Abstract
Fetal and early postnatal inflammation have been associated with increased morbidity in extremely preterm infants. This study aimed to demonstrate if postpartum levels of docosahexaenoic acid (DHA) and arachidonic acid (AA) were associated with early inflammation. In a cohort of 90 extremely preterm infants, DHA and AA in cord blood, on the first postnatal day and on postnatal day 7 were examined in relation to early systemic inflammation, defined as elevated C-reactive protein (CRP) and/or interleukin-6 (IL-6) within 72 h from birth, with or without positive blood culture. Median serum level of DHA was 0.5 mol% (95% CI (confidence interval) 0.2–0.9, P = 0.006) lower than the first postnatal day in infants with early systemic inflammation, compared to infants without signs of inflammation, whereas levels of AA were not statistically different between infants with and without signs of inflammation. In cord blood, lower serum levels of both DHA (correlation coefficient −0.40; P = 0.010) and AA (correlation coefficient −0.54; p < 0.001) correlated with higher levels of IL-6. Levels of DHA or AA did not differ between infants with and without histological signs of chorioamnionitis or fetal inflammation. In conclusion, serum levels of DHA at birth were associated with the inflammatory response during the early postnatal period in extremely preterm infants.
Highlights
Fetal inflammation, as well as early postnatal inflammation, have been associated with increased mortality, and both short- and long term morbidity in preterm infants [1,2,3,4]
The present study aimed to investigate if serum levels of docosahexaenoic acid (DHA) and arachidonic acid (AA), in cord blood and during the first postnatal day, were associated with inflammatory conditions during the perinatal and early postnatal periods in extremely preterm infants
We demonstrated that levels of the omega-3 LCPUFA DHA the first postnatal day were lower in extremely preterm infants with early systemic inflammation compared to infants without systemic inflammation
Summary
As well as early postnatal inflammation, have been associated with increased mortality, and both short- and long term morbidity in preterm infants [1,2,3,4]. Placental transfer of LCPUFAs (long-chain polyunsaturated fatty acid) is abruptly interrupted. Preterm infants are able to synthesize DHA and AA from their C18 counterparts (α-linolenic and linoleic acid, respectively), albeit the endogenous synthesis rate is believed to be too low to meet infants’ requirements [7,8], and preterm infants are at risk of dysregulated inflammation. Supplementation with omega-3 LCPUFAs during pregnancy reduces the risk of preterm birth [9], potentially by a reduced inflammatory response [10]. Lower postnatal levels of AA were associated with a higher risk of developing retinopathy of prematurity (ROP) [17]
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