ω-3 LCPUFA supplementation during pregnancy and risk of allergic outcomes or sensitization in offspring

Abstract

Background: Allergic diseases have seen a rise worldwide in the last two decades, with children suffering the highest burden of the condition. The ω-3 Long-Chain Poly-Unsaturated fatty Acid (LCPUFA) poses anti-inflammatory properties that could lead to a reduction in inflammatory mediators in allergies. Objective: A systematic review and meta-analysis of the most recent follow-ups of randomised controlled trials (RCTs) was conducted to assess the effectiveness of ω-3 LCPUFA supplementation started during pregnancy on allergic outcomes in offspring. Methods: RCTs with a minimum of 1-month follow-up post gestation were eligible for inclusion. The CENTRAL, MEDLINE, SCOPUS, WHO's International Clinical Trials Register, E-theses and Web of Science databases were searched. Study quality was evaluated using the Cochrane Collaboration's risk of bias tool. Results: Ten RCTs (3,637 children), from nine unique trials examined the effectiveness of ω-3 LCPUFA supplementation started during pregnancy on the development of allergic outcomes in offspring. There were heterogeneities between the trials in terms of their sample, type and duration of intervention and follow-up. Pooled estimates showed a significant reduction in childhood "sensitisation to egg" (Relative Risk (RR)=0.54, 95% Confidence Interval (CI)=0.32-0.90) and "sensitisation to peanut" (RR=0.62, 95% CI=0.40-0.96). No statistical differences were found for other allergic outcomes e.g. any allergies, eczema, asthma/wheeze. Conclusion: These results suggest intake of ω-3 LCPUFA started during pregnancy can reduce the risk of sensitisation to egg and peanut; however the evidence is limited due to the small number of studies contributed to meta-analyses. The current evidence on the association between supplementation with ω-3 LCPUFA started during pregnancy and allergic outcomes is weak due to the risk of bias and heterogeneities between studies.

Dietary factors during pregnancy and atopic outcomes in childhood: A systematic review from the European Academy of Allergy and Clinical Immunology

“…We did not find a significant effect on any allergic sensitization outcome. The discrepancy may be attributed to the fact that one of the studies included by Vadhaninia et al 126 was excluded from our review, as maternal supplementation continued up to 2.5 months post-delivery. 127 Our findings are also different from the conclusions drawn by Garcia-Larsen et al 13 The difference probably lies in the choice of studies included in each systematic review.…”

Associations of Plasma Fatty Acid Patterns during Pregnancy with Respiratory and Allergy Outcomes at School Age

“…Differences might be due to assessment of PUFAs in groups versus patterns, or the age at which asthma was assessed, at a younger age, as it is difficult to distinguish asthma from a viral-induced wheeze. A recent literature-based meta-analysis of randomized controlled trials mainly included studies with a follow-up until infancy and did not find a beneficial effect of n-3 PUFA supplementation in pregnancy on wheezing or asthma in the children [ 23 ]. Randomized controlled trials with a longer follow-up until school-age or young adulthood suggested that prenatal n-3 PUFA supplementation reduced the risk of asthma, although no consistent effect on lung function or allergy development was observed [ 6 , 24 , 25 , 26 ].…”

Omega-3 Fatty Acids in Pregnancy—The Case for a Target Omega-3 Index

“…In a recent pertinent meta-analysis of seven intervention trials with 2047 children, it was confirmed in a slightly less pronounced manner that EPA and DHA in pregnancy reduce asthma and persistent wheezing in the child [46]. Epidemiologic studies and some, but not all, intervention trials demonstrated that EPA and DHA in pregnancy can reduce the propensity towards allergies in the children [52][53][54][55].…”