Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct 17;12(10):e064515.
doi: 10.1136/bmjopen-2022-064515.

High doses of enteral docosahexaenoic acid omega-3 supplementation for prevention of bronchopulmonary dysplasia in very preterm infants: a protocol for a systematic review and meta-analysis

Isabelle Marc  1 , Amélie Boutin  2 , Etienne Pronovost  2 , Mireille Guillot  2 , Frédéric Bergeron  3 , Lynne Moore  4 , Maria Makrides  5   6
Affiliations

High doses of enteral docosahexaenoic acid omega-3 supplementation for prevention of bronchopulmonary dysplasia in very preterm infants: a protocol for a systematic review and meta-analysis

Isabelle Marc et al. BMJ Open. .

Abstract

Introduction: Docosahexaenoic acid (DHA) supplementation in the neonatal period has been proposed to prevent bronchopulmonary dysplasia (BPD) in very preterm infants. We aim to determine the effects of an enteral supplementation with high doses of DHA on the risk for BPD at 36 weeks' postmenstrual age (PMA) in very preterm infants born less than 29 weeks' gestation compared with a control.

Methods and analysis: We will conduct a systematic review and meta-analysis of randomised controlled trials (RCTs) searching PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, MedRxiv, ClinicalTrials.gov (up to 1 November 2021) as well as reference lists and citations of included articles and previous reviews. RCTs targeting infants born less than 29 weeks' gestation and evaluating the effect of high doses of DHA enteral supplementation in the neonatal period compared with a control will be eligible. Primary outcome will be BPD defined as the need for oxygen and/or ventilation at 36 weeks' PMA. Two authors will independently screen for inclusion, extract data and assess data quality using the Cochrane instrument (risk-of-bias tool 2.0). We will perform meta-analysis using random effects models. Prespecified subgroup analyses are planned for the infant gestational age and sex, the marine source of DHA, mode of administration and duration of exposure. Sensitivity analysis will be performed according to the accuracy of the BPD definition (ie, physiological definition) and according to the risk of bias of the RCTs.

Ethics and dissemination: This protocol for a systematic review and meta-analysis does not require ethics approval, as no primary data are collected. This study will assess the effectiveness of high doses of enteral DHA supplementation on BPD and provide evidence to clinicians and families for decision-making. Findings will be disseminated through conferences, media interviews and publications to peer review journals.

Prospero registration number: CRD42021286705.

Keywords: NEONATOLOGY; NUTRITION & DIETETICS; PAEDIATRICS.

PubMed Disclaimer

Conflict of interest statement

Competing interests: IM and MM were both principal investigators of RCTs expected to be included in this review.

References

    1. Jobe AH. The new bronchopulmonary dysplasia. Curr Opin Pediatr 2011;23:167–72. 10.1097/MOP.0b013e3283423e6b - DOI - PMC - PubMed
    1. Kinsella JP, Greenough A, Abman SH. Bronchopulmonary dysplasia. Lancet 2006;367:1421–31. 10.1016/S0140-6736(06)68615-7 - DOI - PubMed
    1. Anderson PJ, Doyle LW. Neurodevelopmental outcome of bronchopulmonary dysplasia. Semin Perinatol 2006;30:227–32. 10.1053/j.semperi.2006.05.010 - DOI - PubMed
    1. Schmidt B, Asztalos EV, Roberts RS, et al. . Impact of bronchopulmonary dysplasia, brain injury, and severe retinopathy on the outcome of extremely low-birth-weight infants at 18 months: results from the trial of indomethacin prophylaxis in preterms. JAMA 2003;289:1124–9. 10.1001/jama.289.9.1124 - DOI - PubMed
    1. Martin CR, Dasilva DA, Cluette-Brown JE, et al. . Decreased postnatal docosahexaenoic and arachidonic acid blood levels in premature infants are associated with neonatal morbidities. J Pediatr 2011;159:743–9. 10.1016/j.jpeds.2011.04.039 - DOI - PMC - PubMed

Publication types