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Developmental biology - Premature Birth|
Low level of omega-3 tied to preterm births
The findings suggest pregnant women with low levels of EPA+DHA, should eat more fish or take a fish oil supplement as it could potentially lower their risk for preterm birth. The authors cautioned, however, that broad generalizations about the study's findings may be limited by the fact it was conducted in Demark, where preterm birth rates are low. The results should be replicated in other populations. They also caution their findings may not only reflect variation in diet as variation in underlying genetic factors can also play a role.
"An effect of this magnitude is rare, but tight precision of the estimate supports the reliability these findings. It will be important to replicate these findings in other populations, but the results of this study certainly suggest that assessment of plasma EPA+DHA status in women has the potential to be used in the future to help predict women's risk," explains co-author Jeremy Furtado, senior research scientist at Harvard Chan School.
"Early preterm birth has immense health, economic, and emotional costs. Our findings are consistent with the results of most randomized trials of long chain omega-3 fatty acid supplements in pregnancy. They support the importance of ensuring adequate intake of these nutrients during pregnancy, either through fish intake or supplements, to help prevent early preterm birth," says co-author Andrew Thorne-Lyman, Associate Research Scientist, Johns Hopkins Bloomberg School of Public Health, who worked on this study while a faculty member at Harvard Chan School.
Fish oil supplementation has been shown to delay spontaneous delivery, but the levels and clinical significance remain uncertain. We examined the association between plasma fatty acids quantified in pregnancy and subsequent risk of early preterm birth.
In a case-control design nested in the Danish National Birth Cohort, we identified 376 early preterm cases (<34 gestational weeks, excluding preeclampsia cases) and 348 random controls. Plasma eicosapentaenoic acid plus docosahexaenoic acid (EPA+DHA% of total fatty acids), were measured twice in pregnancy, at gestation weeks 9 and 25 (medians). Odds ratios and 95% confidence intervals (CI's) for associations between EPA+DHA and early preterm risk were estimated by logistic regression, adjusted for the woman's age, height, pre-pregnancy BMI, parity, smoking, and socioeconomic factors. Hypotheses and analytical plan were defined and archived a priori.
Analysis using restricted cubic splines of the mean of 1st and 2nd sample measurements showed a strong and significant non-linear association (p?0.0001) in which the risk of early preterm birth steeply increased when EPA+DHA concentrations were lower than 2% and flattened out at higher levels. Women in the lowest quintile (EPA+DHA?1.6%) had 10.27 times (95% confidence interval 6.80–15.79, p?0.0001) increased risk, and women in the second lowest quintile had 2.86 (95% CI 1.79–4.59, p?0.0001) times increased risk, when compared to women in the three aggregated highest quintiles (EPA+DHA?>=?1.8%).
Low plasma concentration of EPA and DHA during pregnancy is a strong risk factor for subsequent early preterm birth in Danish women.
Authors: S.F. Olsen, T.I. Halldorsson, A.L. Thorne-Lyman, M. Strøm, S. Gørtz, C. Granstrøm, P.H. Nielsen, J. Wohlfahrt, J.A. Lykke, J. Langhoff-Roos, A.S. Cohen, J.D. Furtado, E.L. Giovannucci, W. Zhou
This work was supported by grants from Veterans Administration 1I01BX001716 and NIH R01 CA204430 to K.K.S., and partial support from NIH grants 1R01AR071189-01A1 and R01AR073004 to A.S.
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Omega-3 supplements made from the flesh of fish, are safe in pregnancy. Nothing else.
Supplements made from fish liver - cod liver oil - are not safe in pregnancy.