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Effect of n-3 long chain polyunsaturated fatty acid supplementation in pregnancy on infants' allergies in first year of life: randomised controlled trial.

Abstract

OBJECTIVE

To determine whether dietary n-3 long chain polyunsaturated fatty acid (LCPUFA) supplementation of pregnant women with a fetus at high risk of allergic disease reduces immunoglobulin E associated eczema or food allergy at 1 year of age.

DESIGN

Follow-up of infants at high hereditary risk of allergic disease in the Docosahexaenoic Acid to Optimise Mother Infant Outcome (DOMInO) randomised controlled trial.

SETTING

Adelaide, South Australia.

PARTICIPANTS

706 infants at high hereditary risk of developing allergic disease whose mothers were participating in the DOMInO trial.

INTERVENTIONS

The intervention group (n=368) was randomly allocated to receive fish oil capsules (providing 900 mg of n-3 LCPUFA daily) from 21 weeks' gestation until birth; the control group (n=338) received matched vegetable oil capsules without n-3 LCPUFA.

MAIN OUTCOME MEASURE

Immunoglobulin E associated allergic disease (eczema or food allergy with sensitisation) at 1 year of age.

RESULTS

No differences were seen in the overall percentage of infants with immunoglobulin E associated allergic disease between the n-3 LCPUFA and control groups (32/368 (9%) v 43/338 (13%); unadjusted relative risk 0.68, 95% confidence interval 0.43 to 1.05, P=0.08; adjusted relative risk 0.70, 0.45 to 1.09, P=0.12), although the percentage of infants diagnosed as having atopic eczema (that is, eczema with associated sensitisation) was lower in the n-3 LCPUFA group (26/368 (7%) v 39/338 (12%); unadjusted relative risk 0.61, 0.38 to 0.98, P=0.04; adjusted relative risk 0.64, 0.40 to 1.02, P=0.06). Fewer infants were sensitised to egg in the n-3 LCPUFA group (34/368 (9%) v 52/338 (15%); unadjusted relative risk 0.61, 0.40 to 0.91, P=0.02; adjusted relative risk 0.62, 0.41 to 0.93, P=0.02), but no difference between groups in immunoglobulin E associated food allergy was seen.

CONCLUSION

n-3 LCPUFA supplementation in pregnancy did not reduce the overall incidence of immunoglobulin E associated allergies in the first year of life, although atopic eczema and egg sensitisation were lower. Longer term follow-up is needed to determine if supplementation has an effect on respiratory allergic diseases and aeroallergen sensitisation in childhood.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry ACTRN12610000735055 (DOMInO trial: ACTRN12605000569606).

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  • Authors+Show Affiliations

    ,

    Women's and Children's Health Research Institute, North Adelaide, South Australia, Australia.

    , , , , ,

    Source

    BMJ (Clinical research ed.) 344: 2012 Jan 30 pg e184

    MeSH

    Australia
    Breast Feeding
    Confounding Factors (Epidemiology)
    Dermatitis, Atopic
    Dietary Supplements
    Eggs
    Fatty Acids, Omega-3
    Female
    Fetal Blood
    Fish Oils
    Food Hypersensitivity
    Humans
    Hypersensitivity, Immediate
    Immunoglobulin E
    Infant
    Infant Formula
    Intention to Treat Analysis
    Male
    Maternal Nutritional Physiological Phenomena
    Pregnancy
    Regression Analysis
    Treatment Outcome

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    22294737

    Citation

    Palmer, D J., et al. "Effect of N-3 Long Chain Polyunsaturated Fatty Acid Supplementation in Pregnancy On Infants' Allergies in First Year of Life: Randomised Controlled Trial." BMJ (Clinical Research Ed.), vol. 344, 2012, pp. e184.
    Palmer DJ, Sullivan T, Gold MS, et al. Effect of n-3 long chain polyunsaturated fatty acid supplementation in pregnancy on infants' allergies in first year of life: randomised controlled trial. BMJ. 2012;344:e184.
    Palmer, D. J., Sullivan, T., Gold, M. S., Prescott, S. L., Heddle, R., Gibson, R. A., & Makrides, M. (2012). Effect of n-3 long chain polyunsaturated fatty acid supplementation in pregnancy on infants' allergies in first year of life: randomised controlled trial. BMJ (Clinical Research Ed.), 344, pp. e184. doi:10.1136/bmj.e184.
    Palmer DJ, et al. Effect of N-3 Long Chain Polyunsaturated Fatty Acid Supplementation in Pregnancy On Infants' Allergies in First Year of Life: Randomised Controlled Trial. BMJ. 2012 Jan 30;344:e184. PubMed PMID: 22294737.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Effect of n-3 long chain polyunsaturated fatty acid supplementation in pregnancy on infants' allergies in first year of life: randomised controlled trial. AU - Palmer,D J, AU - Sullivan,T, AU - Gold,M S, AU - Prescott,S L, AU - Heddle,R, AU - Gibson,R A, AU - Makrides,M, Y1 - 2012/01/30/ PY - 2012/2/2/entrez PY - 2012/2/2/pubmed PY - 2012/3/20/medline SP - e184 EP - e184 JF - BMJ (Clinical research ed.) JO - BMJ VL - 344 N2 - OBJECTIVE: To determine whether dietary n-3 long chain polyunsaturated fatty acid (LCPUFA) supplementation of pregnant women with a fetus at high risk of allergic disease reduces immunoglobulin E associated eczema or food allergy at 1 year of age. DESIGN: Follow-up of infants at high hereditary risk of allergic disease in the Docosahexaenoic Acid to Optimise Mother Infant Outcome (DOMInO) randomised controlled trial. SETTING: Adelaide, South Australia. PARTICIPANTS: 706 infants at high hereditary risk of developing allergic disease whose mothers were participating in the DOMInO trial. INTERVENTIONS: The intervention group (n=368) was randomly allocated to receive fish oil capsules (providing 900 mg of n-3 LCPUFA daily) from 21 weeks' gestation until birth; the control group (n=338) received matched vegetable oil capsules without n-3 LCPUFA. MAIN OUTCOME MEASURE: Immunoglobulin E associated allergic disease (eczema or food allergy with sensitisation) at 1 year of age. RESULTS: No differences were seen in the overall percentage of infants with immunoglobulin E associated allergic disease between the n-3 LCPUFA and control groups (32/368 (9%) v 43/338 (13%); unadjusted relative risk 0.68, 95% confidence interval 0.43 to 1.05, P=0.08; adjusted relative risk 0.70, 0.45 to 1.09, P=0.12), although the percentage of infants diagnosed as having atopic eczema (that is, eczema with associated sensitisation) was lower in the n-3 LCPUFA group (26/368 (7%) v 39/338 (12%); unadjusted relative risk 0.61, 0.38 to 0.98, P=0.04; adjusted relative risk 0.64, 0.40 to 1.02, P=0.06). Fewer infants were sensitised to egg in the n-3 LCPUFA group (34/368 (9%) v 52/338 (15%); unadjusted relative risk 0.61, 0.40 to 0.91, P=0.02; adjusted relative risk 0.62, 0.41 to 0.93, P=0.02), but no difference between groups in immunoglobulin E associated food allergy was seen. CONCLUSION: n-3 LCPUFA supplementation in pregnancy did not reduce the overall incidence of immunoglobulin E associated allergies in the first year of life, although atopic eczema and egg sensitisation were lower. Longer term follow-up is needed to determine if supplementation has an effect on respiratory allergic diseases and aeroallergen sensitisation in childhood. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12610000735055 (DOMInO trial: ACTRN12605000569606). SN - 1756-1833 UR - https://www.unboundmedicine.com/medline/citation/22294737/Effect_of_n_3_long_chain_polyunsaturated_fatty_acid_supplementation_in_pregnancy_on_infants'_allergies_in_first_year_of_life:_randomised_controlled_trial_ L2 - http://www.bmj.com/cgi/pmidlookup?view=long&pmid=22294737 DB - PRIME DP - Unbound Medicine ER -