Asthma reduced 31 percent when Omega-3 taken during pregnancy – RCT

Created December 2016

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

N Engl J Med 2016; 375:2530-2539 Dec 29, 2016DOI: 10.1056/NEJMoa1503734

Omega-3 during pregnancy reduced Asthma and Respiratory Tract Infections 3 years later in the children Vitamin D during pregnancy provides somewhat less benefit (earlier studies) Exepect that taking both Omega-3 and Vitamin D during and after pregnancy would be very beneficial Note 1: Magnesium also helps Note 2: Vitamin D receptor problems with Asthma (increase risk by 30%) can be dealt with Note 3: Omega-3 during pregnancy has other benefits - such as 3X reduction in Stillbirth RCT See also VitaminDWiki * Vitamin D during pregnancy reduces risk of childhood asthma by 13 percent – meta-analysis Dec 2016 * Asthma in 3 year olds decreased somewhat with 4,000 IU during pregnancy – RCT Jan 2016 * Acute Lower Respiratory Infections in Children - associated with low vitamin D – meta-analysis Dec 2014 * Infant wheezing 40 percent less likely if mother supplemented with vitamin D, vitamin E, or Zinc – meta-analysis Aug 2015 * Childhood asthma about 1.3 times more likely if poor Vitamin D Receptor – meta-analysis Aug 2016 * Overview: Omega-3 many benefits include helping vitamin D Omega-3 and Pregnancy (items in both categories) {category} Healthy pregnancies need lots of vitamin D has the following summary {include}

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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.)

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New York Times Review of the Study

  • “They recruited 736 women. Starting in their third trimester, half the women took 2.4 grams of fish oil a day and half took placebo capsules of olive oil, continuing until one week after birth.”

  • “ About a quarter of the mothers and a fifth of the fathers had asthma, and they were evenly distributed between the fish-oil and placebo groups.”

  • “ The capsules were an over-the-counter product called Incromega TG33/22, a fish extract made by the British chemical company Croda Health Care. The extract contained the fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).”

Tags: Breathing Omega-3 Pregnancy