Identifying women who may benefit from higher dose omega-3 supplementation during pregnancy to reduce their risk of prematurity: exploratory analyses from the ORIP trial

Objectives The risk factors for prematurity are multifactorial and include low omega-3 status. Omega-3 supplementation in pregnancy has been found to reduce prematurity risk, particularly among women with low omega-3 levels. This study aimed to identify maternal characteristics that predict whether...

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Main Authors: Lisa N Yelland, Fang Huang, Maria Makrides, Karen P Best, Thomas R Sullivan, Robert A Gibson, Lucy A Simmonds, Sagar K Thakkar, Surabhi Devaraj, Irma Silva Zolezzi
Format: Article
Language:English
Published: BMJ Publishing Group 2023-04-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/13/4/e070220.full
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author Lisa N Yelland
Fang Huang
Maria Makrides
Karen P Best
Thomas R Sullivan
Robert A Gibson
Lucy A Simmonds
Sagar K Thakkar
Surabhi Devaraj
Irma Silva Zolezzi
author_facet Lisa N Yelland
Fang Huang
Maria Makrides
Karen P Best
Thomas R Sullivan
Robert A Gibson
Lucy A Simmonds
Sagar K Thakkar
Surabhi Devaraj
Irma Silva Zolezzi
author_sort Lisa N Yelland
collection DOAJ
description Objectives The risk factors for prematurity are multifactorial and include low omega-3 status. Omega-3 supplementation in pregnancy has been found to reduce prematurity risk, particularly among women with low omega-3 levels. This study aimed to identify maternal characteristics that predict whether women with a singleton pregnancy will benefit from omega-3 supplementation to reduce their risk of prematurity.Design Exploratory analyses of a multicentre, double-blind randomised trial.Setting 6 tertiary care centres in four states in Australia.Participants 5328 singleton pregnancies in 5305 women recruited before 20 weeks of gestation.Interventions Fish oil capsules containing 900 mg omega-3 long-chain polyunsaturated fatty acids per day versus vegetable oil capsules consumed from enrolment until 34 weeks’ gestation.Outcome measures Early preterm birth (EPTB, <34 weeks’ gestation) and preterm birth (PTB, <37 weeks’ gestation) analysed using logistic regression models with interactions between treatment group and a range of maternal biological, clinical and demographic characteristics.Results Omega-3 supplementation reduced the odds of EPTB for women with low total omega-3 status in early pregnancy (OR=0.30, 95% CI 0.10–0.93). No additional maternal characteristics influenced whether omega-3 supplementation reduced the odds of EPTB. For PTB, women were more likely to benefit from omega-3 supplementation if they were multiparous (OR=0.65, 95% CI 0.49–0.87) or avoided alcohol in the lead up to pregnancy (OR=0.62, 95% CI 0.45–0.86).Conclusions Our results support previous findings that women with low total omega-3 levels in early pregnancy are most likely to benefit from taking omega-3 supplements to reduce their risk of EPTB. Understanding how other maternal characteristics influence the effectiveness of omega-3 supplementation on reducing PTB requires further investigation.Trial registration number ACTRN12613001142729.
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spelling doaj-art-b90f4523f77e4b5781e69ee003ebeff52024-11-15T20:40:11ZengBMJ Publishing GroupBMJ Open2044-60552023-04-0113410.1136/bmjopen-2022-070220Identifying women who may benefit from higher dose omega-3 supplementation during pregnancy to reduce their risk of prematurity: exploratory analyses from the ORIP trialLisa N Yelland0Fang Huang1Maria Makrides2Karen P Best3Thomas R Sullivan4Robert A Gibson5Lucy A Simmonds6Sagar K Thakkar7Surabhi Devaraj8Irma Silva Zolezzi9School of Public Health, The University of Adelaide, Adelaide, South Australia, AustraliaNestlé Research, Societe des Produits Nestle SA, Beijing, ChinaSchool of Medicine, The University of Adelaide, Adelaide, South Australia, AustraliaWomen and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, AustraliaWomen and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, AustraliaSchool of Agriculture, Food and Wine, University of Adelaide, Waite Campus, Glen Osmond, South Australia, AustraliaCollege of Business, Government and Law, Flinders University, Adelaide, South Australia, AustraliaNestlé Product Technology Center—Nutrition, Societe des Produits Nestle SA, Vevey, Vaud, SwitzerlandNestlé Research, Societe des Produits Nestle SA, SingaporeNestlé Product Technology Center—Nutrition, Societe des Produits Nestle SA, Vevey, Vaud, SwitzerlandObjectives The risk factors for prematurity are multifactorial and include low omega-3 status. Omega-3 supplementation in pregnancy has been found to reduce prematurity risk, particularly among women with low omega-3 levels. This study aimed to identify maternal characteristics that predict whether women with a singleton pregnancy will benefit from omega-3 supplementation to reduce their risk of prematurity.Design Exploratory analyses of a multicentre, double-blind randomised trial.Setting 6 tertiary care centres in four states in Australia.Participants 5328 singleton pregnancies in 5305 women recruited before 20 weeks of gestation.Interventions Fish oil capsules containing 900 mg omega-3 long-chain polyunsaturated fatty acids per day versus vegetable oil capsules consumed from enrolment until 34 weeks’ gestation.Outcome measures Early preterm birth (EPTB, <34 weeks’ gestation) and preterm birth (PTB, <37 weeks’ gestation) analysed using logistic regression models with interactions between treatment group and a range of maternal biological, clinical and demographic characteristics.Results Omega-3 supplementation reduced the odds of EPTB for women with low total omega-3 status in early pregnancy (OR=0.30, 95% CI 0.10–0.93). No additional maternal characteristics influenced whether omega-3 supplementation reduced the odds of EPTB. For PTB, women were more likely to benefit from omega-3 supplementation if they were multiparous (OR=0.65, 95% CI 0.49–0.87) or avoided alcohol in the lead up to pregnancy (OR=0.62, 95% CI 0.45–0.86).Conclusions Our results support previous findings that women with low total omega-3 levels in early pregnancy are most likely to benefit from taking omega-3 supplements to reduce their risk of EPTB. Understanding how other maternal characteristics influence the effectiveness of omega-3 supplementation on reducing PTB requires further investigation.Trial registration number ACTRN12613001142729.https://bmjopen.bmj.com/content/13/4/e070220.full
spellingShingle Lisa N Yelland
Fang Huang
Maria Makrides
Karen P Best
Thomas R Sullivan
Robert A Gibson
Lucy A Simmonds
Sagar K Thakkar
Surabhi Devaraj
Irma Silva Zolezzi
Identifying women who may benefit from higher dose omega-3 supplementation during pregnancy to reduce their risk of prematurity: exploratory analyses from the ORIP trial
BMJ Open
title Identifying women who may benefit from higher dose omega-3 supplementation during pregnancy to reduce their risk of prematurity: exploratory analyses from the ORIP trial
title_full Identifying women who may benefit from higher dose omega-3 supplementation during pregnancy to reduce their risk of prematurity: exploratory analyses from the ORIP trial
title_fullStr Identifying women who may benefit from higher dose omega-3 supplementation during pregnancy to reduce their risk of prematurity: exploratory analyses from the ORIP trial
title_full_unstemmed Identifying women who may benefit from higher dose omega-3 supplementation during pregnancy to reduce their risk of prematurity: exploratory analyses from the ORIP trial
title_short Identifying women who may benefit from higher dose omega-3 supplementation during pregnancy to reduce their risk of prematurity: exploratory analyses from the ORIP trial
title_sort identifying women who may benefit from higher dose omega 3 supplementation during pregnancy to reduce their risk of prematurity exploratory analyses from the orip trial
url https://bmjopen.bmj.com/content/13/4/e070220.full
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