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Fish oil supplementation in pregnancy modifies neonatal allergen-specific immune responses and clinical outcomes in infants at high risk of atopy: a randomized, controlled trial.

Abstract

BACKGROUND

There is growing interest in the potential role of anti-inflammatory n-3 polyunsaturated fatty acids (n-3 PUFAs) in the prevention of allergic disease.

OBJECTIVE

We sought to determine whether maternal dietary supplementation with n-3 PUFAs during pregnancy could modify immune responses in infants.

METHODS

In a randomized, controlled trial 98 atopic, pregnant women received fish oil (3.7 g n-3 PUFAs per day) or placebo from 20 weeks' gestation until delivery. Neonatal PUFA levels and immunologic response to allergens were measured at birth.

RESULTS

Eighty-three women completed the study. Fish oil supplementation (n = 40) achieved significantly higher proportions of n-3 PUFAs in neonatal erythrocyte membranes (mean +/- SD, 17.75% +/- 1.85% as a percentage of total fatty acids) compared with the control group (n = 43, 13.69% +/- 1.22%, P <.001). All neonatal cytokine (IL-5, IL-13, IL-10, and IFN-gamma) responses (to all allergens) tended to be lower in the fish oil group (statistically significant only for IL-10 in response to cat). Although this study was not designed to examine clinical effects, we noted that infants in the fish oil group were 3 times less likely to have a positive skin prick test to egg at 1 year of age (odds ratio, 0.34; 95% confidence interval, 0.11 to 1.02; P =.055). Although there was no difference in the frequency of atopic dermatitis at 1 year of age, infants in the fish oil group also had significantly less severe disease (odds ratio, 0.09; 95% confidence interval, 0.01 to 0.94; P =.045).

CONCLUSIONS

These data suggest a potential reduction in subsequent infant allergy after maternal PUFA supplementation. More detailed follow-up studies are required in larger cohorts to establish the robustness of these findings and to ascertain their significance in relation to longer-term modification of allergic disease in children.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    School of Paediatrics and Child Health, University of Western Australia, Perth, Australia.

    , , , , ,

    Source

    MeSH

    Adult
    Allergens
    Antibody Formation
    Asthma
    Cytokines
    Dermatitis, Atopic
    Dietary Fats, Unsaturated
    Dietary Supplements
    Erythrocyte Membrane
    Fatty Acids, Omega-3
    Female
    Fetal Blood
    Fish Oils
    Gestational Age
    Humans
    Infant
    Lymphocyte Activation
    Maternal-Fetal Exchange
    Pregnancy
    Risk Factors

    Pub Type(s)

    Clinical Trial
    Journal Article
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    14657879

    Citation

    Dunstan, Janet A., et al. "Fish Oil Supplementation in Pregnancy Modifies Neonatal Allergen-specific Immune Responses and Clinical Outcomes in Infants at High Risk of Atopy: a Randomized, Controlled Trial." The Journal of Allergy and Clinical Immunology, vol. 112, no. 6, 2003, pp. 1178-84.
    Dunstan JA, Mori TA, Barden A, et al. Fish oil supplementation in pregnancy modifies neonatal allergen-specific immune responses and clinical outcomes in infants at high risk of atopy: a randomized, controlled trial. J Allergy Clin Immunol. 2003;112(6):1178-84.
    Dunstan, J. A., Mori, T. A., Barden, A., Beilin, L. J., Taylor, A. L., Holt, P. G., & Prescott, S. L. (2003). Fish oil supplementation in pregnancy modifies neonatal allergen-specific immune responses and clinical outcomes in infants at high risk of atopy: a randomized, controlled trial. The Journal of Allergy and Clinical Immunology, 112(6), pp. 1178-84.
    Dunstan JA, et al. Fish Oil Supplementation in Pregnancy Modifies Neonatal Allergen-specific Immune Responses and Clinical Outcomes in Infants at High Risk of Atopy: a Randomized, Controlled Trial. J Allergy Clin Immunol. 2003;112(6):1178-84. PubMed PMID: 14657879.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Fish oil supplementation in pregnancy modifies neonatal allergen-specific immune responses and clinical outcomes in infants at high risk of atopy: a randomized, controlled trial. AU - Dunstan,Janet A, AU - Mori,Trevor A, AU - Barden,Anne, AU - Beilin,Lawrence J, AU - Taylor,Angie L, AU - Holt,Patrick G, AU - Prescott,Susan L, PY - 2003/12/6/pubmed PY - 2004/3/9/medline PY - 2003/12/6/entrez SP - 1178 EP - 84 JF - The Journal of allergy and clinical immunology JO - J. Allergy Clin. Immunol. VL - 112 IS - 6 N2 - BACKGROUND: There is growing interest in the potential role of anti-inflammatory n-3 polyunsaturated fatty acids (n-3 PUFAs) in the prevention of allergic disease. OBJECTIVE: We sought to determine whether maternal dietary supplementation with n-3 PUFAs during pregnancy could modify immune responses in infants. METHODS: In a randomized, controlled trial 98 atopic, pregnant women received fish oil (3.7 g n-3 PUFAs per day) or placebo from 20 weeks' gestation until delivery. Neonatal PUFA levels and immunologic response to allergens were measured at birth. RESULTS: Eighty-three women completed the study. Fish oil supplementation (n = 40) achieved significantly higher proportions of n-3 PUFAs in neonatal erythrocyte membranes (mean +/- SD, 17.75% +/- 1.85% as a percentage of total fatty acids) compared with the control group (n = 43, 13.69% +/- 1.22%, P <.001). All neonatal cytokine (IL-5, IL-13, IL-10, and IFN-gamma) responses (to all allergens) tended to be lower in the fish oil group (statistically significant only for IL-10 in response to cat). Although this study was not designed to examine clinical effects, we noted that infants in the fish oil group were 3 times less likely to have a positive skin prick test to egg at 1 year of age (odds ratio, 0.34; 95% confidence interval, 0.11 to 1.02; P =.055). Although there was no difference in the frequency of atopic dermatitis at 1 year of age, infants in the fish oil group also had significantly less severe disease (odds ratio, 0.09; 95% confidence interval, 0.01 to 0.94; P =.045). CONCLUSIONS: These data suggest a potential reduction in subsequent infant allergy after maternal PUFA supplementation. More detailed follow-up studies are required in larger cohorts to establish the robustness of these findings and to ascertain their significance in relation to longer-term modification of allergic disease in children. SN - 0091-6749 UR - https://www.unboundmedicine.com/medline/citation/14657879/Fish_oil_supplementation_in_pregnancy_modifies_neonatal_allergen_specific_immune_responses_and_clinical_outcomes_in_infants_at_high_risk_of_atopy:_a_randomized_controlled_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091674903022711 DB - PRIME DP - Unbound Medicine ER -