ArticleTranslational pediatrics2026
Retinopathy of prematurity and cognitive development in enteral docosahexaenoic acid-supplemented preterm infants: a systematic review and meta-analysis.
Article in Translational pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Balancing DHA and arachidonic acid: the next step in nutrition for very preterm infants. A commentary.Pediatric research · 2026Article
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7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Background: Docosahexaenoic acid (DHA) plays a pivotal role in brain and retinal maturation. Preterm infants are born DHA-deficient. In this study, we aimed to systematically evaluate the effects of enteral DHA supplementation on retinopathy of prematurity (ROP) and cognitive development in preterm infants. Methods: The PubMed, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov databases were searched from inception to August 1, 2025. Randomized controlled trials (RCTs) investigating enteral DHA supplementation in preterm infants [<37 weeks gestational age (GA) or birth weight <2,500 g] were included if they reported cognitive outcomes, assessed with the Bayley Scales of Infant Development II at 6, 12, and 18 months postterm, or ROP classified according to the International Classification of ROP (ICROP). Results: Thirteen RCTs involving 3,150 infants were analyzed. Early supplementation with enteral DHA did not influence the cognitive development of infants at 6, 12, and 18 months. However, subgroup analysis revealed a GA-dependent trend, with Mental Development Index (MDI) improvement reaching statistical significance in infants <30 weeks GA [mean difference (MD): 3.07, 95% confidence interval (CI): 0.13-6.01]. Supplementation with DHA did not decrease the risk of any ROP [risk ratio (RR): 0.86, 95% CI: 0.67-1.10] but was associated with a significantly decreased risk of severe ROP (RR: 0.66, 95% CI: 0.51-0.86). Data were reanalyzed only including RCTs with ROP as the primary outcome indicator. The incidence of either severe ROP (RR: 0.35, 95% CI: 0.21-0.59) or any ROP (RR: 0.78, 95% CI: 0.64-0.95) was decreased by DHA supplementation, with greater efficacy observed at lower GA (RR: 0.43 for <25 weeks GA). Conclusions: In preterm infants, enteral DHA lowers the incidence of severe ROP by 34% but has no significant effect on cognitive outcomes. There was a tendency for the effect of DHA to be more notable at lower GAs. These findings support targeted DHA strategies for extremely preterm infants, emphasizing the need for high-quality RCTs to optimize dosing and timing.
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