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Prenatal omega-3 LCPUFA and symptoms of allergic disease and sensitization throughout early childhood - a longitudinal analysis of long-term follow-up of a randomized controlled trial.
World Allergy Organ J 2018; 11(1):10WA

Abstract

Background

Randomized controlled trials of prenatal omega (ω-3) long chain polyunsaturated fatty acid (LCPUFA) supplementation are suggestive of some protective effects on allergic sensitization and symptoms of allergic disease in childhood. Due to the nature of the atopic march, investigation of any effects of this prenatal intervention may be most informative when consistently assessed longitudinally during childhood.

Methods

Follow-up of children (n = 706) with familial risk of allergy from the Docosahexaenoic Acid to Optimize Mother Infant Outcome (DOMInO) trial. The intervention group received fish oil capsules (900 mg of ω-3 LCPUFA) daily from <21 weeks' gestation until birth; the control group received vegetable oil capsules without ω-3 LCPUFA. This new longitudinal analysis reports previously unpublished data collected at 1 and 3 years of age. The allergic disease symptom data at 1, 3 and 6 years of age were consistently reported by parents using the "International Study of Asthma and Allergies in Childhood" (ISAAC) questionnaire. Sensitization was determined by skin prick test to age specific, common allergen extracts.

Results

Changes over time in symptoms of allergic disease with sensitization (IgE-mediated) and sensitization did not differ between the groups; interaction p = 0.49, p = 0.10, respectively. Averaged across the 1, 3 and 6-year assessments, there were no significant effects of prenatal ω-3 LCPUFA supplementation on IgE-mediated allergic disease symptoms (adjusted relative risk 0.88 (95% CI 0.69, 1.12), p = 0.29) or sensitization (adjusted relative risk 0.97 (95% CI 0.82, 1.15), p = 0.76). Sensitization patterns to common allergens were consistent with the atopic march, with egg sensitization at 1 year strongly associated with house dust mite sensitization at 6 years, (p < 0.0001).

Discussion

Although there is some evidence to suggest that maternal supplementation with 900mg ω-3 LCPUFA has a protective effect on early symptoms of allergic disease and sensitization in the offspring, we did not observe any differences in the progression of disease over time in this longitudinal analysis. Further investigation into the dose and timing of ω-3 LCPUFA supplementation, including long-term follow up of children using consistent outcome reporting, is essential to determine whether this intervention may be of benefit as a primary prevention strategy for allergic disease.

Conclusion

Maternal supplementation with 900 mg of ω-3 LCPUFA did not change the progression of IgE-mediated allergic disease symptoms or sensitization throughout childhood from 1 to 6 years.

Trial registration

Australian New Zealand Clinical Trials Registry (ACTRN); DOMInO trial ACTRN12605000569606, early childhood allergy follow up ACTRN12610000735055 and 6-year allergy follow up ACTRN12615000498594.

Authors+Show Affiliations

1Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, South Australia Australia. 2School of Medicine, University of Adelaide, Adelaide, South Australia Australia. 7South Australian Health and Medical Research Institute, 72 King William Road, North Adelaide, South Australia 5006 Australia.3School of Public Health, University of Adelaide, Adelaide, South Australia Australia.4School of Medicine, University of Western Australia, Nedlands, Western Australia 6009 Australia. Telethon Kids Institute, University of Western Australia, Subiaco, Western Australia 6008 Australia.2School of Medicine, University of Adelaide, Adelaide, South Australia Australia.6Department of Respiratory and Sleep Medicine, Women's & Children's Hospital, North Adelaide, South Australia Australia.2School of Medicine, University of Adelaide, Adelaide, South Australia Australia. 6Department of Respiratory and Sleep Medicine, Women's & Children's Hospital, North Adelaide, South Australia Australia.1Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, South Australia Australia. 2School of Medicine, University of Adelaide, Adelaide, South Australia Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29977437

Citation

Best, K P., et al. "Prenatal Omega-3 LCPUFA and Symptoms of Allergic Disease and Sensitization Throughout Early Childhood - a Longitudinal Analysis of Long-term Follow-up of a Randomized Controlled Trial." The World Allergy Organization Journal, vol. 11, no. 1, 2018, p. 10.
Best KP, Sullivan TR, Palmer DJ, et al. Prenatal omega-3 LCPUFA and symptoms of allergic disease and sensitization throughout early childhood - a longitudinal analysis of long-term follow-up of a randomized controlled trial. World Allergy Organ J. 2018;11(1):10.
Best, K. P., Sullivan, T. R., Palmer, D. J., Gold, M., Martin, J., Kennedy, D., & Makrides, M. (2018). Prenatal omega-3 LCPUFA and symptoms of allergic disease and sensitization throughout early childhood - a longitudinal analysis of long-term follow-up of a randomized controlled trial. The World Allergy Organization Journal, 11(1), p. 10. doi:10.1186/s40413-018-0190-7.
Best KP, et al. Prenatal Omega-3 LCPUFA and Symptoms of Allergic Disease and Sensitization Throughout Early Childhood - a Longitudinal Analysis of Long-term Follow-up of a Randomized Controlled Trial. World Allergy Organ J. 2018;11(1):10. PubMed PMID: 29977437.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prenatal omega-3 LCPUFA and symptoms of allergic disease and sensitization throughout early childhood - a longitudinal analysis of long-term follow-up of a randomized controlled trial. AU - Best,K P, AU - Sullivan,T R, AU - Palmer,D J, AU - Gold,M, AU - Martin,J, AU - Kennedy,D, AU - Makrides,M, Y1 - 2018/06/15/ PY - 2018/01/03/received PY - 2018/05/18/accepted PY - 2018/7/7/entrez PY - 2018/7/7/pubmed PY - 2018/7/7/medline KW - Allergic disease KW - Allergy KW - Asthma KW - Atopy KW - Omega-3 KW - Paediatric KW - Perinatal KW - Pregnancy KW - Prevention SP - 10 EP - 10 JF - The World Allergy Organization journal JO - World Allergy Organ J VL - 11 IS - 1 N2 - Background: Randomized controlled trials of prenatal omega (ω-3) long chain polyunsaturated fatty acid (LCPUFA) supplementation are suggestive of some protective effects on allergic sensitization and symptoms of allergic disease in childhood. Due to the nature of the atopic march, investigation of any effects of this prenatal intervention may be most informative when consistently assessed longitudinally during childhood. Methods: Follow-up of children (n = 706) with familial risk of allergy from the Docosahexaenoic Acid to Optimize Mother Infant Outcome (DOMInO) trial. The intervention group received fish oil capsules (900 mg of ω-3 LCPUFA) daily from <21 weeks' gestation until birth; the control group received vegetable oil capsules without ω-3 LCPUFA. This new longitudinal analysis reports previously unpublished data collected at 1 and 3 years of age. The allergic disease symptom data at 1, 3 and 6 years of age were consistently reported by parents using the "International Study of Asthma and Allergies in Childhood" (ISAAC) questionnaire. Sensitization was determined by skin prick test to age specific, common allergen extracts. Results: Changes over time in symptoms of allergic disease with sensitization (IgE-mediated) and sensitization did not differ between the groups; interaction p = 0.49, p = 0.10, respectively. Averaged across the 1, 3 and 6-year assessments, there were no significant effects of prenatal ω-3 LCPUFA supplementation on IgE-mediated allergic disease symptoms (adjusted relative risk 0.88 (95% CI 0.69, 1.12), p = 0.29) or sensitization (adjusted relative risk 0.97 (95% CI 0.82, 1.15), p = 0.76). Sensitization patterns to common allergens were consistent with the atopic march, with egg sensitization at 1 year strongly associated with house dust mite sensitization at 6 years, (p < 0.0001). Discussion: Although there is some evidence to suggest that maternal supplementation with 900mg ω-3 LCPUFA has a protective effect on early symptoms of allergic disease and sensitization in the offspring, we did not observe any differences in the progression of disease over time in this longitudinal analysis. Further investigation into the dose and timing of ω-3 LCPUFA supplementation, including long-term follow up of children using consistent outcome reporting, is essential to determine whether this intervention may be of benefit as a primary prevention strategy for allergic disease. Conclusion: Maternal supplementation with 900 mg of ω-3 LCPUFA did not change the progression of IgE-mediated allergic disease symptoms or sensitization throughout childhood from 1 to 6 years. Trial registration: Australian New Zealand Clinical Trials Registry (ACTRN); DOMInO trial ACTRN12605000569606, early childhood allergy follow up ACTRN12610000735055 and 6-year allergy follow up ACTRN12615000498594. SN - 1939-4551 UR - https://www.unboundmedicine.com/medline/citation/29977437/Prenatal_omega_3_LCPUFA_and_symptoms_of_allergic_disease_and_sensitization_throughout_early_childhood___a_longitudinal_analysis_of_long_term_follow_up_of_a_randomized_controlled_trial_ L2 - https://waojournal.biomedcentral.com/articles/10.1186/s40413-018-0190-7 DB - PRIME DP - Unbound Medicine ER -