title: Omega-3 long-chain polyunsaturated fatty acids for extremely preterm infants: a systematic review.
abstract: OBJECTIVE
  Omega-3 long chain polyunsaturated fatty acid (LCPUFA) exposure can be associated with reduced neonatal morbidities. We systematically review the evidence for the benefits of omega-3 LCPUFAs for reducing neonatal morbidities in extremely preterm infants.
  
  
  METHODS
  Data sources were PubMed, Embase, Center for Reviews and Dissemination, and the Cochrane Register of Controlled Trials. Original studies were selected that included infants born at <29 weeks' gestation, those published until May 2013, and those that evaluated the relationship between omega-3 LCPUFA supplementation and major adverse neonatal outcomes. Data were extracted on study design and outcome. Effect estimates were pooled.
  
  
  RESULTS
  Of the 1876 studies identified, 18 randomized controlled trials (RCTs) and 6 observational studies met the defined criteria. No RCT specifically targeted a population of extremely preterm infants. Based on RCTs, omega-3 LCPUFA was not associated with a decreased risk of bronchopulmonary dysplasia in infants overall (pooled risk ratio [RR] 0.97, 95% confidence interval [CI] 0.82-1.13], 12 studies, n = 2809 infants); however, when considering RCTs that include only infants born at ≤32 weeks' gestation, a trend toward a reduction in the risk of bronchopulmonary dysplasia (pooled RR 0.88, 95% CI 0.74-1.05, 7 studies, n = 1156 infants) and a reduction in the risk of necrotizing enterocolitis (pooled RR 0.50, 95% CI 0.23-1.10, 5 studies, n = 900 infants) was observed with LCPUFA.
  
  
  CONCLUSIONS
  Large-scale interventional studies are required to determine the clinical benefits of omega-3 LCPUFA, specifically in extremely preterm infants, during the neonatal period.
authors.affiliation: Department of Pediatrics, Centre Mère-Enfant, and.
authors.forename: Peiyin
authors.initials: P
authors.lastname: Zhang
authors.affiliation: Department of Pediatrics, Children's and Women's Health Centre, University of British Columbia, Vancouver, Canada; and.
authors.forename: Pascal M
authors.initials: PM
authors.lastname: Lavoie
authors.affiliation: Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa University, Ottawa, Canada.
authors.forename: Thierry
authors.initials: T
authors.lastname: Lacaze-Masmonteil
authors.affiliation: Health Technology Assessment Unit, CHU de Quebec, Laval University, Quebec, Canada;
authors.forename: Marc
authors.initials: M
authors.lastname: Rhainds
authors.affiliation: Department of Pediatrics, Centre Mère-Enfant, and isabelle.marc@crchul.ulaval.ca.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Marc
mesh_terms: D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000517:prevention & control*
chemical_list: D015525:Fatty Acids, Omega-3
keywords: fatty acids; infants; neonatal; omega-3; preterm; systematic review