Prenatal n-3 fatty acid supplementation and risk for preterm delivery

  • Makrides M & al.
  • N Engl J Med
  • 12 Sep 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Maternal supplementation with n−3 long-chain polyunsaturated fatty acids (LC-PUFA) in early pregnancy (
  • The incidence of post-term obstetrical interventions did not increase with the supplementation of n-3 LC-PUFA.

Why this matters

  • The World Health Organization recommends an intake of 300 mg of n-3 LC-PUFA  per day in pregnant women
  • Previous studies have suggested that n-3 LC-PUFA may lower the incidence of preterm delivery; however, limited data exist regarding their role in pregnancy.

Study design

  • Omega-3 to Reduce the Incidence of Preterm Birth (ORIP) study included 5517 pregnant women who were randomly assigned to receive n−3 long-chain polyunsaturated fatty acid capsules (n-3 group; n=2770) and vegetable-oil capsules (control group; n=2774].
  • Primary outcome: early preterm delivery (delivery
  • Funding: The Australian National Health and Medical Research Council and others.

Key results

  • No significant difference was observed in early preterm delivery between n-3 and control group (2.2% vs 2.0%; adjusted relative risk [aRR], 1.13; 95% CI, 0.79-1.63; P=.50).
  • The incidence of post-term obstetrical interventions (>41 weeks), adverse events, or other pregnancy or neonatal outcomes did not differ between the two groups.
  • The proportion of infants born very large for gestational age at birth (>97th percentile) was higher in the n−3 group vs control group (5.2% vs 4.0%; aRR, 1.30; 95% CI, 1.02 to 1.65).
  • No significant difference was observed in the serious adverse events between both the groups (0.5% vs 0.4%; P=.41).
  • Minor gastrointestinal disturbances were more frequent in the n−3 vs control group.

Limitations

  • In the absence of clear evidence in terms of change in other infant anthropometry measures, and a large number of outcomes assessed, this may be a chance finding.