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Prenatal Fish Oil Supplementation and Allergy: 6-Year Follow-up of a Randomized Controlled Trial.

Abstract

BACKGROUND AND OBJECTIVE

Evidence from randomized controlled trials in early infancy suggest that prenatal supplementation with Ω-3 (n-3) long-chain polyunsaturated fatty acids (LCPUFA) reduces the incidence of allergic disease characterized by an immunoglobulin E (IgE) response. We aimed to determine whether protective effects were evident in the 6-year-old offspring of women supplemented with n-3 rich fish oil during pregnancy.

METHODS

Six-year follow-up of children (n = 706) with a family history of allergic disease from the Docosahexaenoic Acid to Optimize Mother Infant Outcome (DOMInO) trial. Women were randomly allocated to receive n-3 LCPUFA-rich fish oil capsules (800 mg/d docosahexaenoic acid DHA and 100mg/d eicosapentaenoic acid) or vegetable oil capsules (without n-3 LCPUFA). Allergic disease symptoms including eczema, wheeze, rhinitis, and rhino-conjunctivitis, were assessed using the International Study of Asthma and Allergies in Childhood questionnaire and sensitization to allergens was measured by skin prick test.

RESULTS

There was no difference in the percentage of children with any IgE-associated allergic disease between the n-3 LCPUFA and control groups (116/367 [31.5%] vs 106/336 [31.5%]; adjusted relative risk, 1.04; 95% confidence interval, 0.82-1.33; P = .73). There was a reduction in the percentage of children sensitized to house dust mite Dermatophagoides farinae (49/367 [13.4%] vs 68/336 [20.3%]; adjusted relative risk, 0.67, 95% confidence interval, 0.44-1.00; P = .0495).

CONCLUSIONS

Prenatal n-3 LCPUFA supplementation did not reduce IgE-associated allergic disease at 6 years of age. Secondary outcomes were suggestive of a protective effect of the intervention on the incidence of D. farinae sensitization.

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  • Authors+Show Affiliations

    ,

    Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia; Women's & Children's Health Research Institute, Discipline of Paediatrics, School of Medicine, and karen.best@adelaide.edu.au.

    ,

    School of Population Health, University of Adelaide, Adelaide, South Australia, Australia;

    ,

    Women's & Children's Health Research Institute, School of Paediatrics and Child Health, University of Western Australia, Subiaco, Western Australia, Australia; and.

    ,

    Discipline of Paediatrics, School of Medicine, and.

    ,

    Discipline of Paediatrics, School of Medicine, and Department of Respiratory and Sleep Medicine, Women's & Children's Hospital, North Adelaide, South Australia, Australia.

    ,

    Department of Respiratory and Sleep Medicine, Women's & Children's Hospital, North Adelaide, South Australia, Australia.

    Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia; Women's & Children's Health Research Institute, Discipline of Paediatrics, School of Medicine, and.

    Source

    Pediatrics 137:6 2016 06 pg

    MeSH

    Adult
    Animals
    Child
    Dermatophagoides farinae
    Dietary Supplements
    Docosahexaenoic Acids
    Eicosapentaenoic Acid
    Female
    Follow-Up Studies
    Humans
    Hypersensitivity
    Immunoglobulin E
    Male
    Pregnancy
    Prenatal Care
    Prenatal Exposure Delayed Effects

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    27225316

    Citation

    Best, Karen P., et al. "Prenatal Fish Oil Supplementation and Allergy: 6-Year Follow-up of a Randomized Controlled Trial." Pediatrics, vol. 137, no. 6, 2016.
    Best KP, Sullivan T, Palmer D, et al. Prenatal Fish Oil Supplementation and Allergy: 6-Year Follow-up of a Randomized Controlled Trial. Pediatrics. 2016;137(6).
    Best, K. P., Sullivan, T., Palmer, D., Gold, M., Kennedy, D. J., Martin, J., & Makrides, M. (2016). Prenatal Fish Oil Supplementation and Allergy: 6-Year Follow-up of a Randomized Controlled Trial. Pediatrics, 137(6), doi:10.1542/peds.2015-4443.
    Best KP, et al. Prenatal Fish Oil Supplementation and Allergy: 6-Year Follow-up of a Randomized Controlled Trial. Pediatrics. 2016;137(6) PubMed PMID: 27225316.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Prenatal Fish Oil Supplementation and Allergy: 6-Year Follow-up of a Randomized Controlled Trial. AU - Best,Karen P, AU - Sullivan,Thomas, AU - Palmer,Debra, AU - Gold,Michael, AU - Kennedy,Declan John, AU - Martin,James, AU - Makrides,Maria, PY - 2016/03/22/accepted PY - 2016/5/27/entrez PY - 2016/5/27/pubmed PY - 2017/6/15/medline JF - Pediatrics JO - Pediatrics VL - 137 IS - 6 N2 - BACKGROUND AND OBJECTIVE: Evidence from randomized controlled trials in early infancy suggest that prenatal supplementation with Ω-3 (n-3) long-chain polyunsaturated fatty acids (LCPUFA) reduces the incidence of allergic disease characterized by an immunoglobulin E (IgE) response. We aimed to determine whether protective effects were evident in the 6-year-old offspring of women supplemented with n-3 rich fish oil during pregnancy. METHODS: Six-year follow-up of children (n = 706) with a family history of allergic disease from the Docosahexaenoic Acid to Optimize Mother Infant Outcome (DOMInO) trial. Women were randomly allocated to receive n-3 LCPUFA-rich fish oil capsules (800 mg/d docosahexaenoic acid DHA and 100mg/d eicosapentaenoic acid) or vegetable oil capsules (without n-3 LCPUFA). Allergic disease symptoms including eczema, wheeze, rhinitis, and rhino-conjunctivitis, were assessed using the International Study of Asthma and Allergies in Childhood questionnaire and sensitization to allergens was measured by skin prick test. RESULTS: There was no difference in the percentage of children with any IgE-associated allergic disease between the n-3 LCPUFA and control groups (116/367 [31.5%] vs 106/336 [31.5%]; adjusted relative risk, 1.04; 95% confidence interval, 0.82-1.33; P = .73). There was a reduction in the percentage of children sensitized to house dust mite Dermatophagoides farinae (49/367 [13.4%] vs 68/336 [20.3%]; adjusted relative risk, 0.67, 95% confidence interval, 0.44-1.00; P = .0495). CONCLUSIONS: Prenatal n-3 LCPUFA supplementation did not reduce IgE-associated allergic disease at 6 years of age. Secondary outcomes were suggestive of a protective effect of the intervention on the incidence of D. farinae sensitization. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/27225316/Prenatal_Fish_Oil_Supplementation_and_Allergy:_6_Year_Follow_up_of_a_Randomized_Controlled_Trial_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=27225316 DB - PRIME DP - Unbound Medicine ER -