Decreased Postnatal Docosahexaenoic and Arachidonic Acid Blood Levels in Premature Infants are Associated with Neonatal Morbidities

作者：Martin Camilia R^*; DaSilva Deborah A; Cluette Brown Joanne E; DiMonda Clementina; Hamill Ashley; Bhutta Abdul Q; Coronel Emmanuel; Wilschanski Michael; Stephens Alisa J; Driscoll David F; Bistrian Bruce R; Ware James H; Zaman Munir M; Freedman Steven D

来源：Journal of Pediatrics, 2011, 159(5): 743-U76.

DOI：10.1016/j.jpeds.2011.04.039

Objective To measure the changes in whole blood fatty acid levels in premature infants and evaluate associations between these changes and neonatal morbidities.
Study design This was a retrospective cohort study of 88 infants born at <30 weeks' gestation. Serial fatty acid profiles during the first postnatal month and infant outcomes, including chronic lung disease (CLD), retinopathy of prematurity, and late-onset sepsis, were analyzed. Regression modeling was applied to determine the association between fatty acid levels and neonatal morbidities.
Results Docosahexaenoic acid (DHA) and arachidonic acid levels declined rapidly in the first postnatal week, with a concomitant increase in linoleic acid levels. Decreased DHA level was associated with an increased risk of CLD (OR, 2.5; 95% CI, 1.3-5.0). Decreased arachidonic acid level was associated with an increased risk of late-onset sepsis (hazard ratio, 1.4; 95% CI, 1.1-1.7). The balance of fatty acids was also a predictor of CLD and late-onset sepsis. An increased linoleic acid: DHA ratio was associated with an increased risk of CLD (OR, 8.6; 95% CI, 1.4-53.1) and late-onset sepsis (hazard ratio, 4.6; 95% CI, 1.5-14.1).
Conclusion Altered postnatal fatty acid levels in premature infants are associated with an increased risk of CLD and late-onset sepsis. (J Pediatr 2011;159:743-9).

• 出版日期2011-11