A Fatty Acids Study in Preventing Retinopathy of Prematurity

Summary

Most fatty acids, important for development and especially the Omega-3 fatty acids for the brain development are transferred in the third trimester with means that in the premature infant this transport via the placenta is interrupted and the infant is dependent on the concentrations in breast milk which vary depending on the mother's diet and her stores. It has even been suggested that low Omega-3 would be a cause of premature delivery. Many countries have much higher levels of Omega-3 fatty acids in breast milk than found in Sweden and breast milk substitutions are generally now supplemented with the Long Chained Poly Unsaturated Fatty Acids (LCPUFA). Therefore the supplementation to be given can not be seen to give any risks for the infant. On the contrary, several studies have shown that mother who eat equal to or less than twice fish a week during pregnancy give birth to infants with impaired development. Low Omega-3 levels in premature infants between gestational ages of 23 and 40 weeks can be one reason for Retinopathy of Prematurity (ROP) development. Restoration of Omega-3, Dokosahexaenacid (DHA) and Eikosapentaenacid (EPA) to normal in utero levels may prevent ROP by allowing normal vessel growth and survival. An increase of Omega-3 levels bringing levels to within physiological range may prevent development of ROP.

Timeline

Start

2013-03

Primary completion

2015-09

Completion

2015-09

Publications

• Cakir B, Hellstrom W, Tomita Y, Fu Z, Liegl R, Winberg A, Hansen-Pupp I, Ley D, Hellstrom A, Lofqvist C, Smith LE. IGF1, serum glucose, and retinopathy of prematurity in extremely preterm infants. JCI Insight. 2020 Oct 2;5(19):e140363. doi: 10.1172/jci.insight.140363.
• Nilsson AK, Pedersen A, Malmodin D, Lund AM, Hellgren G, Lofqvist C, Pupp IH, Hellstrom A. Serum choline in extremely preterm infants declines with increasing parenteral nutrition. Eur J Nutr. 2021 Mar;60(2):1081-1089. doi: 10.1007/s00394-020-02312-2. Epub 2020 Jun 25.
• Lundgren P, Hellgren G, Pivodic A, Savman K, Smith LEH, Hellstrom A. Erythropoietin serum levels, versus anaemia as risk factors for severe retinopathy of prematurity. Pediatr Res. 2019 Aug;86(2):276-282. doi: 10.1038/s41390-018-0186-6. Epub 2018 Sep 18.
• Lofqvist CA, Najm S, Hellgren G, Engstrom E, Savman K, Nilsson AK, Andersson MX, Hard AL, Smith LEH, Hellstrom A. Association of Retinopathy of Prematurity With Low Levels of Arachidonic Acid: A Secondary Analysis of a Randomized Clinical Trial. JAMA Ophthalmol. 2018 Mar 1;136(3):271-277. doi: 10.1001/jamaophthalmol.2017.6658.

Drugs

Indications