A Clinical Study on the Impact of Docosahexaenoic Acid on the Prevention of Necrotizing Enterocolitis in Preterm Neonates

Abstract

Preterm birth is defined as birth that occurs at less than 37 completed weeks’ gestation. It takes place in approximately 12% of deliveries globally and can significantly influence child’s long- term health. Preterm neonates have under-developed immune-regulatory system; consequently, there is a risk for developing chronic inflammation. Moreover, dysregulation of inflammatory responses plays a principal role in the etiology of many fatal neonatal inflammatory disorders and therefore represents an ongoing challenge to HCWs involved in neonatal care. Necrotizing enterocolitis is an acute devastating neonatal intestinal inflammatory disorder primarily described in 1965. It involves gut wall inflammation and injury that may proceed to necrosis and, eventually, gut perforation. NEC is more prevalent in early preterm infants than in late-preterm or term infants. The incidence of NEC also drastically increases for infants with a birth weight less than 1500 g. Due to the obscure multifactorial etiology, early diagnosis and effective treatment of NEC are limited. Consequently, effective strategies in the prevention of NEC, including nutritional approaches, are critically needed. A growing body of evidence suggests the imperative role of immune modulatory nutrients in primary prevention of NEC including probiotics, prebiotics, LCPUFA and amino acids. LCPUFA, including DHA, are essential for normal health and neurodevelopment. Additionally, there is increasing evidence that n-3 LCPUFA may reduce the incidence or severity of the common inflammatory disorders and comorbidities of prematurity by influencing various