DOCOSAHEXANOIC ACID SUPPLEMENTATION IN PRETERM NEONATES ADMITTED IN NICU AND ITS EFFECT ON INFLAMMATORY MARKERS AT DAY 10 -AN OPEN LABELLED RANDOMIZED CONTROL TRIAL

Abstract

Introduction: With an undeveloped immune-regulatory system, preterm neonates are more susceptible to developing chronic inflammation. This sensitivity raise the likelihood that they may develop inflammation. In the immediate life, there is an urgent need for effective measures in the prevention of ‘SEPSIS, NEC, BPD, and ROP’ including dietary approaches. The purpose of this research is to find whether or not supplementation with DHA has the ability to modify immune responses and decrease inflammation in pre-term newborns who have been hospitalized to NICU Methods: In order to carry out this experiment, a randomized controlled trial with open labels was used. Fifty infants were divided into 2 groups by random assignment by a computerized randomized controlled trial (RCT): one group received DHA and the other group acted as control. Newborns between 32 & 34 weeks gestational age were considered for the study, Levels of C-reactive protein, interleukin-6 & procalcitonin were measured on the tenth day of life. Results: 25 neonates in DHA Group and 24 neonates in control group have finished study. A statistically noteworthy variance was detected between the 2 groups for procalcitonin & IL-6. xxi Mean Procalcitonin values is 0.27 + 0.152 in DHA given group, whereas in control group , the Mean Procalcitonin is 0.72+0.930, p value between two groups is0.029, less than 0.05, which is statistically significant. In DHA group IL-6 values are 2.47+ 0.552 whereas in Control group IL-6 values are 3.40+1.80, p value between two groups is 0.019, less than 0.05, which is statistically significant. A statistically noteworthy variance between DHA group and control group for abdominal distension and ROP is also noted. In DHA supplementation group, abdominal distension is seen in 1 patient (4%) and in control group abdominal distension is seen in 8 patients (33.3%) and P value is 0.011, which is statistically noteworthy. Presence of ROP are seen in 2 patients, In group 2 control group presence of ROP are seen in 2 patients. p value is 0.043 indicating they were significant statistically. Conclusion: The study suggests that DHA supplementation may improve clinical conditions such as abdominal distension and may possibly reduce the incidence of inflammation as evidenced by documentation of inflammatory markers (CRP, procalcitonin, IL-6). The observations of this research imply that supplementing of oral DHA may help in preventing retinopathy of prematurity, however to what extent DHA help in preventing ROP needs further study with larger sample size.