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. 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 to those with CLD (CLD group) and then by CLD severity. 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 to 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 1-4, 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 ∝-linolenic acid (ALA) compared to 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 1-4, 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 1-4. Results were similar when groups were compared by CLD severity. In this study, low ARA status was associated with CLD.
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