Poster Theater Flash Session
Vitamins and Minerals
To assess the effects of antenatal omega‐3 long chain polyunsaturated fatty acids (LCPUFA), as supplements or as dietary additions, on pregnancy and perinatal outcomes.
Methods : Systematic review of randomized controlled trials (RCTs) comparing omega‐3 fatty acids (as supplements or as foods) during pregnancy with placebo or no omega‐3. Using Cochrane search methods, two review authors independently assessed study eligibility, extracted data, assessed risk of bias in trials and assessed quality of evidence. The primary outcomes were birth < 34 weeks, birth < 37 weeks and birth >42 weeks of gestation.
Results : We included 70 RCTs, involving 19,927 women at low, mixed or high risk of poor pregnancy outcomes. Most trials were conducted in upper‐middle or high‐income countries with singleton pregnancies. Preterm birth < 37 weeks (13.4% versus 11.9%; risk ratio (RR) 0.89, 95% confidence interval (CI) 0.81 to 0.97; 26 RCTs, 10,304 participants; high‐quality evidence) and early preterm birth < 34 weeks (4.6% versus 2.7%; RR 0.58, 95% CI 0.44 to 0.77; 9 RCTs, 5204 participants; high‐quality evidence) were both lower in women who received omega‐3 LCPUFA compared with no omega‐3. Prolonged gestation >42 weeks was probably increased (from 1.6% to 2.6%) in women who received omega‐3 LCPUFA compared with no omega‐3 (RR 1.61 95% CI 1.11 to 2.33; 5141 participants; 6 RCTs; moderate‐quality evidence).
There was a reduced risk of low birthweight babies (RR 0.90, 95% CI 0.82 to 0.99; 15 trials, 8449 participants; high‐quality evidence); but a possible small increase in large‐for‐gestational age babies (RR 1.15, 95% CI 0.97 to 1.36; 6 RCTs, 3722 participants; moderate‐quality evidence) with omega‐3 LCPUFA. There were possibly fewer perinatal deaths (RR 0.75, 95% CI 0.54 to 1.03; 10 RCTs, 7416 participants; moderate‐quality evidence) and possibly fewer neonatal care admissions (RR 0.92, 95% CI 0.83 to 1.03; 9 RCTs, 6920 participants; moderate‐quality evidence) with omega-3 LCPUFA.
Conclusions : Omega‐3 LCPUFA supplementation during pregnancy can be an effective strategy for reducing the incidence of preterm birth for women with singleton pregnancies. Further studies should establish if, and how, outcomes vary by different types of omega‐3 LCPUFA, timing and doses; and/or by characteristics of women.
Funding Sources : National Institute for Health Research, via Cochrane Infrastructure funding to Cochrane Pregnancy and Childbirth.