Fish Oil-Derived Fatty Acids in Pregnancy and Wheeze and Asthma in Offspring
Bisgaard H, Stokholm J, Chawes BL, Vissing NH, Bjarnadóttir E, Schoos AM, Wolsk HM, Pedersen TM, Vinding RK, Thorsteinsdóttir S, Følsgaard NV, Fink NR, Thorsen J, Pedersen AG, Waage J, Rasmussen MA, Stark KD, Olsen SF, Bønnelykke K
The New England journal of medicine · 339 citations
How it was studied
- Design
- Randomized controlled trial (indexed by PubMed)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
Who paid for it
- Funding
- Possibly industry funded
- Nonprofit
- Lundbeckfonden
- Company
- Lundbeck Foundation
- Grants
- Lundbeckfonden (R16-2007-1694)
Based on 2 listed funder(s).
Publication
- Published
- 2016-12-28 · N Engl J Med · vol. 375 · issue 26 · pp. 2530–2539
- Publisher
- Massachusetts Medical Society
- Cited
- 461 citations · more than 100% of similar papers · 37.3× the field average
- Impact
- Top 10% most cited in its field
- References
- 35 works
- Access
- Free to read
- Research areas
- Neonatal Respiratory Health Research · Fatty Acid Research and Health · Delphi Technique in Research
- Keywords
- Wheeze, Offspring, Fish oil, Polyunsaturated fatty acid, Asthma, Pregnancy, Long chain, Fish <Actinopterygii>, Medicine, Risk factor, Environmental health, Physiology, Internal medicine, Biology, Fatty acid, Chemistry, Biochemistry, Fishery
- MeSH
- humans, respiratory tract infections, asthma, respiratory sounds, fatty acids, omega-3, fish oils, risk, follow-up studies, double-blind method, pregnancy, pregnancy trimester, third, dietary supplements, child, preschool, female, male, medication adherence, kaplan-meier estimate, olive oil
19 authors
From DK, CA, US
- Hans BisgaardUniversity of Copenhagen; Gentofte Hospital; Copenhagen Prospective Studies on Asthma in Childhood
- Jakob StokholmUniversity of Copenhagen; Gentofte Hospital; Næstved Sygehus; Copenhagen Prospective Studies on Asthma in Childhood
- Bo ChawesUniversity of Copenhagen; Gentofte Hospital; Copenhagen Prospective Studies on Asthma in Childhood
- Nadja Hawwa VissingUniversity of Copenhagen; Gentofte Hospital; Copenhagen Prospective Studies on Asthma in Childhood
- Elín BjarnadóttirUniversity of Copenhagen; Gentofte Hospital; Næstved Sygehus; Copenhagen Prospective Studies on Asthma in Childhood
- Ann‐Marie Malby SchoosUniversity of Copenhagen; Gentofte Hospital; Copenhagen Prospective Studies on Asthma in Childhood
Abstract
Background
Reduced intake of n-3 long-chain polyunsaturated fatty acids (LCPUFAs) may be a contributing factor to the increasing prevalence of wheezing disorders. We assessed the effect of supplementation with n-3 LCPUFAs in pregnant women on the risk of persistent wheeze and asthma in their offspring.
Methods
We randomly assigned 736 pregnant women at 24 weeks of gestation to receive 2.4 g of n-3 LCPUFA (fish oil) or placebo (olive oil) per day. Their children formed the Copenhagen Prospective Studies on Asthma in Childhood2010 (COPSAC2010) cohort and were followed prospectively with extensive clinical phenotyping. Neither the investigators nor the participants were aware of group assignments during follow-up for the first 3 years of the children's lives, after which there was a 2-year follow-up period during which only the investigators were unaware of group assignments. The primary end point was persistent wheeze or asthma, and the secondary end points included lower respiratory tract infections, asthma exacerbations, eczema, and allergic sensitization.
Results
A total of 695 children were included in the trial, and 95.5% completed the 3-year, double-blind follow-up period. The risk of persistent wheeze or asthma in the treatment group was 16.9%, versus 23.7% in the control group (hazard ratio, 0.69; 95% confidence interval [CI], 0.49 to 0.97; P=0.035), corresponding to a relative reduction of 30.7%. Prespecified subgroup analyses suggested that the effect was strongest in the children of women whose blood levels of eicosapentaenoic acid and docosahexaenoic acid were in the lowest third of the trial population at randomization: 17.5% versus 34.1% (hazard ratio, 0.46; 95% CI, 0.25 to 0.83; P=0.011). Analyses of secondary end points showed that supplementation with n-3 LCPUFA was associated with a reduced risk of infections of the lower respiratory tract (31.7% vs. 39.1%; hazard ratio, 0.75; 95% CI, 0.58 to 0.98; P=0.033), but there was no statistically significant association between supplementation and asthma exacerbations, eczema, or allergic sensitization.
Conclusions
Supplementation with n-3 LCPUFA in the third trimester of pregnancy reduced the absolute risk of persistent wheeze or asthma and infections of the lower respiratory tract in offspring by approximately 7 percentage points, or one third. (Funded by the Lundbeck Foundation and others; ClinicalTrials.gov number, NCT00798226 .).
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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