当前位置： SCI文献检索 > BMJ Open期刊下所有文献 > Neurodevelopmental outcomes at 7 years' corrected age in preterm infants who were fed high-dose docosahexaenoic acid to term equivalent: a follow-up of a randomised controlled trial.

Neurodevelopmental outcomes at 7 years' corrected age in preterm infants who were fed high-dose docosahexaenoic acid to term equivalent: a follow-up of a randomised controlled trial.

Abstract：

OBJECTIVE:To determine if improvements in cognitive outcome detected at 18 months' corrected age (CA) in infants born <33 weeks' gestation receiving a high-docosahexaenoic acid (DHA) compared with standard-DHA diet were sustained in early childhood. DESIGN:Follow-up of a multicentre randomised controlled trial. Randomisation was stratified for sex, birth weight (<1250 vs ≥1250 g) and hospital. SETTING:Five Australian tertiary hospitals from 2008 to 2013. PARTICIPANTS:626 of the 657 participants randomised between 2001 and 2005 were eligible to participate. INTERVENTIONS:High-DHA (≈1% total fatty acids) enteral feeds compared with standard-DHA (≈0.3% total fatty acids) from age 2-4 days until term CA. PRIMARY OUTCOME:Full Scale IQ of the Wechsler Abbreviated Scale of Intelligence (WASI) at 7 years CA. Prespecified subgroup analyses based on the randomisation strata (sex, birth weight) were conducted. RESULTS:604 (92% of the 657 originally randomised) consented to participate (291 high-DHA, 313 standard-DHA). To address missing data in the 604 consenting participants (22 for primary outcome), multiple imputation was performed. The Full Scale IQ was not significantly different between groups (high-DHA 98.3, SD 14.0, standard-DHA 98.5, SD 14.9; mean difference adjusted for sex, birthweight strata and hospital -0.3, 95% CI -2.9 to 2.2; p=0.79). There were no significant differences in any secondary outcomes. In prespecified subgroup analyses, there was a significant sex by treatment interaction on measures of parent-reported executive function and behaviour. Scores were within the normal range but girls receiving the high-DHA diet scored significantly higher (poorer outcome) compared with girls receiving the standard-DHA diet. CONCLUSIONS:Supplementing the diets of preterm infants with a DHA dose of approximately 1% total fatty acids from days 2-4 until term CA showed no evidence of benefit at 7 years' CA. TRIAL REGISTRATION NUMBER:Australian New Zealand Clinical Trials Registry: ACTRN12606000327583.

journal_name

BMJ Open

journal_title

BMJ open

authors

Collins CT,Gibson RA,Anderson PJ,McPhee AJ,Sullivan TR,Gould JF,Ryan P,Doyle LW,Davis PG,McMichael JE,French NP,Colditz PB,Simmer K,Morris SA,Makrides M

doi

10.1136/bmjopen-2014-007314

subject

Has Abstract

pub_date

2015-03-18 00:00:00

pages

e007314

issue

issn

2044-6055

pii

bmjopen-2014-007314

journal_volume

pub_type

杂志文章,多中心研究,随机对照试验

在线工具

Neurodevelopmental outcomes at 7 years' corrected age in preterm infants who were fed high-dose docosahexaenoic acid to term equivalent: a follow-up of a randomised controlled trial.