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. 2023 Apr 17;13(4):e070220. doi: 10.1136/bmjopen-2022-070220.
ABSTRACT
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.
PMID:37068907 | PMC:PMC10111924 | DOI:10.1136/bmjopen-2022-070220