There is hope of a new way to protect extremely premature
babies from impaired vision or blindness resulting from the eye disease
retinopathy of prematurity (ROP). A study at Sahlgrenska Academy published in JAMA Ophthalmology points to a clear
link between ROP and low levels of the fatty acid arachidonic acid, measured in
children’s blood.

“Seeing such a strong connection between arachidonic acid
levels and ROP is something that is entirely new. However, we looked at the
data, it’s always low levels of arachidonic acid that is most clearly
associated with the disease,” says Chatarina Löfqvist, an associate professor
in experimental ophthalmology and the first author of the article.

“What we believe and hope is that providing the children
with arachidonic acid will raise the levels and reduce the amount of ROP to
minimise the risk of children becoming blind,” she continues.

Every year thousands of children in Sweden are screened for
ROP, a disease that afflicts extremely premature babies whose retinal blood
vessels have not fully developed. The children can be visually impaired, and in
the worst cases become blind, due to retinal detachment.

In the current study researchers investigated the levels of
about 20 different fatty acids in the blood of 90 children born before 28 weeks
of pregnancy at Sahlgrenska University Hospital in Gothenburg.

The fact that arachidonic acid so clearly stood out
surprised the research team led by Professor Ann Hellström. The fatty acid
belongs to the omega-6 polyunsaturated fatty acid family, which at high levels
is associated with inflammation and heart disease in adults. During the foetal
period, however, the situation may be different.

“Arachidonic acid seems to be of special importance during
the whole pregnancy as a building block for membranes,” Ann Hellström says.
“The mother provides the foetus with arachidonic acid, which is at a much lower
level in her own blood compared to the foetal levels. Therefore, we believe
that it’s important that the premature babies receive this fatty acid as a

The hypothesis will now be tested in a new study involving
210 children at neonatal units in Gothenburg, Lund and Stockholm. Children will
be given a supplement with a combination of DHA, an omega-3 polyunsaturated
fatty acid, which is also important for the construction of blood vessels and
nerve tissue, and arachidonic acid, an omega-6 polyunsaturated fatty acid. At
present, the latter is not included in the nutritional supplements that
premature babies receive immediately after birth.

“Many times new treatments are introduced on the basis of
intuition and opinion, but the evidence is not always there,” Ann Hellström
observes. “Now we have something entirely new to go on, a fatty acid that we
had not at all expected to be important in foetal growth. However, we found it
by systematically surveying all fatty acids to find evidence of which were
involved in development in both healthy and sick infants.”


Reference: Löfqvist
C, et al. Association of Retinopathy of Prematurity With Low Levels of
Arachidonic Acid: A Secondary Analysis of a Randomized Clinical Trial. JAMA Ophthalmology. Published 8
February 2018.