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研究探讨n-3长链多不饱和脂肪酸在妊娠期的作用
作者:小柯机器人 发布时间:2019/9/12 15:34:39

澳大利亚南澳健康与医学研究所Maria Makrides与合作者在最新研究中,探讨了n−3 长链多不饱和脂肪酸在妊娠期的作用。2019年9月12日出版的《新英格兰医学杂志》发表了相关成果。

以前的研究表明,母亲补充n−3长链多不饱和脂肪酸可降低早产的发生率,但也可能延长妊娠期。
 
课题组在澳大利亚的6个中心进行了一项多中心、双盲、随机试验,共有5486名单胎或多胎妊娠的孕妇被纳入初步分析。其中2734名服用含900毫克n−3长链多不饱和脂肪酸的鱼油胶囊(n-3组),2752名服用含微量n−3长链多不饱和脂肪酸的植物油胶囊(对照组),从妊娠20周前开始服用,持续至妊娠34周或分娩。早产定义为妊娠34周前分娩。
 
n-3组中发生早产61例(2.2%),对照组中发生55例(2.0%),差异不显著。两组中过期分娩(>41周)、不良事件、其他妊娠或新生儿结局等均无显著差异,但n−3组的分娩孕周显著大于对照组,校正相对风险比为1.30。两组之间严重不良事件的百分比没有差异。与对照组相比,n-3组中轻度胃肠道紊乱更为常见。
 
从妊娠早期(<20周)到妊娠34周补充n−3 长链多不饱和脂肪酸并没有降低早产的发生率,但也未增加产后干预的发生率。

附:英文原文

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

Author: Maria Makrides, Ph.D., Karen Best, Ph.D., Lisa Yelland, Ph.D., Andrew McPhee, M.B., B.S., Shao Zhou, Ph.D., Julie Quinlivan, M.B., B.S., Ph.D., Jodie Dodd, M.B., B.S., Ph.D., Elinor Atkinson, M.B., B.S., Huda Safa, M.B., Ch.B., Jacqueline van Dam, M.B., B.S., Nisha Khot, M.B., B.S., Gustaaf Dekker, M.D., Ph.D., Monika Skubisz, M.B., B.S., Ph.D., Amanda Anderson, Ph.D., Beth Kean, B.Med.Sci., Anneka Bowman, M.Res., Carly McCallum, B.Nutr.Diet., Kara Cashman, G.Dip.Stat., and Robert Gibson, Ph.D.

Issue&Volume: Vol 381 No 11

Abstract: 

BACKGROUND
Previous studies have suggested that maternal supplementation with n−3 long-chain polyunsaturated fatty acids may reduce the incidence of preterm delivery but may also prolong gestation beyond term; however, more data are needed regarding the role of n−3 long-chain polyunsaturated fatty acids in pregnancy.

METHODS
We performed a multicenter, double-blind, randomized trial in which women who were pregnant with single or multiple fetuses were assigned to receive either fish-oil capsules that contained 900 mg of n−3 long-chain polyunsaturated fatty acids (n−3 group) or vegetable-oil capsules that contained trace n−3 long-chain polyunsaturated fatty acids (control group) daily, beginning before 20 weeks of gestation and continuing to 34 weeks of gestation or delivery, whichever occurred first. The primary outcome was early preterm delivery, defined as delivery before 34 completed weeks of gestation. Other pregnancy and neonatal outcomes were also assessed.

RESULTS
A total of 5544 pregnancies in 5517 women were randomly assigned at six centers in Australia; 5486 pregnancies were included in the primary analysis. Early preterm delivery occurred in the case of 61 of 2734 pregnancies (2.2%) in the n−3 group and 55 of 2752 pregnancies (2.0%) in the control group; the between-group difference was not significant (adjusted relative risk, 1.13; 95% confidence interval [CI], 0.79 to 1.63; P=0.50). There were no significant differences between the groups in the incidence of interventions in post-term (>41 weeks of gestation) deliveries, in adverse events, or in other pregnancy or neonatal outcomes, except that a higher percentage of infants born to women in the n−3 group than in the control group were very large for gestational age at birth (adjusted relative risk, 1.30; 95% CI, 1.02 to 1.65). Percentages of serious adverse events did not differ between the groups. Minor gastrointestinal disturbances were more commonly reported in the n−3 group than in the control group.

CONCLUSIONS
Supplementation with n−3 long-chain polyunsaturated fatty acids from early pregnancy (<20 weeks of gestation) until 34 weeks of gestation did not result in a lower incidence of early preterm delivery or a higher incidence of interventions in post-term deliveries than control. (Funded by the Australian National Health and Medical Research Council and the Thyne Reid Foundation; ORIP Australian New Zealand Clinical Trials Registry number, ACTRN12613001142729. opens in new tab.)

DOI: 10.1056/NEJMoa1816832

Source: https://www.nejm.org/doi/full/10.1056/NEJMoa1816832

期刊信息

The New England Journal of Medicine:《新英格兰医学杂志》,创刊于1812年。隶属于麻省医学协会,最新IF:70.67
官方网址:http://www.nejm.org/
投稿链接:http://www.nejm.org/page/author-center/home