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Omega-3 long-chain PUFA intake during pregnancy and allergic disease outcomes in the offspring: a systematic review and meta-analysis of observational studies and randomized controlled trials.
Am J Clin Nutr 2016; 103(1):128-43AJ

Abstract

BACKGROUND

There is some evidence that increased maternal intake of omega-3 (n-3) long-chain polyunsaturated fatty acids (LC-PUFAs) during pregnancy may reduce the incidence of immunoglobulin E (IgE)-mediated allergic disease.

OBJECTIVE

We aimed to evaluate prenatal n-3 LC-PUFA dietary exposure in observational studies and n-3 LC-PUFA supplementation in randomized controlled trials (RCTs) on outcomes of IgE-mediated allergic disease.

DESIGN

We conducted searches of the Cochrane Central Register of Controlled Trials, PubMed, Ovid MEDLINE, EMBASE, CINAHL, SCOPUS, and Web of Science to 30 July 2015. We included prospective cohort studies that showed an association between maternal fish or n-3 LC-PUFA intake during pregnancy and RCTs with a prenatal intervention to modify maternal n-3 LC-PUFA intake and outcomes of allergic disease (eczema, rhino-conjunctivitis, asthma) or sensitization in the offspring.

RESULTS

A total of 13 publications from 10 prospective cohort studies and 7 publications representing 5 unique RCTs were included. Three RCTs were combined in a meta-analysis for selected outcomes. Nine of 13 observational study publications and 5 of 7 publications from RCTs found a protective association between increased prenatal n-3 LC-PUFA or fish intake and incidence of allergic disease symptoms in the child. Meta-analysis was limited because of the heterogeneity of the RCTs. Pooled results showed a significant reduction in the incidence of "atopic eczema," "any positive SPT [skin-prick test]," "sensitization to egg," and "sensitization to any food" in the first 12 mo of life [RRs (95% CIs): 0.53 (0.35, 0.81), P = 0.004; 0.68 (0.52-0.89), P = 0.006; 0.55 (0.39-0.76), P = 0.0004; and 0.59 (0.46, 0.76), P < 0.0001, respectively].

CONCLUSIONS

Our systematic review and meta-analysis was suggestive of benefits of increased n-3 LC-PUFAs in the maternal diet and outcomes of childhood allergic disease. However, due to the inconsistency in results, the hypothesis linking maternal n-3 LC-PUFA intake to childhood allergic disease cannot unequivocally be confirmed or rejected.

Authors+Show Affiliations

Women's & Children's Health Research Institute and Discipline of Pediatrics, University of Adelaide, Adelaide, Australia; South Australian Health and Medical Research Institute, Adelaide, Australia; karen.best@adelaide.edu.au.Department of Allergy and Immunology, Children's Youth and Women's Health Network, North Adelaide, Australia.Discipline of Pediatrics, University of Adelaide, Adelaide, Australia; Department of Respiratory and Sleep Medicine, Women's & Children's Hospital, North Adelaide, Australia; and.Discipline of Pediatrics, University of Adelaide, Adelaide, Australia; Department of Respiratory and Sleep Medicine, Women's & Children's Hospital, North Adelaide, Australia; and.Women's & Children's Health Research Institute and Discipline of Pediatrics, University of Adelaide, Adelaide, Australia; South Australian Health and Medical Research Institute, Adelaide, Australia;

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

26675770

Citation

Best, Karen P., et al. "Omega-3 Long-chain PUFA Intake During Pregnancy and Allergic Disease Outcomes in the Offspring: a Systematic Review and Meta-analysis of Observational Studies and Randomized Controlled Trials." The American Journal of Clinical Nutrition, vol. 103, no. 1, 2016, pp. 128-43.
Best KP, Gold M, Kennedy D, et al. Omega-3 long-chain PUFA intake during pregnancy and allergic disease outcomes in the offspring: a systematic review and meta-analysis of observational studies and randomized controlled trials. Am J Clin Nutr. 2016;103(1):128-43.
Best, K. P., Gold, M., Kennedy, D., Martin, J., & Makrides, M. (2016). Omega-3 long-chain PUFA intake during pregnancy and allergic disease outcomes in the offspring: a systematic review and meta-analysis of observational studies and randomized controlled trials. The American Journal of Clinical Nutrition, 103(1), pp. 128-43. doi:10.3945/ajcn.115.111104.
Best KP, et al. Omega-3 Long-chain PUFA Intake During Pregnancy and Allergic Disease Outcomes in the Offspring: a Systematic Review and Meta-analysis of Observational Studies and Randomized Controlled Trials. Am J Clin Nutr. 2016;103(1):128-43. PubMed PMID: 26675770.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Omega-3 long-chain PUFA intake during pregnancy and allergic disease outcomes in the offspring: a systematic review and meta-analysis of observational studies and randomized controlled trials. AU - Best,Karen P, AU - Gold,Michael, AU - Kennedy,Declan, AU - Martin,James, AU - Makrides,Maria, Y1 - 2015/12/16/ PY - 2015/03/18/received PY - 2015/10/09/accepted PY - 2015/12/18/entrez PY - 2015/12/18/pubmed PY - 2016/5/3/medline KW - allergic disease KW - asthma KW - eczema KW - fatty acids KW - hayfever KW - n–3 LC-PUFA KW - pregnancy allergy prevention KW - prenatal supplementation KW - randomized controlled trial SP - 128 EP - 43 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 103 IS - 1 N2 - BACKGROUND: There is some evidence that increased maternal intake of omega-3 (n-3) long-chain polyunsaturated fatty acids (LC-PUFAs) during pregnancy may reduce the incidence of immunoglobulin E (IgE)-mediated allergic disease. OBJECTIVE: We aimed to evaluate prenatal n-3 LC-PUFA dietary exposure in observational studies and n-3 LC-PUFA supplementation in randomized controlled trials (RCTs) on outcomes of IgE-mediated allergic disease. DESIGN: We conducted searches of the Cochrane Central Register of Controlled Trials, PubMed, Ovid MEDLINE, EMBASE, CINAHL, SCOPUS, and Web of Science to 30 July 2015. We included prospective cohort studies that showed an association between maternal fish or n-3 LC-PUFA intake during pregnancy and RCTs with a prenatal intervention to modify maternal n-3 LC-PUFA intake and outcomes of allergic disease (eczema, rhino-conjunctivitis, asthma) or sensitization in the offspring. RESULTS: A total of 13 publications from 10 prospective cohort studies and 7 publications representing 5 unique RCTs were included. Three RCTs were combined in a meta-analysis for selected outcomes. Nine of 13 observational study publications and 5 of 7 publications from RCTs found a protective association between increased prenatal n-3 LC-PUFA or fish intake and incidence of allergic disease symptoms in the child. Meta-analysis was limited because of the heterogeneity of the RCTs. Pooled results showed a significant reduction in the incidence of "atopic eczema," "any positive SPT [skin-prick test]," "sensitization to egg," and "sensitization to any food" in the first 12 mo of life [RRs (95% CIs): 0.53 (0.35, 0.81), P = 0.004; 0.68 (0.52-0.89), P = 0.006; 0.55 (0.39-0.76), P = 0.0004; and 0.59 (0.46, 0.76), P < 0.0001, respectively]. CONCLUSIONS: Our systematic review and meta-analysis was suggestive of benefits of increased n-3 LC-PUFAs in the maternal diet and outcomes of childhood allergic disease. However, due to the inconsistency in results, the hypothesis linking maternal n-3 LC-PUFA intake to childhood allergic disease cannot unequivocally be confirmed or rejected. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/26675770/Omega_3_long_chain_PUFA_intake_during_pregnancy_and_allergic_disease_outcomes_in_the_offspring:_a_systematic_review_and_meta_analysis_of_observational_studies_and_randomized_controlled_trials_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.115.111104 DB - PRIME DP - Unbound Medicine ER -