Prospective Cohort Study Investigating Polyunsaturated Fatty Acids and Chronic Lung Disease in Preterm Infants

Teryn Igawa; Tessa C Gillespie; Esther S Kim; Lauren J Lee; Tristan Grogan; Alison Chu; Kara L Calkins

doi:10.1055/a-2496-2310

Prospective Cohort Study Investigating Polyunsaturated Fatty Acids and Chronic Lung Disease in Preterm Infants

Am J Perinatol. 2025 Jan 9. doi: 10.1055/a-2496-2310. Online ahead of print.

Authors

Teryn Igawa¹, Tessa C Gillespie², Esther S Kim³, Lauren J Lee⁴, Tristan Grogan^{5

6}, Alison Chu¹, Kara L Calkins¹

Affiliations

¹ Department of Pediatrics, Children's Discovery and Innovation Institute, David Geffen School of Medicine UCLA and UCLA Mattel Children's Hospital, Los Angeles.
² Department of Pediatrics, Stanford University and Stanford Medicine, Palo Alto, California.
³ Division of Neonatology, Department of Pediatrics, UCLA - Olive View, Sylmar, California.
⁴ Department of Pediatrics, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts.
⁵ Department of Medicine Statistics Core, David Geffen School of Medicine, UCLA, Los Angeles, California.
⁶ Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, UCLA, Los Angeles, California.

PMID: 39638326
DOI: 10.1055/a-2496-2310

Abstract

Objective: 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.

Study design: 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 with those with CLD (CLD group) and then by CLD severity.

Results: 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 with 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 to 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 α-linolenic acid (ALA) compared with 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 to 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 to 4. Results were similar when groups were compared by CLD severity.

Conclusion: In this study, low ARA status was associated with CLD.

Key points: · In this study, infants with CLD had a similar RBCM% of LA, but a lower percentage of its downstream LC-PUFA, ARA, compared with infants without CLD.. · In this study, infants with CLD had a higher RBCM% of α-linolenic acid, but a similar percentage of its downstream LC-PUFA, DHA, compared with infants without CLD.. · In this study, these trends were similiar when groups were compared by CLD severity..