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#Grand Rounds

Does N-3 Long-Chain Polyunsaturated Fatty Acid Supplementation Decrease Early Preterm Births?

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BACKGROUND AND PURPOSE:

  • Previous studies on maternal use of n-3 Long-Chain Polyunsaturated Fatty Acid Supplementation demonstrated the following  
    • Benefit: Reduced preterm delivery
    • Risk:  Postterm pregnancy
  • Makrides et al. (NEJM, 2019) sought to determine whether supplementation with n-3 long-chain polyunsaturated fatty acids from early pregnancy through 34 weeks gestation reduced the incidence of preterm birth

METHODS:

  • Multicenter, double-blind, randomized trial (RCT)
  • Participants
    • Single or multiple fetuses
    • No fetal anomalies
    • Exclusion: Taking daily supplements containing >150 mg of n−3 long-chain polyunsaturated fatty acids
  • Groups
    • n-3 group (3 capsules): 900 mg of n−3 long-chain polyunsaturated fatty acids daily (approximately 800 mg of DHA and approximately 100 mg of eicosapentaenoic acid)
    • Control group (3 capsules): Vegetable-oil capsules that contained trace n−3 long-chain polyunsaturated fatty acids daily
  • Intervention time period: <20 weeks until 34 weeks
  • Primary outcome
    • Early preterm delivery (< 34 weeks)
  • Secondary outcomes
    • Additional pregnancy, delivery, and neonatal outcomes

RESULTS:

  • 5,486 pregnancies
    • 2,734 in the n−3 group | 2,752 in the control group
  • Mean duration of gestation: 273 days in both groups
  • There was no significant difference in primary outcome (early preterm delivery)
    • n-3 group: 2.2%
    • Control group: 2.0%
    • Adjusted relative risk (RR) 1.13 (95% CI, 0.79 to 1.63; P=0.50)
  • There were no significant differences in secondary outcomes
    • Overall preterm delivery
    • Post-term induction of labor or cesarean section
    • Birth weight NICU admission
  • There were more LGA infants in the n−3 group
    • adjusted RR 1.30 (95% CI, 1.02 to 1.65)
  • Minor GI upset was reported more frequently in the n-3 group

CONCLUSION:

  • N-3 long-chain polyunsaturated fatty acids did not reduce early preterm delivery in a general population of pregnant women

Learn More – Primary Sources:

A Randomized Trial of Prenatal n−3 Fatty Acid Supplementation and Preterm Delivery

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