Association between omega-3 fatty acid supplementation and lower risk of preterm delivery: a systematic review and meta-analysis

Sun, Lu; Li, Yuxin; Xie, Wei; Xue, Xiaoou

doi:10.1080/14767058.2020.1785423

Cited by 10 publications

(6 citation statements)

References 51 publications

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“…The ability to objectively identify a high-risk pool of women sPTB ≤ 32 weeks in the first trimester would facilitate future therapeutic trials, whether that be a current or new therapy. However, whether the prevention therapy is progesterone, DHA [ 28 , 29 , 30 ], cervical cerclage, or pessary, it is clear that new therapeutic approaches are needed. In addition, since the financial costs of sPTB ≤ 32 weeks represent the majority of healthcare costs in year one of life, even a small decrease in the rate of sPTB ≤ 32 weeks would likely be cost-effective [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Maternal Plasma RNA in First Trimester Nullipara for the Prediction of Spontaneous Preterm Birth ≤ 32 Weeks: Validation Study

et al. 2023

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The first-trimester prediction of spontaneous preterm birth (sPTB) has been elusive, and current screening is heavily dependent on obstetric history. However, nullipara lack a relevant history and are at higher risk for spontaneous (s)PTB ≤ 32 weeks compared to multipara. No available objective first-trimester screening test has proven a fair predictor of sPTB ≤ 32 weeks. We questioned whether a panel of maternal plasma cell-free (PCF) RNAs (PSME2, NAMPT, APOA1, APOA4, and Hsa-Let-7g) previously validated at 16–20 weeks for the prediction of sPTB ≤ 32 weeks might be useful in first-trimester nullipara. Sixty (60) nulliparous women (40 with sPTB ≤ 32 weeks) who were free of comorbidities were randomly selected from the King’s College Fetal Medicine Research Institute biobank. Total PCF RNA was extracted and the expression of panel RNAs was quantitated by qRT-PCR. The analysis employed, primarily, multiple regression with the main outcome being the prediction of subsequent sPTB ≤ 32 weeks. The test performance was judged by the area under the curve (AUC) using a single threshold cut point with observed detection rates (DRs) at three fixed false positive rates (FPR). The mean gestation was 12.9 ± 0.5 weeks (range 12.0–14.1 weeks). Two RNAs were differentially expressed in women destined for sPTB ≤ 32 weeks: APOA1 (p < 0.001) and PSME2 (p = 0.05). APOA1 testing at 11–14 weeks predicted sPTB ≤ 32 weeks with fair to good accuracy. The best predictive model generated an AUC of 0.79 (95% CI 0.66–0.91) with observed DRs of 41%, 61%, and 79% for FPRs of 10%, 20%, and 30%, including crown–rump length, maternal weight, race, tobacco use, and age.

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Section: Discussionmentioning

confidence: 99%

Maternal Plasma RNA in First Trimester Nullipara for the Prediction of Spontaneous Preterm Birth ≤ 32 Weeks: Validation Study

et al. 2023

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“…Omega-3 long-chain polyunsaturated fatty acid is also a hot topic in the current research on preterm birth, but there is still a controversy about whether it can reduce the incidences of preterm birth. Some studies claimed that higher intakes of foods containing EPA and DHA during pregnancy is an effective strategy for reducing the incidence of preterm birth [ 35 , 36 ], while the systematic review published in 2020 claimed that omega-3 fatty acid supplementation was not associated with reduced risk of preterm birth [ 37 ]. The main natural dietary source of DHA and EPA is sea fish, such as salmon, mackerel, sardines [ 36 , 38 ], which are regarded as low consumption foods in Shanghai.…”

Section: Discussionmentioning

confidence: 99%

Effects of Dietary Patterns during Pregnancy on Preterm Birth: A Birth Cohort Study in Shanghai

et al. 2021

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The objective of this study was to analyse representative dietary patterns during pregnancy in Shanghai and explore the effects of dietary patterns during pregnancy on preterm birth. Data were derived from the ‘Iodine Status in Pregnancy and Offspring Health Cohort’ (ISPOHC) study. Multistage, stratified random sampling was used to select survey participants from 16 districts in Shanghai, which were divided into five sampling areas; 40–70 pregnant women were selected from each area. A total of 4361 pregnant women and their offspring were involved in the study. The male-to-female ratio of the babies was 1.04:1, and the incidence of single preterm birth was 4.2%. Three dietary patterns were extracted by factor analysis: a ‘Vegetarian Pattern’, an ‘Animal Food Pattern’ (AFP), and a ‘Dairy and Egg Pattern’. These patterns explained 40.513% of the variance in dietary intake. Binary logistic regression, which was used to analyse the association between birth outcomes and scores measuring maternal dietary patterns, found only the AFP was a significant risk factor for preterm birth. Higher AFP scores were positively associated with preterm birth (Q2 vs. Q1 OR = 1.487, 95% CI: 1.002–2.207; Q3 vs. Q1 OR = 1.885, 95% CI: 1.291–2.754). After adjusting for other potential contributors, a higher AFP score was still a significant risk factor for preterm birth (Q2 vs. Q1 OR = 1.470, 95% CI: 0.990–2.183; Q3 vs. Q1 OR = 1.899, 95% CI: 1.299–2.776). The incidence of preterm birth was 4.2%. A higher score of AFP was significantly associated with a higher risk of preterm birth. The animal food intake of pregnant women should be reasonably consumed during pregnancy.

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“…Omega-3 fatty acids can be obtained from consuming fish, such as tuna, salmon, and sardines, or can also be obtained from fish oil supplements [ 15 ]. However, currently fish consumption in various countries is still low, and women of childbearing age tend to be reluctant to increase fish consumption, due to the perception that the mercury content and other pollutants in fish can have a negative impact on the fetus [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, preterm birth and other health problems in mother and baby are correlated with blood levels of EPA and DHA, and the numbers are predicted to be reduced by increasing EPA and DHA intake. However, very high intake or levels of EPA and DHA can also cause health problems, such as bleeding, prolonged pregnancy, or even preterm birth [ 8 – 15 ]. The variations in EPA and DHA levels between pregnant women who give birth at term and those who give birth before term have not yet been explained by previous studies.…”

Section: Introductionmentioning

confidence: 99%

Differential DHA and EPA Levels in Women with Preterm and Term Births: A Tertiary Hospital Study in Indonesia

Aziz,

Hidayat,

Irwantoro

et al. 2024

Med Sci Monit

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Background Preterm birth is one of the main causes of neonatal death worldwide. One strategy focused on preventing preterm birth is the administration of long chain polyunsaturated fatty acids (LCPUFAs) during pregnancy. Omega-3 LCPUFAs, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are essential in metabolic and physiological processes during embryonic and fetal development. This study aimed to compare DHA and EPA levels in 44 women with preterm births and 44 women with term births at a tertiary hospital in West Java Province, Indonesia, between November 2022 and March 2023. Material/Methods A total of 88 patients in this study consisted of 44 patients with term births (≥37 gestational weeks) and 44 patients with preterm births (<37 gestational weeks) at a tertiary hospital in West Java Province, Indonesia. This observational, cross-sectional study was conducted from November 2022 to March 2023. Using the enzyme-linked immunosorbent assay test, maternal DHA and EPA levels were investigated. IBM SPSS 24.0 was used to statistically measure outcomes. Results Average maternal DHA and EPA levels in patients with preterm births were significantly lower than those in term births. Preterm labor risk was further increased by DHA levels of ≤5.70 μg/mL (OR=441.00, P =0.000) and EPA levels ≤3971.54 μg/mL (OR=441.00, P =0.000). Conclusions Since the average maternal DHA and EPA levels were significantly lower in patients with preterm births, adequate intake of omega-3 LCPUFA in early pregnancy and consistency with existing nutritional guidelines was associated with a lower risk of preterm delivery for pregnant women.

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Association between omega-3 fatty acid supplementation and lower risk of preterm delivery: a systematic review and meta-analysis

Cited by 10 publications

References 51 publications

Maternal Plasma RNA in First Trimester Nullipara for the Prediction of Spontaneous Preterm Birth ≤ 32 Weeks: Validation Study

Maternal Plasma RNA in First Trimester Nullipara for the Prediction of Spontaneous Preterm Birth ≤ 32 Weeks: Validation Study

Effects of Dietary Patterns during Pregnancy on Preterm Birth: A Birth Cohort Study in Shanghai

Differential DHA and EPA Levels in Women with Preterm and Term Births: A Tertiary Hospital Study in Indonesia

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