title: Parenteral Fish-Oil Lipid Emulsions in the Prevention of Severe Retinopathy of Prematurity: A Systematic Review and Meta-Analysis.
abstract: ObjectiveOmega-3 fatty acids are vital for brain and retinal maturation. It is not clear if early use of ω-3 fatty acids in the form of fish-oil lipid emulsions (FLEs) prevents retinopathy of prematurity (ROP) in preterm infants. The aim of this meta-analysis is to evaluate whether early administration of parenteral FLEs reduces ROP requiring laser therapy or severe ROP ≥stage 3 in preterm infants.MethodsA literature search was performed to identify studies comparing parenteral FLEs with soybean-based lipid emulsions (SLEs) in preventing ROP. The main outcome was incidence of severe ROP or ROP requiring laser therapy.ResultsStudies met the inclusion criteria (four RCTs and two observational studies). The pooled relative risk of ROP requiring laser therapy or severe ROP ≥ stage 3 in FLEs group was 0.47 [95% CI: 0.24-0.90] and 0.40 [95% CI: 0.22-0.76] in RCTs and observational studies, respectively. FLEs also reduced cholestasis; however, other secondary outcomes of bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), sepsis, intraventricular hemorrhage (IVH), and mortality were similar.ConclusionThe use of FLEs may reduce the incidence of severe ROP or need for laser therapy in preterm infants. A large multicenter RCT is required to confirm this.
authors.affiliation: Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Sakeer
authors.initials: S
authors.lastname: Vayalthrikkovil
authors.affiliation: Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Rani A
authors.initials: RA
authors.lastname: Bashir
authors.affiliation: Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Yacov
authors.initials: Y
authors.lastname: Rabi
authors.affiliation: Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Harish
authors.initials: H
authors.lastname: Amin
authors.affiliation: Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Jill-Marie
authors.initials: JM
authors.lastname: Spence
authors.affiliation: Health Sciences Library, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Helen Lee
authors.initials: HL
authors.lastname: Robertson
authors.affiliation: Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Abhay
authors.initials: A
authors.lastname: Lodha
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000517:prevention & control; D020345:Enterocolitis, Necrotizing / Q000517:prevention & control; D005217:Fat Emulsions, Intravenous / Q000627:therapeutic use*; D005395:Fish Oils / Q000627:therapeutic use*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D010288:Parenteral Nutrition / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D012178:Retinopathy of Prematurity / Q000453:epidemiology* / Q000517:prevention & control* / Q000628:therapy
chemical_list: D005217:Fat Emulsions, Intravenous; D005395:Fish Oils