title: High-dose docosahexaenoic acid supplementation of preterm infants: respiratory and allergy outcomes.
abstract: BACKGROUND
  Docosahexaenoic acid (DHA) has been associated with downregulation of inflammatory responses.
  
  
  OBJECTIVE
  To report the effect of DHA supplementation on long-term atopic and respiratory outcomes in preterm infants.
  
  
  METHODS
  This study is a multicenter, randomized controlled trial comparing the outcomes for preterm infants <33 weeks' gestation who consumed expressed breast milk from mothers taking either tuna oil (high-DHA diet) or soy oil (standard-DHA) capsules. Data collected included incidence of bronchopulmonary dysplasia (BPD) and parental reporting of atopic conditions over the first 18 months of life.
  
  
  RESULTS
  Six hundred fifty-seven infants were enrolled (322 to high-DHA diet, 335 to standard), and 93.5% completed the 18-month follow-up. There was a reduction in BPD in boys (relative risk [RR]: 0.67 [95% confidence interval (CI): 0.47-0.96]; P=.03) and in all infants with a birth weight of <1250 g (RR: 0.75 [95% CI: 0.57-0.98]; P=.04). There was no effect on duration of respiratory support, admission length, or home oxygen requirement. There was a reduction in reported hay fever in all infants in the high-DHA group at either 12 or 18 months (RR: 0.41 [95% CI: 0.18-0.91]; P=.03) and at either 12 or 18 months in boys (RR: 0.15 [0.03-0.64]; P=.01). There was no effect on asthma, eczema, or food allergy.
  
  
  CONCLUSIONS
  DHA supplementation for infants of <33 weeks' gestation reduced the incidence of BPD in boys and in all infants with a birth weight of <1250 g and reduced the incidence of reported hay fever in boys at either 12 or 18 months.
authors.affiliation: Department of Newborn Research, Royal Women's Hospital, 20 Flemington Rd, Parkville, Victoria 3052, Australia.
authors.forename: Brett J
authors.initials: BJ
authors.lastname: Manley
authors.forename: Maria
authors.initials: M
authors.lastname: Makrides
authors.forename: Carmel T
authors.initials: CT
authors.lastname: Collins
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: McPhee
authors.forename: Robert A
authors.initials: RA
authors.lastname: Gibson
authors.forename: Philip
authors.initials: P
authors.lastname: Ryan
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Sullivan
authors.forename: Peter G
authors.initials: PG
authors.lastname: Davis
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000517:prevention & control; D019587:Dietary Supplements; D004281:Docosahexaenoic Acids / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000517:prevention & control; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D013997:Time Factors
chemical_list: D004281:Docosahexaenoic Acids