Docosahexaenoic acid and bronchopulmonary dysplasia in preterm infants: a systematic review and meta-analysis

Bronchopulmonary dysplasia (BPD) is a common and serious complication of extremely preterm birth. Given the anti-inflammatory properties, docosahexaenoic acid (DHA) supplementation has been proposed as a strategy for the management of BPD. This study aimed to investigate the effects of DHA supplementation on BPD based on a systematic review.A comprehensive literature search was conducted using ClinicalTrials.Gov, CINAHL, Cochrane Library, EMBASE, MEDLINE, PubMed, and the WHO ICTRP from their respective dates of inception to June 2017. The studies included were randomized controlled trials (RCTs) that enrolled preterm infants <33 weeks of gestational age. Trials were included if DHA supplementation was compared with a control.Four RCTs from five reports (1,966 neonates) met our inclusion criteria. The meta-analysis of these studies showed that DHA supplementation did not decrease the risk of BPD at 36 weeks of postmenstrual age among preterm infants (low certainty of evidence). DHA supplementation did not significantly reduce the risk of other neonatal morbidities including death (low certainty of evidence), BPD at 28 days of life (moderate certainty of evidence), necrotizing enterocolitis (low certainty of evidence), intraventricular hemorrhage, severe retinopathy of prematurity, or sepsis.DHA supplementation may not exert significant clinical benefits in the treatment of BPD and other neonatal morbidities.