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Am J Perinatol 2017; 34(07): 705-715
DOI: 10.1055/s-0036-1597131
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Parenteral Fish-Oil Lipid Emulsions in the Prevention of Severe Retinopathy of Prematurity: A Systematic Review and Meta-Analysis

Sakeer Vayalthrikkovil
1   Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
,
Rani A. Bashir
1   Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
,
Yacov Rabi
1   Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
2   Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
,
Harish Amin
1   Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
2   Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
,
Jill-Marie Spence
1   Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
,
Helen Lee Robertson
3   Health Sciences Library, University of Calgary, Calgary, Alberta, Canada
,
Abhay Lodha
1   Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
2   Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
4   Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
5   Department of Pediatrics, Peter Lougheed Center, Calgary, Alberta, Canada
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Publikationsverlauf

31. Juli 2016

21. Oktober 2016

Publikationsdatum:
19. Dezember 2016 (online)

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Abstract

Objective Omega-3 fatty acids are vital for brain and retinal maturation. It is not clear if early use of ω-3 fatty acids in the form of fish-oil lipid emulsions (FLEs) prevents retinopathy of prematurity (ROP) in preterm infants. The aim of this meta-analysis is to evaluate whether early administration of parenteral FLEs reduces ROP requiring laser therapy or severe ROP ≥stage 3 in preterm infants.

Methods A literature search was performed to identify studies comparing parenteral FLEs with soybean-based lipid emulsions (SLEs) in preventing ROP. The main outcome was incidence of severe ROP or ROP requiring laser therapy.

Results Studies met the inclusion criteria (four RCTs and two observational studies). The pooled relative risk of ROP requiring laser therapy or severe ROP ≥ stage 3 in FLEs group was 0.47 [95% CI: 0.24–0.90] and 0.40 [95% CI: 0.22–0.76] in RCTs and observational studies, respectively. FLEs also reduced cholestasis; however, other secondary outcomes of bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), sepsis, intraventricular hemorrhage (IVH), and mortality were similar.

Conclusion The use of FLEs may reduce the incidence of severe ROP or need for laser therapy in preterm infants. A large multicenter RCT is required to confirm this.

Keywords

fish oil - prematurity - retinopathy of prematurity - total parenteral nutrition

Note

This study was presented as an oral presentation at the 39th AAP District-VIII Conference, 2015, in Victoria and as poster presentation at PAS, 2015, in San Diego and at the Canadian National Perinatal Research Meeting, 2015, at Montebello.