title: Decreased postnatal docosahexaenoic and arachidonic acid blood levels in premature infants are associated with neonatal morbidities.
abstract: OBJECTIVE
  To measure the changes in whole blood fatty acid levels in premature infants and evaluate associations between these changes and neonatal morbidities.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  Altered postnatal fatty acid levels in premature infants are associated with an increased risk of CLD and late-onset sepsis.
authors.affiliation: Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA. cmartin1@bidmc.harvard.edu
authors.forename: Camilia R
authors.initials: CR
authors.lastname: Martin
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Dasilva
authors.forename: Joanne E
authors.initials: JE
authors.lastname: Cluette-Brown
authors.forename: Clementina
authors.initials: C
authors.lastname: Dimonda
authors.forename: Ashley
authors.initials: A
authors.lastname: Hamill
authors.forename: Abdul Q
authors.initials: AQ
authors.lastname: Bhutta
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Coronel
authors.forename: Michael
authors.initials: M
authors.lastname: Wilschanski
authors.forename: Alisa J
authors.initials: AJ
authors.lastname: Stephens
authors.forename: David F
authors.initials: DF
authors.lastname: Driscoll
authors.forename: Bruce R
authors.initials: BR
authors.lastname: Bistrian
authors.forename: James H
authors.initials: JH
authors.lastname: Ware
authors.forename: Munir M
authors.initials: MM
authors.lastname: Zaman
authors.forename: Steven D
authors.initials: SD
authors.lastname: Freedman
mesh_terms: D016718:Arachidonic Acid / Q000097:blood*; D002908:Chronic Disease; D015331:Cohort Studies; D004281:Docosahexaenoic Acids / Q000097:blood*; D005227:Fatty Acids / Q000097:blood; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D008171:Lung Diseases / Q000097:blood* / Q000453:epidemiology; D008297:Male; D010102:Oxygen Inhalation Therapy; D016016:Proportional Hazards Models; D012178:Retinopathy of Prematurity / Q000097:blood / Q000453:epidemiology; D012189:Retrospective Studies; D018805:Sepsis / Q000097:blood / Q000453:epidemiology
chemical_list: D005227:Fatty Acids; D004281:Docosahexaenoic Acids; D016718:Arachidonic Acid