The influence of fish-oil lipid emulsions on retinopathy of prematurity in very low birth weight infants: A randomized controlled trial

Objective: To compare the effect of two lipid emulsions on the development of retinopathy of prematurity in very low birth weight infants. Design: Randomized controlled study. Patients and methods: Eighty very low birth weight infants receiving parenteral nutrition from the first day of life were evaluated. One of the two lipid emulsions were used in the study infants: Group 1 (n = 40) received fish-oil based lipid emulsion (SmofLipid(R)) and Group 2 (n = 40) soybean oil based lipid emulsion (Intralipid(R)). Main outcome measures: The development of retinopathy of prematurity and the need for laser photocoagulation were assessed. Results: The maternal and perinatal characteristics were similar in both groups. The median (range) duration of parenteral nutrition [14 days (10-28) vs 14(10-21)] and hospitalization [34 days (20-64) vs 34 (21-53)] did not differ between the groups. Laboratory data including complete blood count, triglyceride level, liver and kidney function tests recorded before and after parenteral nutrition also did not differ between the two groups. In Group 1, two patients (5.0%) and in Group 2,13 patients (32.5%) were diagnosed with retinopathy of prematurity (OR: 9.1,95% Cl 1.9-43.8, p = 0.004). One patient in each group needed laser photocoagulation, without significant difference. Multivariate analysis showed that only receiving fish-oil emulsion in parenteral nutrition decreased the risk of development of retinopathy of prematurity [OR: 0.76, 95% Cl (0.06-0.911), p = 0.04]. Conclusions: Premature infants with very low birth weight receiving an intravenous fat emulsion containing fish oil developed less retinopathy of prematurity. (C) 2013 Elsevier Ireland Ltd. All rights reserved.