Omega-3 long-chain polyunsaturated fatty acids and fish oil supplementation during pregnancy: which evidence?

Saccone, Gabriele; Saccone, Irene; Berghella, Vincenzo

doi:10.3109/14767058.2015.1086742

Cited by 82 publications

(50 citation statements)

References 58 publications

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“…Different strategies have been adopted for prevention of SPTB, [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] including progesterone 16,22 and cerclage, 17,18 as well as lifestyle modification such as smoking cessation, 23 diet and aerobic exercise, 24 and nutritional supplements, [25][26][27][28][29][30] including omega-3, 25-28 folic acid, 29 and vitamins. 30 The evidence supports the use of vaginal progesterone in singleton pregnancies with short cervix, 16 while cervical cerclage seems to be beneficial only in the subgroup of women with both prior SPTB and TVU CL 25 mm.…”

Section: Discussionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 99%

“…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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“…Previous research warranted future studies including children of multiple gestations. (81) Our analyses examined twins in addition to singletons and independently.…”

Section: Discussionmentioning

confidence: 99%

Prenatal fish oil supplementation and early childhood development in the Upstate KIDS Study

Vollet

Ghassabian

Sundaram

et al. 2017

J Dev Orig Health Dis

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Fish oil contains omega-3 fatty acids, which play a vital role in fetal growth and development. In utero exposure to omega-3 fatty acids is exclusively dependent on maternal nutrition. Previous studies have suggested that prenatal fish oil supplementation has positive impacts on child neurodevelopment later in life. This study examines the associations between fish oil supplementation both before pregnancy and throughout pregnancy and subsequent child development. Mother-child pairs from the Upstate KIDS Study, a birth cohort consisting of children born between 2008 and 2010, were included. Self-reported prenatal fish oil supplementation data was available for 5,845 children (3807 singletons and 2038 twins). At multiple time points, from 4 months to 3 years of age, child development was reported by the parents on the Ages and Stages Questionnaire (ASQ). Five developmental domains were assessed: fine motor, gross motor, communication, personal-social and problem solving. Generalized linear mixed models were used to estimate odds ratios (OR) while adjusting for covariates. Primary analyses showed that the risk of failing the ASQ problem solving domain was significantly lower among children of women who took fish oil before pregnancy (OR 0.40, 95% CI: 0.18 – 0.89) and during pregnancy (OR 0.43, 95% CI: 0.22 – 0.83). Gender interaction was not statistically significant although stratified results indicated stronger associations among girls. Similarly, associations were primarily among singletons. Prenatal fish oil supplementation may be beneficial in regards to neurodevelopment. Specifically, it is associated with a lower risk of failing the problem solving domain up to 3 years of age.

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“…However, the authors reported a positive effect of supplementation on neonatal outcome of patients with gestational diabetes (hyperbilirubinemia rate, hospitalization rate) as well as a significant reduction in perinatal death in singleton pregnancies supplemented before 20 weeks of gestation [65].…”

Section: Discussionmentioning

confidence: 99%

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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Omega-3 long-chain polyunsaturated fatty acids and fish oil supplementation during pregnancy: which evidence?

Cited by 82 publications

References 58 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

Prenatal fish oil supplementation and early childhood development in the Upstate KIDS Study

Maternal and fetal benefits of DHA supplementation during pregnancy

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