Omega-3 Fatty Acid Supplementation During Pregnancy and Respiratory Symptoms in Children

Escamilla-Núñez, Consuelo; Barraza‐Villarreal, Albino; Hernández‐Cadena, Leticia; Navarro-Olivos, Efraín; Sly, Peter D.; Romieu, Isabelle

doi:10.1378/chest.13-1432

Cited by 33 publications

(35 citation statements)

References 19 publications

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“…After removal of duplicates and title/abstract screening, the remaining 79 full text papers were assessed against the eligibility criteria for this systematic review. Ten publications from nine unique RCTs were included in the final analyses, including a total of 3,637 children (21,28,30,32,34,38,43,47,48,50) . In the case of one trial (29) , both the reports of an earlier (28) as well as latest follow-up data (47) were included, since some of the allergic outcomes of interest for this systematic review were reported only in the earlier published paper of this trial i.e.…”

Section: Resultsmentioning

confidence: 99%

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ω-3 LCPUFA supplementation during pregnancy and risk of allergic outcomes or sensitization in offspring

Vahdaninia

MacKenzie

Dean

et al. 2019

Annals of Allergy, Asthma & Immunology

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Background: Allergic diseases have seen a rise worldwide in the last two decades, with children suffering the highest burden of the condition. The ω-3 Long-Chain Poly-Unsaturated fatty Acid (LCPUFA) poses anti-inflammatory properties that could lead to a reduction in inflammatory mediators in allergies. Objective: A systematic review and meta-analysis of the most recent follow-ups of randomised controlled trials (RCTs) was conducted to assess the effectiveness of ω-3 LCPUFA supplementation started during pregnancy on allergic outcomes in offspring. Methods: RCTs with a minimum of 1-month follow-up post gestation were eligible for inclusion. The CENTRAL, MEDLINE, SCOPUS, WHO's International Clinical Trials Register, E-theses and Web of Science databases were searched. Study quality was evaluated using the Cochrane Collaboration's risk of bias tool. Results: Ten RCTs (3,637 children), from nine unique trials examined the effectiveness of ω-3 LCPUFA supplementation started during pregnancy on the development of allergic outcomes in offspring. There were heterogeneities between the trials in terms of their sample, type and duration of intervention and follow-up. Pooled estimates showed a significant reduction in childhood "sensitisation to egg" (Relative Risk (RR)=0.54, 95% Confidence Interval (CI)=0.32-0.90) and "sensitisation to peanut" (RR=0.62, 95% CI=0.40-0.96). No statistical differences were found for other allergic outcomes e.g. any allergies, eczema, asthma/wheeze. Conclusion: These results suggest intake of ω-3 LCPUFA started during pregnancy can reduce the risk of sensitisation to egg and peanut; however the evidence is limited due to the small number of studies contributed to meta-analyses. The current evidence on the association between supplementation with ω-3 LCPUFA started during pregnancy and allergic outcomes is weak due to the risk of bias and heterogeneities between studies.

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Section: Resultsmentioning

confidence: 99%

“…Four trials were conducted on high-risk (atopy) populations (21,32,34,38) and the remainder (28,30,43,47,48,50) were carried out on sample with low-risk allergies. The sample size of studies at randomisation were also varied, from 98 (21) to 1,094 (43) pregnant women.…”

Section: Participants and Sample Sizesmentioning

confidence: 99%

ω-3 LCPUFA supplementation during pregnancy and risk of allergic outcomes or sensitization in offspring

Vahdaninia

MacKenzie

Dean

et al. 2019

Annals of Allergy, Asthma & Immunology

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“…A more recent large randomized study of prenatal omega-3 fatty acid supplementation found that prenatal DHA supplementation compared with vegetable oil supplementation decreased atopic eczema and sensitization to egg [4]. Similarly, a follow-up study of 869 children found that DHA supplementation significantly reduced respiratory symptoms among children born to atopic mothers; although, paradoxically, respiratory symptoms were increased among children born to DHA-supplemented non-atopic mothers [10] Our hypothesis that omega-3 fatty acid supplementation may function in neonatal immune modulation is supported by these studies.…”

Section: Introductionmentioning

confidence: 99%

Prenatal Omega-3 Supplementation and Eczema Risk Among Offspring at Age 36 Months

Berman

Clinton

Limb

et al. 2016

Insights Allergy Asthma Bronchitis

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Background Long-term follow-up was completed in 84 mother-infant pairs of 118 women who completed a randomized controlled trial of prenatal supplementation with EPA- or DHA-rich fish oil or soy oil placebo. The goal of this study was to determine whether prenatal omega-3 fatty acid supplementation protects offspring against development of early childhood allergies. Methods and Findings Assessment of childhood allergic/atopic disease among offspring at age 36 months was performed by maternal interview using the National Health Interview Survey (NHIS) questions for childhood digestive allergies, wheezing, eczema or skin allergy, and respiratory allergy. Multiple logistic regressions examined the association between prenatal supplementation and childhood outcomes, adjusted for covariates. Eczema was reported in 26/84 (31%) of offspring at age 36 months, and was significantly more prevalent in the omega-3 supplementation groups vs. placebo: EPA 13/31 (41.9%); DHA 10/26 (38.5%); placebo 3/27 (11.1%), p=0.019. Compared to placebo, EPA and DHA were associated with ≥5 times risk of offspring eczema [odds ratios (ORs): EPA 5.8 (95% CI 1.4–23.3); DHA 5.0 (95% CI 1.2–21.0)]. After adjusting for other potential risk factors (race, birth weight, vaginal/Cesarean delivery, and maternal eczema) the magnitudes of association for omega-3 supplementation increased: EPA OR 8.1 (95% CI 1.4–45.6); DHA OR 9.6 (95% CI 1.6–58.5). Maternal eczema was also significantly associated with offspring eczema in the adjusted model: OR 10.8 (95% CI 2.1–54.3) Conclusion Contrary to our hypothesis, acids supplementation compared to soy oil was associated with a substantial increase in risk of childhood eczema. This association was not observed on childhood respiratory or digestive outcomes. It is unclear if these findings were driven by unfavorable effects of omega-3s, or whether there may have been unanticipated protective effects of the soy-based placebo with regards to eczema.

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“…We choose this n ‐3 PUFA supplementation dose because it was similar to those given for human study supplementation (Escamilla‐Nuñez et al . ). Furthermore, the enriched diet was designed to obtain an omega‐3/omega‐6 ratio near 1 (Table ), which is commonly recommended (Simopoulos, ).…”

Section: Methodsmentioning

confidence: 97%

Consequences of maternal omega‐3 polyunsaturated fatty acid supplementation on respiratory function in rat pups

Tenorio‐Lopes

Baldy

Jochmans-Lemoine

et al. 2016

The Journal of Physiology

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Most pre-term infants present respiratory instabilities and apnoeas as a result of incomplete development of the neural circuits that control breathing. Because omega-3 polyunsaturated fatty acids (n-3 PUFA) benefit brain development, we hypothesized that n-3 PUFA supplementation (via the maternal diet) improves respiratory function in rat pups. Pups received n-3 PUFA supplementation from an enriched diet (13 g kg of n-3 PUFA) administered to the mother from birth until the experiments were performed (postnatal days 10-11). Controls received a standard diet (0.3 g kg of n-3 PUFA). Breathing was measured in intact pups at rest and during hypoxia (FiO = 0.12; 20 min) using whole body plethysmography. The duration of apnoeas induced by stimulating the laryngeal chemoreflex (LCR) was measured under anaesthesia. Lung morphology was compared between groups. Maternal n-3 PUFA supplementation effectively raised n-3 PUFA levels above control levels both in the blood and brainstem of pups. In intact, resting pups, n-3 PUFA increased the frequency and duration of apnoeas, especially in females. During hypoxia, n-3 PUFA supplemented pups hyperventilated 23% more than controls; their anapyrexic response was 1 °C less than controls. In anaesthetized pups, n-3 PUFA shortened the duration of LCR-induced apnoeas by 32%. The relative pulmonary surface area of n-3 PUFA supplemented pups was 12% higher than controls. Although n-3 PUFA supplementation augments apnoeas, there is no clear evidence of deleterious consequences on these pups. Based on the improved lung architecture and responses to respiratory challenges, this neonatal treatment appears to be beneficial to the offspring. However, further experiments are necessary to establish its overall safety.

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Omega-3 Fatty Acid Supplementation During Pregnancy and Respiratory Symptoms in Children

Abstract: BACKGROUND:Prenatal consumption of omega-3 fatty acids can act as an adjuvant in the development of the immune system and aff ect the infl ammatory response of neonates.

Cited by 33 publications

References 19 publications

ω-3 LCPUFA supplementation during pregnancy and risk of allergic outcomes or sensitization in offspring

ω-3 LCPUFA supplementation during pregnancy and risk of allergic outcomes or sensitization in offspring

Prenatal Omega-3 Supplementation and Eczema Risk Among Offspring at Age 36 Months

Consequences of maternal omega‐3 polyunsaturated fatty acid supplementation on respiratory function in rat pups

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