Metabolic Mechanisms Induced by Enteral DHA and ARA Supplementation in Preterm Infants

NCT ID: NCT05380401

Last Updated: 2025-09-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

328 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-03-09

Study Completion Date

2028-04-30

Brief Summary

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A comprehensive analysis of the impact of exogenous enteral DHA and ARA supplementation on lipid metabolism including the production of downstream derived mediators and how this impacts important biological pathways such as metabolism, inflammation, and organogenic factors.

Detailed Description

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Infants will be randomized to receive the combined enteral DHA/ARA supplement within the first 48 hours after birth to 36 weeks postmenstrual age. The randomization procedure will follow a stratified permuted block scheme to fulfill two goals: (1) randomize infants into one of four arms and (2) ensure an adequate sample size within each week of gestational age. Preterm infants will be randomized using random permuted blocks within each of the 5 birth gestational age strata. When treatment assignment is open and sample size is not overtly large, a block randomization procedure with randomly chosen block sizes can maintain treatment assignment balance and reduce the potential for selection bias. This approach will also ensure that preterm infants of all eligible gestational ages at birth are approximately equally represented in each of 4 arms of the trial, thus ensuring that important comorbidities and standard of care applicable to infants of different gestational ages at birth are also approximately equally distributed across the study arms. There is no placebo for this study. There is no blinding in this study. Consent will also be obtained from the mother of the infant, as they will be asked to provide milk samples if they're breastfeeding their infant, and maternal medical history and demographical data will be recorded.

Conditions

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Premature

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

There will be four arms of the trial encompassing the period from enrollment to 36 weeks' postmenstrual age: (a) DHA/ARA supplement throughout the duration of the protocol, "d-on"; (b) no DHA/ARA supplement throughout the duration of the protocol, "d-off"; (c) a cross-over arm of DHA/ARA supplement from enrollment to 31 6/7 weeks post-menstrual age (PMA) then no supplement from 32 to 36 weeks' PMA, "x- on/off"; and (d) a cross-over arm of no DHA/ARA supplement till 31 6/7 weeks' then long-chain polyunsaturated fatty acids (LCPUFA) supplement from 32 to 36 weeks PMA, "x-off/on".
Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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DHA/ARA supplement

DHA/ARA supplement throughout the duration of the protocol, "d-on"

Group Type OTHER

Enfamil® DHA & ARA Supplement for Special Dietary Use

Intervention Type DIETARY_SUPPLEMENT

Dosage: 60 mg/kg/day of DHA and 120 mg/kg/day of ARA. Route of administration: enteral tube or by oral syringe

No DHA/ARA supplement

no DHA/ARA supplement throughout the duration of the protocol, "d-off"

Group Type NO_INTERVENTION

No interventions assigned to this group

DHA/ARA initially then no supplement

DHA/ARA supplement from enrollment to 31 6/7 weeks post-menstrual age (PMA) then no supplement from 32 to 36 weeks' PMA, "x- on/off"

Group Type OTHER

Enfamil® DHA & ARA Supplement for Special Dietary Use

Intervention Type DIETARY_SUPPLEMENT

Dosage: 60 mg/kg/day of DHA and 120 mg/kg/day of ARA. Route of administration: enteral tube or by oral syringe

No supplement initially then DHA/ARA supplement

No DHA/ARA supplement till 31 6/7 weeks' then long-chain polyunsaturated fatty acids (LCPUFA) supplement from 32 to 36 weeks PMA, "x-off/on"

Group Type OTHER

Enfamil® DHA & ARA Supplement for Special Dietary Use

Intervention Type DIETARY_SUPPLEMENT

Dosage: 60 mg/kg/day of DHA and 120 mg/kg/day of ARA. Route of administration: enteral tube or by oral syringe

Interventions

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Enfamil® DHA & ARA Supplement for Special Dietary Use

Dosage: 60 mg/kg/day of DHA and 120 mg/kg/day of ARA. Route of administration: enteral tube or by oral syringe

Intervention Type DIETARY_SUPPLEMENT

Other Intervention Names

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DHA/ARA Supplement

Eligibility Criteria

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Inclusion Criteria

* born between 25 0/7 and 29 6/7 weeks of gestation
* less than 48 hours of age at first lipid dose (The cohort is defined by gestational age rather than birth weight to avoid an over-represented sample of growth-restricted infants in birth weight defined cohorts.)

Exclusion Criteria

* serious congenital anomalies
* conditions at birth that will require surgery prior to discharge
* imminent death such that withdrawal of intensive care support is anticipated within the first 72 hours after birth
Maximum Eligible Age

36 Weeks

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

NIH

Sponsor Role collaborator

The University of Texas Health Science Center at San Antonio

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Cynthia Blanco, MD, MSCI-TS

Role: PRINCIPAL_INVESTIGATOR

University of Texas Health Science Center San Antonio

Locations

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University of California, Los Angeles (UCLA)

Los Angeles, California, United States

Site Status RECRUITING

Yale New Haven Hospital

New Haven, Connecticut, United States

Site Status RECRUITING

Ann & Robert H. Lurie Children's Hospital of Chicago

Chicago, Illinois, United States

Site Status RECRUITING

Northwestern University

Chicago, Illinois, United States

Site Status RECRUITING

Weill Cornell Medicine

New York, New York, United States

Site Status RECRUITING

University Health System

San Antonio, Texas, United States

Site Status RECRUITING

University of Texas Health Science Center at San Antonio

San Antonio, Texas, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Cynthia Blanco, MD, MSCI-TS

Role: CONTACT

210-567-5225

Diana Anzueto Guerra

Role: CONTACT

210-567-5254

Facility Contacts

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Kara Calkins, MD

Role: primary

Ashley Dong

Role: backup

Sarah Taylor, MD

Role: primary

Tessa Kehoe

Role: backup

Daniel Robinson, MD

Role: primary

Jonah Silverglade

Role: backup

Daniel Robinson, MD

Role: primary

Jonah Silverglade

Role: backup

Camilia Martin, MD

Role: primary

Martha Liu

Role: backup

Diana Anzueto Guerra, MS

Role: primary

210-567-5254

Cynthia Blanco, MD

Role: backup

210-567-5225

Cynthia Blanco, MD

Role: primary

Diana Anzueto Guerra

Role: backup

Other Identifiers

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1R01HD108646

Identifier Type: NIH

Identifier Source: secondary_id

View Link

HSC20220120H

Identifier Type: -

Identifier Source: org_study_id

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