Abstract
Background
Long chain polyunsaturated fatty acids (LCPUFAs) have proven to be essential for development in preterm infants and have been studied for their capacity to reduce inflammation and infection rates, including sepsis in enteral and parenteral nutrition. The aim of this review and meta-analysis is to gather the information available on this subject to determine if n-3 polyunsaturated fatty acids can reduce sepsis incidence in preterm infants.
Methods
This systematic review was conducted by searching in the databases MEDLINE (via PubMed), ISI-Web of Science, EMBASE, SCOPUS, SciELO, and Cochrane Library databases. We analyzed the data regarding sepsis using the Grading of Recommendations Assessment, Development and Evaluation approach to assess the quality of the evidence.
Results
A total of 40 trials were included for review and 35 trials had the data available for quantitative analysis. LCPUFAs supplementation did not reduce incidence of sepsis (relative risk (RR), confidence interval (CI) 0.95 [0.87, 1.03] P = 0.87; I2 = 0%). These results remained consistent after the sensitivity analysis.
Conclusion
The results of this systematic review and meta-analysis indicate that LCPUFA supplementation is not associated with a significant decrease in the incidence of sepsis in premature infants.
Impact
-
Reviewing the information available about LCPUFA supplementation and sepsis since the results in previous Clinical Trials (CT) are inconclusive.
-
It summarizes the results of 42 CT and we have not found conclusive results regarding sepsis in the literature.
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It could be of clinical interest for pediatricians and nutritionists.
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Acknowledgements
This review was not registered, and a protocol was not prepared previously. This research has been funded by the Ministerio de Ciencia, e Innovación y Universidades PID2020-119084RB-C21, the European Society for Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN), and the 20th National Grants for Research in Life Sciences 2021/2021 from Ramón Areces Foundation (Spain).
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W.C.A.: Methodology, Validation, Formal Analysis, Investigation, Resources, Data Curation, Writing and Original Draft. M.L.C.: Methodology, Investigation, Validation. C.d.L.: Methodology, Investigation, Validation. M.A.J.V.: Methodology, Investigation, Validation. M.R.L.G.: Methodology, Investigation, Validation. C.Z.: Methodology, Investigation, Validation. M.S.d.P.: Conceptualization, Methodology, Writing, and Review and Editing, Supervision, Funding Acquisition, Project Administration.
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Witte Castro, A., Couce, M.L., de Lamas, C. et al. Long-chain polyunsaturated fatty acids supplementation and sepsis: a systematic review and meta-analysis. Pediatr Res 97, 924–938 (2025). https://doi.org/10.1038/s41390-024-03579-5
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DOI: https://doi.org/10.1038/s41390-024-03579-5
