ARA and DHA metabolism in preterm neonates in context

Czech version

Authors: J. Dušek ^1,2; J. Dušková ^2,3,4
Authors‘ workplace: Neonatologické oddělení Nemocnice České Budějovice, a. s. ¹; Zdravotně sociální fakulta Jihočeské univerzity v Českých Budějovicích ²; Anesteziologické resuscitační oddělení Nemocnice České Budějovice, a. s. ³; University Hospital of Umeå, Sweden ⁴
Published in: Čes-slov Neonat 2025; 31 (2): 104-110.
Category: Original Paper

Overview

Arachidonic acid (ARA) and docosahexaenoic acid (DHA) are essential fatty acids that play a key role in neurodevelopment, vision, immunity, and growth in preterm infants. Due to limited endogenous synthesis and the premature cessation of transplacental transfer, these infants are at high risk of deficiency, which is associated with increased morbidity including necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH), and impaired psychomotor development. Supplementation with ARA and DHA in an optimal 2 : 1 ratio mimics the composition of human milk and offers benefits in terms of neurological maturation, growth, and immune function. Individualized dosing is essential, considering clinical conditions (e.g., BPD, intestinal stoma), genetic polymorphisms (e.g., FADS), and the transition phase from parenteral to enteral nutrition. Emerging evidence highlights long-term benefits of supplementation, including a lower incidence of ADHD and metabolic syndrome. ARA and DHA thus represent a cornerstone of modern neonatal nutrition, with emphasis on a personalized approach and monitoring of serum levels.

Keywords:

Retinopathy of prematurity – bronchopulmonary dysplasia – intraventricular hemorrhage – necrotizing enterocolitis – arachidonic acid – docosahexaenoic acid

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