Omega-3 Fatty Acids and Gestational Length in a High-Risk Psychiatric Population Due to Psychiatric Morbidity and Medication Exposure During Pregnancy

Freeman, Marlene P.; Cohen, Lee S.; McInerney, Kathryn A.

doi:10.1097/jcp.0000000000000168

Cited by 3 publications

(1 citation statement)

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“…Studies of antioxidants to reduce preterm birth, regardless of smoking status, have yielded mixed results. 9–15 Some have suggested potential benefits for smokers, and hence, this represents an area requiring further investigation.…”

Section: Introductionmentioning

confidence: 99%

The effect of omega-3 supplementation on pregnancy outcomes by smoking status

Kuper

Abramovici

Jauk

et al. 2017

American Journal of Obstetrics and Gynecology

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BACKGROUND Smoking during pregnancy is associated with adverse maternal and neonatal outcomes such as preterm delivery, intrauterine growth restriction, stillbirth, and low birth weight. Since smoking causes oxidative stress, some have suggested using antioxidants to counteract the effects of oxidative stress. Smokers have lower serum levels of omega-3 fatty acids, an important antioxidant, and thus, investigating whether omega-3 supplementation in smokers reduces adverse maternal and neonatal outcomes represents an important area of research. OBJECTIVE To investigate whether the antioxidant effect of omega-3 fatty acid supplementation on the incidence of adverse pregnancy outcomes differs between smokers and nonsmokers. STUDY DESIGN Secondary analysis of a multicenter randomized controlled trial of omega-3 supplementation for preterm delivery prevention in women with a singleton pregnancy and a history of a prior singleton spontaneous preterm delivery. Subjects were randomized to begin omega-3 or placebo prior to 22 weeks which was continued until delivery. All women received 17 alpha-hydroxyprogesterone caproate intramuscularly weekly beginning between 16 to 20 weeks of gestation and continued until 36 weeks of gestation or delivery, whichever occurred first. The primary outcome was spontaneous preterm delivery. Secondary outcomes were indicated preterm delivery, any preterm delivery (spontaneous and indicated), pregnancy-associated hypertension (gestational hypertension and preeclampsia), a neonatal composite (retinopathy of prematurity, intraventricular hemorrhage grade III or IV, patent ductus arteriosus, necrotizing enterocolitis, sepsis, respiratory morbidity, or perinatal death), low birth weight (<2500 grams), small for gestational age (less than the 10th percentile), and neonatal intensive care unit or intermediate nursery admission. The study population was stratified into smokers and nonsmokers, and the incidence of each outcome was compared by omega-3 supplementation versus placebo in each subgroup. Zelen tests were performed to test for homogeneity of effect in smokers and nonsmokers. RESULTS Of 851 subjects included in the analysis, 136 (16%) smoked. Baseline characteristics between omega-3 and placebo groups did not differ in smokers or nonsmokers. Omega-3 supplementation was associated with a lower risk of spontaneous preterm delivery in smokers (RR 0.56, 95% CI 0.36–0.87) but not in nonsmokers (RR 1.04, 95% CI 0.84–1.29); p-value for interaction = 0.013. Low birth weight was also less frequent in smokers receiving omega-3 supplementation (RR 0.57, 95% CI 0.36–0.90) compared to nonsmokers (RR 0.93, 95% CI 0.71–1.24); p-value for interaction = 0.047. The effect on other secondary outcomes did not differ significantly between smokers and nonsmokers. CONCLUSION Omega-3 supplementation in smokers may have a protective effect against recurrent spontaneous preterm delivery and low birth weight.

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Section: Introductionmentioning

confidence: 99%

The effect of omega-3 supplementation on pregnancy outcomes by smoking status

Kuper

Abramovici

Jauk

et al. 2017

American Journal of Obstetrics and Gynecology

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A multi-national, multi-disciplinary Delphi consensus study on using omega-3 polyunsaturated fatty acids (n-3 PUFAs) for the treatment of major depressive disorder

Guu

Mischoulon

Sarris

et al. 2020

Journal of Affective Disorders

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Prevention of fetal growth restriction in pregnancy

et al. 2018

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Living in large cities, environmentally unfriendly background, smoking during pregnancy are associated with increasing number of complications, such as premature birth, intrauterine growth restriction, stillbirth and low birth weight. Pathogenetic mechanisms of these complications include oxidative stress, which can be combated by adding vitamin supplements with antioxidant activity to the daily routine of a pregnant woman. Smokers have a lower serum level of such important antioxidants as vitamins E, C and omega-3 fatty acids. The additional intake of vitamin complexes containing omega-3 fatty acids by pregnant women living in large megacities, adverse ecological regions and/or abusing smoking, has a preventive effect and can reduce the risk of premature delivery and fetal growth restriction among this cohort of patients.

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Omega-3 Fatty Acids and Gestational Length in a High-Risk Psychiatric Population Due to Psychiatric Morbidity and Medication Exposure During Pregnancy

Cited by 3 publications

References 50 publications

The effect of omega-3 supplementation on pregnancy outcomes by smoking status

The effect of omega-3 supplementation on pregnancy outcomes by smoking status

A multi-national, multi-disciplinary Delphi consensus study on using omega-3 polyunsaturated fatty acids (n-3 PUFAs) for the treatment of major depressive disorder

Prevention of fetal growth restriction in pregnancy

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