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Am J Perinatol 2025; 42(11): 1400-1408
DOI: 10.1055/a-2496-2310
Original Article

Prospective Cohort Study Investigating Polyunsaturated Fatty Acids and Chronic Lung Disease in Preterm Infants

Teryn Igawa
1   Department of Pediatrics, Children's Discovery and Innovation Institute, David Geffen School of Medicine UCLA and UCLA Mattel Children's Hospital, Los Angeles
,
Tessa C. Gillespie
2   Department of Pediatrics, Stanford University and Stanford Medicine, Palo Alto, California
,
Esther S. Kim
3   Division of Neonatology, Department of Pediatrics, UCLA – Olive View, Sylmar, California
,
Lauren J. Lee
4   Department of Pediatrics, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts
,
Tristan Grogan
5   Department of Medicine Statistics Core, David Geffen School of Medicine, UCLA, Los Angeles, California
6   Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, UCLA, Los Angeles, California
,
Alison Chu
1   Department of Pediatrics, Children's Discovery and Innovation Institute, David Geffen School of Medicine UCLA and UCLA Mattel Children's Hospital, Los Angeles
,
Kara L. Calkins 
1   Department of Pediatrics, Children's Discovery and Innovation Institute, David Geffen School of Medicine UCLA and UCLA Mattel Children's Hospital, Los Angeles
› Author Affiliations
Funding T.C.G. received funding from the Short Term Training Program, David Geffen School of Medicine. E.S.K. received funding from T32 EY007026 and the UCLA Children's Discovery and Innovation Institute. A.C. is funded by NIH/NEI (grant no.: R01EY032561). K.L.C. received funding from NIH/NCATS (grant no.: KL2TR000122). Statistical analyses for this research was supported in part by NIH National Center for Advancing Translational Science (NCATS) UCLA CTSI (grant no.: UL1TR001881).
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Abstract

Objective

Chronic lung disease (CLD) is a complication of prematurity. Studies examining the effects of long-chain polyunsaturated fatty acids (LC-PUFAs) on CLD are conflicting. This study investigated LC-PUFAs in the red blood cell membrane (RBCM) in preterm infants.

Study Design

This prospective observational study included infants with gestational age <32 weeks or birth weight <2 kg and at least one LC-PUFA measurement in the first month of life. Subjects without CLD (CON group) were compared with those with CLD (CLD group) and then by CLD severity.

Results

Seventy infants were included (CON n = 29; CLD n = 41). Twenty-six infants had Grade 1 CLD; 12 had Grade 2 CLD; 3 had Grade 3 CLD. When the CLD group was compared with the CON group, the overall mean (95% confidence interval) RBCM% for linoleic acid (LA) was similar (CLD vs. CON 12.5% [11.7–13.4%] vs. 11.2% [10.2–12.3%], p = 0.06) but the overall mean arachidonic acid (ARA) was lower (17.6% [17.1–18.0%] vs. 18.6% [18.1–19.2%], p < 0.01). During weeks 1 to 4, LA% was similar, while ARA% was lower in weeks 2 and 3 (18.8 ± 2.2% vs. 20.0 ± 1.5%, p = 0.05, 16.8 ± 2.0% vs. 18.3 ± 1.6%, p = 0.01). A similar trend was noted when groups were compared by CLD severity. The CLD group had a higher overall mean α-linolenic acid (ALA) compared with the CON group (0.4% [0.3–0.4%] vs. 0.2% [0.2–0.3%], p < 0.01) but no difference in docosahexaenoic acid (DHA; 3.8% [3.4–4.1%] vs. 3.8% [3.4–4.3%], p = 0.80). During weeks 1 to 4, ALA% was higher during week 1 only (0.4 ± 0.3% vs. 0.2 ± 0.1%, p < 0.01), and DHA% was similar for weeks 1 to 4. Results were similar when groups were compared by CLD severity.

Conclusion

In this study, low ARA status was associated with CLD.

Key Points

  • In this study, infants with CLD had a similar RBCM% of LA, but a lower percentage of its downstream LC-PUFA, ARA, compared with infants without CLD.

  • In this study, infants with CLD had a higher RBCM% of α-linolenic acid, but a similar percentage of its downstream LC-PUFA, DHA, compared with infants without CLD.

  • In this study, these trends were similiar when groups were compared by CLD severity.

Keywords

chronic lung disease - long-chain polyunsaturated fatty acids - nutrition - preterm - infant


Publication History

Received: 10 September 2024

Accepted: 03 December 2024

Accepted Manuscript online:
05 December 2024

Article published online:
09 January 2025

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