Fish Oil-Derived Fatty Acids in Pregnancy and Wheeze and Asthma in Offspring

Hans Bisgaard, Jakob Stokholm, Bo L. Chawes, Nadja H. Vissing, Elin Bjarnadóttir, Ann-Marie M. Schoos, Helene M Wolsk, Rebecca K. Vinding, Sunna Thorsteinsdóttir, Nilofar V. Følsgaard, Nadia R. Fink, Jonathan Thorsen, Anders Gorm Pedersen, Johannes Waage, Morten A. Rasmussen, Ken D. Stark, Sjurdur F. Olsen, Klaus Bønnelykke

    Research output: Contribution to journalJournal articleResearchpeer-review

    433 Downloads (Pure)

    Abstract

    Background: Reduced intake of n-3 long-chain polyunsaturated fatty acids (LCPUFAs) may be a contributing factor to the increasing prevalence of wheezing disorders. We assessed the effect of supplementation with n-3 LCPUFAs in pregnant women on the risk of persistent wheeze and asthma in their offspring. Methods: We randomly assigned 736 pregnant women at 24 weeks of gestation to receive 2.4 g of n-3 LCPUFA (fish oil) or placebo (olive oil) per day. Their children formed the Copenhagen Prospective Studies on Asthma in Childhood2010 (COPSAC2010) cohort and were followed prospectively with extensive clinical phenotyping. Neither the investigators nor the participants were aware of group assignments during follow-up for the first 3 years of the children's lives, after which there was a 2-year follow-up period during which only the investigators were unaware of group assignments. The primary end point was persistent wheeze or asthma, and the secondary end points included lower respiratory tract infections, asthma exacerbations, eczema, and allergic sensitization.
    Results: A total of 695 children were included in the trial, and 95.5% completed the 3-year, double-blind follow-up period. The risk of persistent wheeze or asthma in the treatment group was 16.9%, versus 23.7% in the control group (hazard ratio, 0.69; 95% confidence interval [CI], 0.49 to 0.97; P=0.035), corresponding to a relative reduction of 30.7%. Prespecified subgroup analyses suggested that the effect was strongest in the children of women whose blood levels of eicosapentaenoic acid and docosahexaenoic acid were in the lowest third of the trial population at randomization: 17.5% versus 34.1% (hazard ratio, 0.46; 95% CI, 0.25 to 0.83; P=0.011). Analyses of secondary end points showed that supplementation with n-3 LCPUFA was associated with a reduced risk of infections of the lower respiratory tract (31.7% vs. 39.1%; hazard ratio, 0.75; 95% CI, 0.58 to 0.98; P=0.033), but there was no statistically significant association between supplementation and asthma exacerbations, eczema, or allergic sensitization.
    Conclusions: Supplementation with n-3 LCPUFA in the third trimester of pregnancy reduced the absolute risk of persistent wheeze or asthma and infections of the lower respiratory tract in offspring by approximately 7 percentage points, or one third. (Funded by the Lundbeck Foundation and others; ClinicalTrials.gov number, NCT00798226 .).
    Original languageEnglish
    JournalNew England Journal of Medicine
    Volume375
    Issue number26
    Pages (from-to)2530-2539
    ISSN0028-4793
    DOIs
    Publication statusPublished - 2016

    Fingerprint Dive into the research topics of 'Fish Oil-Derived Fatty Acids in Pregnancy and Wheeze and Asthma in Offspring'. Together they form a unique fingerprint.

    Cite this