weight velocity (interaction P=0.02) and weight at 36 weeks PMA (interaction P=0.02). Females in the DHA group gained more weight than in the placebo group (mean difference (MD), 52.6g, [95% CI, 24.5 to 80.8], P<0.001). Weight velocity was significantly higher in female in the DHA group (MD, 0.5g/kg/day, [95% CI, 0.1 to 0.9], P=0.02). At 36 weeks PMA, male weight in DHA group was significantly smaller (MD, -88.9g, [95% CI, -166.2 to -11.6], P=0.02). Compared to placebo, DHA had no significant effect on length and head circumference. Conclusion(s): DHA administered by maternal supplementation during the neonatal period had a positive effect on females’ weight and weight velocity and a negative effect on male’s weight at 36 weeks PMA in the neonatal period in infants born before 29 weeks of gestation. (Grant MOP-136964 from The Canadian Institutes of Health research).
Authors/Institutions: Georgina Angoa, Centre Hospitalier Universitaire de Quebec- Universite Laval, Université Laval, Quebec, Quebec, Canada; Etienne Pronovost, Centre Hospitalier Universitaire de Quebec- Universite Laval, Université Laval, Quebec, Quebec, Canada; Bruno Piedboeuf, Centre Hospitalier Universitaire de Quebec- Universite Laval, Université Laval, Quebec, Quebec, Canada; Pascal M. Lavoie, University of British Columbia, Vancouver, British Columbia, Canada; David Simonyan, CHU de Québec-Université Laval, Québec, Quebec, Canada; Aissatou B. Ndiaye, Centre Hospitalier Universitaire de Quebec- Universite Laval, Université Laval, Quebec, Quebec, Canada; William Fraser, Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Université de Sherbrooke, Sherbrooke, Quebec, Canada; Anne Monique Nuyt, Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Quebec, Quebec, Canada; Ibrahim Mohamed, Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Quebec, Quebec, Canada; Mosarrat Qureshi, Royal Alexandra Hospital, Edmonton, Alberta, Canada; Jehier Afifi, Pediatrics, Dalhousie University,, Halifax, Nova Scotia, Canada; Brigitte Lemyre, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada; Kamran Yusuf, Section of Neonatology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Thierry Ducruet, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada; Benoît Mâsse, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada; Thierry Lacaze-Masmonteil, Cumming School of Medicine, University of Calgary,, Calgary, Alberta, Canada; Isabelle Marc, Centre Hospitalier Universitaire de Quebec- Universite Laval, Université Laval, Quebec, Quebec, Canada
