Omega-3 Long Chain Polyunsaturated Fatty Acids to Prevent Preterm Birth

Saccone, Gabriele; Berghella, Vincenzo

doi:10.1097/aog.0000000000000668

Cited by 60 publications

(29 citation statements)

References 37 publications

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“…Different strategies have been adopted for prevention of SPTB, including progesterone and cerclage, as well as lifestyle modification such as smoking cessation, diet and aerobic exercise, and nutritional supplements, including omega‐3, folic acid, and vitamins …”

Section: Commentmentioning

confidence: 99%

Cervical Pessary for Preventing Preterm Birth in Singleton Pregnancies With Short Cervical Length: A Systematic Review and Meta‐analysis

Saccone

Ciardulli

Xodo

et al. 2017

J of Ultrasound Medicine

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Objectives-To evaluate the effectiveness of cervical pessary for preventing spontaneous preterm birth (SPTB) in singleton gestations with a second trimester short cervix.Methods-Electronic databases were searched from their inception until February 2016. We included randomized clinical trials (RCTs) comparing the use of the cervical pessary with expectant management in singletons pregnancies with transvaginal ultrasound cervical length (TVU CL) 25 mm. The primary outcome was incidence of SPTB <34 weeks. The summary measures were reported as relative risk (RR) with 95% confidence interval (CI).Results-Three RCTs (n 5 1,420) were included. The mean gestational age (GA) at randomization was approximately 22 weeks. The Arabin pessary was used as intervention in all three trials, and was removed by vaginal examination at approximately 37 weeks. Cervical pessary was not associated with prevention of SPTB <37 (20.2% vs 50.2%; RR 0.50, 95% CI 0.23 to 1.09), <34, <32, and <28 weeks, compared to no pessary. No differences were found in the mean of GA at, interval from randomization to delivery, incidence of preterm premature rupture of membranes and of cesarean delivery, and in neonatal outcomes. The Arabin pessary was associated with a significantly higher risk of vaginal discharge.Conclusions-In singleton pregnancies with a TVU CL 25mm at 20 0 -24 6 weeks, the Arabin pessary does not reduce the rate of spontaneous preterm delivery or improve perinatal outcome. Individual patient data meta-analysis may clarify whether cervical pessary may be beneficial in subgroups, such as only singleton gestations without prior SPTB or by different CL cutoffs.

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Section: Commentmentioning

confidence: 99%

Cervical Pessary for Preventing Preterm Birth in Singleton Pregnancies With Short Cervical Length: A Systematic Review and Meta‐analysis

Saccone

Ciardulli

Xodo

et al. 2017

J of Ultrasound Medicine

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“…However for recurrent IUGR, it is not clear that a routine supplementation could improve fetal growth [50]. In patients with previous history of premature rupture of the membranes and preterm birth, the preventive effect of a supplementation was found in some studies [54][55][56] but it is controversial as a recent meta-analysis does not support a beneficial effect of DHA on preterm labour incidence [57].…”

Section: Discussionmentioning

confidence: 99%

“…In a metanalysis reviewing 34 RCTs, the authors found in singleton pregnancies supplemented from the second trimester a significant reduction in the perinatal mortality rate. Further studies for confirming this data are required [57].…”

Section: Dha and Perinatal Mortalitymentioning

confidence: 91%

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Maternal and fetal benefits of DHA supplementation during pregnancy

Hubinont¹,

Savoye²

2017

J Pregnancy Reprod

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During pregnancy, the benefits of long-chain n-3 fatty acids, mainly DHA supplementation has been reported with controversial results. The aim of this review paper is to clarify the role of DHA on maternal and fetal outcomes and to discuss supplementation.Low maternal concentrations of DHA are associated with an increased incidence of preeclampsia, gestational diabetes, postpartum depression, preterm labour and intrauterine fetal growth restriction (IUGR).The effect of a preventive supplementation on these complications is not clearly demonstrated . Some authors report an improved outcome but recent Cochrane database systematic reviews and meta-analysis are not conclusive.DHA supplementation reduces significantly the effects of prenatal stress and the perinatal mortality rate. In patients with previous history of preterm birth, supplementation is also controversial.In conclusion, even if the DHA requirements are increased in pregnancy and if positive correlations are reported between low maternal concentrations and an adverse pregnancy outcome, there are conflicting results on the efficacy of a DHA supplementation. Further studies using different DHA regimens of administration are needed. In the meantime, as it is a safe supplementation with few side effects, DHA should be prescribed in patients with a low dietary intake and risks factors.

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“…see Oken and colleague 5 ). Meta-analyses of randomised trials have not supported benefits of n-3 LCPUFA supplementation for cognitive and visual development, 6 preterm delivery 7 or BMI in childhood. 8 …”

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confidence: 99%

Consumption of Fish and Long‐Chain n‐3 Polyunsaturated Fatty Acids During Pregnancy: has the Tide Turned?

Oken

2015

Paediatric Perinatal Epid

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Omega-3 Long Chain Polyunsaturated Fatty Acids to Prevent Preterm Birth

Abstract: Omega-3 supplementation during pregnancy does not reduce the incidence of preterm birth or improve neonatal outcome.

Cited by 60 publications

References 37 publications

Cervical Pessary for Preventing Preterm Birth in Singleton Pregnancies With Short Cervical Length: A Systematic Review and Meta‐analysis

Cervical Pessary for Preventing Preterm Birth in Singleton Pregnancies With Short Cervical Length: A Systematic Review and Meta‐analysis

Maternal and fetal benefits of DHA supplementation during pregnancy

Consumption of Fish and Long‐Chain n‐3 Polyunsaturated Fatty Acids During Pregnancy: has the Tide Turned?

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