Effects of n-3 polyunsaturated fatty acid supplementation on pregnancy outcomes: a systematic review and meta-analysis

Abstract

IntroductionThere are limited studies exploring the effects of n-3 PUFA supplementation on pregnancy outcomes. The goal of this study was to review relevant studies in order to determine the effect of n-3 polyunsaturated fatty acid (n-3 PUFA) supplementation on pregnancy outcomes based on eligible randomized controlled trials (RCTs).Material and methodsQualified studies were searched by keywords in PubMed, the Cochrane library and Embase. Studies from other pertinent sources were also reviewed, and RCTs published before January 2021 were reviewed. For each study, we assessed and synthesized the outcomes by relative risk (RR) or weighted mean difference (WMD) combined with 95% confidence interval (95% CI).ResultsWe included 13 studies with 9069 patients. Compared with the control group, n-3 PUFA significantly decreased the incidence of preterm delivery (RR: 0.898, 95%CI: 0.819~0.984) and low birthweight (RR: 0.797, 95%CI: 0.655~0.970); increased the birth weight (WMD: 99.340, 95%CI: 10.503~188.177) and birth length (WMD: 0.449, 95%CI: 0.236~0.663). There was no significant difference in pregnancy-induced hypertension, preeclampsia, intrauterine growth retardation (IUIG), early preterm delivery, anti-hypertensive therapy, gestational diabetes and head circumference at birth between the two groups.ConclusionsThe available evidence shows that n-3 PUFA is not beneficial in reducing the incidence of maternal pregnancy outcomes such as gestational diabetes mellitus and hypertension; but it is beneficial to neonatal health such as decreasing the incidence of preterm delivery and low birthweight and increasing birth weight and birth length.

Advances in free fatty acid profiles in gestational diabetes mellitus

“…When the balance of n-6 PUFAs versus n-3 PUFAs favored the former, a positive correlation was observed with GDM incidence, and preventing GDM by supplementing with n-3 PUFAs has not yet been conclusively demonstrated. Available evidence suggests that n-3 PUFA supplementationis not beneficial in reducing the incidence of maternal pregnancy outcomes such as gestational diabetes and hypertension, but is beneficial for neonatal health, such as reducing the incidence of preterm labor and low birth weight, and increasing birth weight and birth length [ 130 ]. Notably, n-3 FA supplementation in pregnant women with GDM is beneficial to reducing IR and inflammation and decreasing adverse pregnancy outcomes.…”

Placental AA/EPA Ratio Is Associated with Obesity Risk Parameters in the Offspring at 6 Years of Age

“…In this context, Aparicio et al found that fish and seafood consumption during pregnancy increased EPA concentration and reduced the maternal serum n-6/n-3 PUFA ratio and AA/EPA ratio in the first and third trimester of gestation [ 35 ]. Similarly, n-3 PUFA supplementation during pregnancy has been shown to have beneficial effects on neonatal health [ 36 ].…”

Dietary management of gestational diabetes: A review

“…[23,24] Some studies suggest EPA is ineffective in preventing GDM. [11,14,15] Some studies have shown that EPA can prevent GDM. [17,18] Pregnant women with established GDM can reduce blood glucose, lipids, high-sensitivity C-reactive protein and insulin resistance levels by consuming EPA.…”

“…[9] Some studies have shown that DHA does not prevent GDM. [10][11][12][13][14][15] Some studies have shown that DHA can prevent GDM. [16][17][18] Meanwhile, prospective clinical studies have shown that DHA increases the risk of GDM.…”