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- Omega-3 polyunsaturated fatty acid intake norms and preterm birth rate: a cross-sectional analysis of 184 countries
- VitaminDWiki Omega-3 pages with PRETERM of PRE-TERM in title (13 as of May 2022)
Omega-3 polyunsaturated fatty acid intake norms and preterm birth rate: a cross-sectional analysis of 184 countries
BMJ Open http://dx.doi.org/10.1136/bmjopen-2018-027249
Timothy H Ciesielski1,2,3, Jacquelaine Bartlett1,3, Scott M Williams1,3
Background The preponderance of evidence now indicates that elevated long-chain omega-3 polyunsaturated fatty acid (LC omega-3 PUFA) intake is often associated with reduced risk of preterm birth (PTB). This conclusion is based on recent meta-analyses that include several studies that reported null findings. We probed the reasons for this heterogeneity across studies and its implications for PTB prevention using country-level data.
Methods We analysed the relationship between national PTB rates (<37 weeks of gestation) and omega-3 PUFA intake norms from 184 countries for the year 2010. To estimate the total LC omega-3 PUFA levels (eicosapentaenoic acid [EPA]/docosahexaenoic acid [DHA]) that these norms produce we utilised a metric that accounts for
- (1) seafood-based omega-3 intake (EPA/DHA) and
- (2) plant-based omega-3 intake (alpha-linolenic acid [ALA]),
- ~20% of which is converted to EPA/DHA in vivo.
We then assessed the shape of the omega-3–PTB relationship with a penalised spline and conducted linear regression analyses within the linear sections of the relationship.
Results Penalised spline analyses indicated that PTB rates decrease linearly with increasing omega-3 levels up to ~600 mg/day. Income-adjusted linear regression analysis among the countries in this exposure range indicated that the number of PTBs per 100 live births decreases by 1.5 (95% CI 2.8 to 0.3) for each 1 SD increase in omega-3 intake norms (383 mg/day).
Conclusions Taken with prior evidence for a causal association on the individual level, our findings indicate that omega-3 PUFA deficiency may be a widespread contributing factor in PTB risk. Consideration of baseline omega-3 PUFA levels is critical in the design of future interventions.
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