Neurodevelopmental outcomes at 7 years’ corrected age in preterm infants who were fed high-dose docosahexaenoic acid to term equivalent: a follow-up of a randomised controlled trial

dc.contributor.author Collins, Carmel T
dc.contributor.author Gibson, Robert A
dc.contributor.author Anderson, Peter J
dc.contributor.author McPhee, Andrew J
dc.contributor.author Sullivan, Thomas R
dc.contributor.author Gould, Jacqueline F
dc.contributor.author Ryan, Philip
dc.contributor.author Doyle, Lex W
dc.contributor.author Davis, Peter G
dc.contributor.author McMichael, Judy E
dc.contributor.author French, Noel P
dc.contributor.author Colditz, Paul B
dc.contributor.author Simmer, Karen
dc.contributor.author Morris, Scott A
dc.contributor.author Makrides, Maria
dc.date.accessioned 2016-03-01T05:32:16Z
dc.date.available 2016-03-01T05:32:16Z
dc.date.issued 2015
dc.description This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work noncommercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http:// creativecommons.org/licenses/by-nc/4.0/ en
dc.description.abstract OBJECTIVE: To determine if improvements in cognitive outcome detected at 18 months' corrected age (CA) in infants born <33 weeks' gestation receiving a high-docosahexaenoic acid (DHA) compared with standard-DHA diet were sustained in early childhood. DESIGN: Follow-up of a multicentre randomised controlled trial. Randomisation was stratified for sex, birth weight (<1250 vs ≥1250 g) and hospital. SETTING: Five Australian tertiary hospitals from 2008 to 2013. PARTICIPANTS: 626 of the 657 participants randomised between 2001 and 2005 were eligible to participate. INTERVENTIONS: High-DHA (≈1% total fatty acids) enteral feeds compared with standard-DHA (≈0.3% total fatty acids) from age 2-4 days until term CA. PRIMARY OUTCOME: Full Scale IQ of the Wechsler Abbreviated Scale of Intelligence (WASI) at 7 years CA. Prespecified subgroup analyses based on the randomisation strata (sex, birth weight) were conducted. RESULTS: 604 (92% of the 657 originally randomised) consented to participate (291 high-DHA, 313 standard-DHA). To address missing data in the 604 consenting participants (22 for primary outcome), multiple imputation was performed. The Full Scale IQ was not significantly different between groups (high-DHA 98.3, SD 14.0, standard-DHA 98.5, SD 14.9; mean difference adjusted for sex, birthweight strata and hospital -0.3, 95% CI -2.9 to 2.2; p=0.79). There were no significant differences in any secondary outcomes. In prespecified subgroup analyses, there was a significant sex by treatment interaction on measures of parent-reported executive function and behaviour. Scores were within the normal range but girls receiving the high-DHA diet scored significantly higher (poorer outcome) compared with girls receiving the standard-DHA diet. CONCLUSIONS: Supplementing the diets of preterm infants with a DHA dose of approximately 1% total fatty acids from days 2-4 until term CA showed no evidence of benefit at 7 years' CA. TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry: ACTRN12606000327583. en
dc.identifier.citation Collins CT, Gibson RA, Anderson PJ, McPhee AJ, Sullivan TR, Gould JF, Ryan P, Doyle LW, Davis PG, McMichael JE, French NP, Colditz PB, Simmer K, Morris SA, Makrides M. Neurodevelopmental outcomes at 7 years' corrected age in preterm infants who were fed high-dose docosahexaenoic acid to term equivalent: a follow-up of a randomised controlled trial. BMJ Open. 2015 Mar 18;5(3):e007314. doi: 10.1136/bmjopen-2014-007314. en
dc.identifier.doi https://doi.org/10.1136/bmjopen-2014-007314 en
dc.identifier.issn 2044-6055
dc.identifier.uri http://hdl.handle.net/2328/36004
dc.language.iso en
dc.publisher BMJ Publishing Group en
dc.relation http://purl.org/au-research/grants/NHMRC/508003 en
dc.relation http://purl.org/au-research/grants/NHMRC/APP1046207 en
dc.relation http://purl.org/au-research/grants/NHMRC/APP628371 en
dc.relation http://purl.org/au-research/grants/NHMRC/APP1059111 en
dc.relation http://purl.org/au-research/grants/NHMRC/APP511117 en
dc.relation http://purl.org/au-research/grants/NHMRC/APP1061704 en
dc.relation.grantnumber NHMRC/508003 en
dc.relation.grantnumber NHMRC/APP1046207 en
dc.relation.grantnumber NHMRC/APP628371 en
dc.relation.grantnumber NHMRC/APP1059111 en
dc.relation.grantnumber NHMRC/APP511117 en
dc.relation.grantnumber NHMRC/APP1061704 en
dc.rights This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work noncommercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http:// creativecommons.org/licenses/by-nc/4.0/ en
dc.rights.license CC-BY-NC
dc.title Neurodevelopmental outcomes at 7 years’ corrected age in preterm infants who were fed high-dose docosahexaenoic acid to term equivalent: a follow-up of a randomised controlled trial en
dc.type Article en
local.contributor.authorOrcidLookup Collins, Carmel T: https://orcid.org/0000-0003-3308-9948
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