Prenatal Fish Oil Supplementation and Allergy: 6-Year Follow-up of a Randomized Controlled Trial
What this study found
Prenatal n-3 LCPUFA supplementation did not reduce overall IgE-associated allergic disease at age 6. The primary composite outcome was essentially identical between groups: 116/367 (31.48%) in the n-3 LCPUFA group versus 106/336 (31.46%) in control, aRR 1.04 (95% CI 0.82-1.33; P = .73). House dust mite sensitization was lower in the supplemented group, 49 (13.42%) versus 68 (20.30%), aRR 0.67 (95% CI 0.44-1.00; P = .0495), but eczema, wheeze, rhinitis, rhino-conjunctivitis, asthma, and hayfever outcomes were not significantly different. The authors concluded that prenatal n-3 LCPUFA did not…
- Study & population
- Randomized controlled trial with 6-year follow-up of children born to mothers with a family history of allergic disease.
- Intervention
- Pregnant participants in the active arm received oral capsules containing 500 mg of fish oil concentrate, providing approximately 800 mg/day DHA and 100 mg/day EPA, taken daily from 21 weeks' gestation until delivery.
- Key limitation
- The main clinical outcome was negative, and the positive house dust mite finding was secondary and borderline significant.
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Open PDFOriginal abstract
BACKGROUND AND OBJECTIVE: Evidence from randomized controlled trials in early infancy suggest that prenatal supplementation with Ω-3 (n-3) long-chain polyunsaturated fatty acids (LCPUFA) reduces the incidence of allergic disease characterized by an immunoglobulin E (IgE) response. We aimed to determine whether protective effects were evident in the 6-year-old offspring of women supplemented with n-3 rich fish oil during pregnancy. METHODS: Six-year follow-up of children (n = 706) with a family history of allergic disease from the Docosahexaenoic Acid to Optimize Mother Infant Outcome (DOMInO) trial. Women were randomly allocated to receive n-3 LCPUFA-rich fish oil capsules (800 mg/d docosahexaenoic acid DHA and 100mg/d eicosapentaenoic acid) or vegetable oil capsules (without n-3 LCPUFA). Allergic disease symptoms including eczema, wheeze, rhinitis, and rhino-conjunctivitis, were assessed using the International Study of Asthma and Allergies in Childhood questionnaire and sensitization to allergens was measured by skin prick test. RESULTS: There was no difference in the percentage of children with any IgE-associated allergic disease between the n-3 LCPUFA and control groups (116/367 [31.5%] vs 106/336 [31.5%]; adjusted relative risk, 1.04; 95% confidence interval, 0.82–1.33; P = .73). There was a reduction in the percentage of children sensitized to house dust mite Dermatophagoides farinae (49/367 [13.4%] vs 68/336 [20.3%]; adjusted relative risk, 0.67, 95% confidence interval, 0.44–1.00; P = .0495). CONCLUSIONS: Prenatal n-3 LCPUFA supplementation did not reduce IgE-associated allergic disease at 6 years of age. Secondary outcomes were suggestive of a protective effect of the intervention on the incidence of D. farinae sensitization.