No Evidence to Support Use of Omega-3 PUFAs in Bronchopulmonary Dysplasia

Intervention with omega-3 long-chain polyunsaturated fatty acids (N-3 LCPUFAs) cannot prevent the occurrence of bronchopulmonary dysplasia (BPD) in preterm infants, according to the results of a meta-analysis published in Pediatrics.

Recognizing that conflicting findings have been reported, investigators sought to explore the effect of N-3 LCPUFAs on the incidence of BPD in preterm infants by conducting a meta-analysis. They searched PubMed, the Cochrane Library, and Embase for relevant articles published from inception of the database through October 1, 2018. They included randomized controlled trials (RCTs) in which the effect of intervention with N-3 LCPUFAs on BPD incidence had been examined. The literature search and data extraction were performed by 2 independent investigators, who established risk ratios and subgroup analyses.

Inclusion criteria were RCTs in which preterm infants (ie, <37 weeks’ gestational age) were evaluated, preterm infants who received a formula that contained N-3 LCPUFAs or were given a direct oral dose of N-3 LCPUFAs, intervention beginning within 1 month of birth, and report of an incidence of BPD or oxygen dependency for ≥28 days following birth or at 36 weeks’ postmenstrual age.

A total of 14 RCTs with 3531 preterm infants were included in the analysis. Results of the analysis demonstrated that intervention with N-3 LCPUFAs was not associated with any statistically significant effect on the incidence of BPD in preterm infants (risk ratio, 0.99; 95% CI, 0.84-1.18; P =.93). Findings from the secondary subgroup analysis, stratified according to gestational age, birth weight, duration of the intervention, and dosage of docosahexaenoic acid, also did not demonstrate any significant effect on the incidence of BPD in preterm infants.

The fact that there was significant variation in the populations, protocols, and ingredients of N-3 LCPUFAs among the RCTs was a study limitation.

The investigators concluded that findings from the current meta-analysis and recent research provide no supporting evidence that N-3 LCPUFAs should be routinely administered to prevent BPD in preterm infants. Future updates with long-term follow-up data are warranted, and additional investigations and larger-scale RCTs are needed.

Reference                                                                                                                              

Wang Q, Zhou B, Cui Q, Chen C. Omega-3 long-chain polyunsaturated fatty acids for bronchopulmonary dysplasia: a meta-analysis [published online June 4, 2019]. Pediatrics. doi:10.1542/peds.2019-0181