TY - JOUR
T1 - Omega-3 fatty acid supply in pregnancy for risk reduction of preterm and early preterm birth
AU - Pediatric-Neonatology Branch, Asia Pacific Health AssociationChild Health Foundation (Stiftung Kindergesundheit)European Academy of PaediatricsEuropean Board & College of Obstetrics and GynaecologyEuropean Foundation for the Care of Newborn InfantsEuropea
AU - Cetin, Irene
AU - Carlson, Susan E.
AU - Burden, Christy
AU - da Fonseca, Eduardo B.
AU - di Renzo, Gian Carlo
AU - Hadjipanayis, Adamos
AU - Harris, William S.
AU - Kumar, Kishore R.
AU - Olsen, Sjurdur Frodi
AU - Mader, Silke
AU - McAuliffe, Fionnuala M.
AU - Muhlhausler, Beverly
AU - Oken, Emily
AU - Poon, Liona C.
AU - Poston, Lucilla
AU - Ramakrishnan, Usha
AU - Roehr, Charles C.
AU - Savona-Ventura, Charles
AU - Smuts, Cornelius M.
AU - Sotiriadis, Alexandros
AU - Su, Kuan Pin
AU - Tribe, Rachel M.
AU - Vannice, Gretchen
AU - Koletzko, Berthold
N1 - Funding Information:
The guideline development was supported by the charitable Child Health Foundation (Stiftung Kindergesundheit, www.kindergesundheit.de ) based at the Ludwig Maximilian University of Munich Hospitals. The guideline development was led by a steering committee (I.C., S.E.C., B.K.) with the support of a scientific manager. Medical-scientific associations in related fields, a global parent organization with a special focus on preterm infants, and renowned experts from all continents were invited to contribute to the guideline development (see list of authors). The steering committee drafted a summary of the evidence and a set of questions and proposed conclusions. These were discussed at an online consensus meeting on May 5, 2023, followed by anonymous online voting on the proposed 10 conclusions. An additional voting was conducted for an eleventh conclusion addressing information dissemination to women and their partners, which was developed during the process. Support of >95% of the guideline group members for a given conclusion was considered as “strong consensus”, >75% to 95% as “consensus”, >50% to 75% as “majority approval”, and <50% as not supported. This was based on the medical guideline standards of the Association of the Scientific Medical Societies in Germany, 4 which have been adopted by academic societies across Europe. 5 The guideline text was drafted by the steering group, shared with all members and supporting organizations, revised with incorporation of the suggestions made, and finally approved by all members.
This work was financially supported in part by the charitable Child Health Foundation, Munich, Germany (www.kindergesundheit.de). B.K. is the Else Kröner Seniorprofessor of Paediatrics at the Ludwig Maximilian University (LMU) of Munich , financially supported by the charitable Else Kröner-Fresenius Foundation , LMU Medical Faculty , and LMU University Hospitals .
Publisher Copyright:
© 2023
PY - 2024/2
Y1 - 2024/2
N2 - This clinical practice guideline on the supply of the omega-3 docosahexaenoic acid and eicosapentaenoic acid in pregnant women for risk reduction of preterm birth and early preterm birth was developed with support from several medical-scientific organizations, and is based on a review of the available strong evidence from randomized clinical trials and a formal consensus process. We concluded the following. Women of childbearing age should obtain a supply of at least 250 mg/d of docosahexaenoic+eicosapentaenoic acid from diet or supplements, and in pregnancy an additional intake of ≥100 to 200 mg/d of docosahexaenoic acid. Pregnant women with a low docosahexaenoic acid intake and/or low docosahexaenoic acid blood levels have an increased risk of preterm birth and early preterm birth. Thus, they should receive a supply of approximately 600 to 1000 mg/d of docosahexaenoic+eicosapentaenoic acid, or docosahexaenoic acid alone, given that this dosage showed significant reduction of preterm birth and early preterm birth in randomized controlled trials. This additional supply should preferably begin in the second trimester of pregnancy (not later than approximately 20 weeks’ gestation) and continue until approximately 37 weeks’ gestation or until childbirth if before 37 weeks’ gestation. Identification of women with inadequate omega-3 supply is achievable by a set of standardized questions on intake. Docosahexaenoic acid measurement from blood is another option to identify women with low status, but further standardization of laboratory methods and appropriate cutoff values is needed. Information on how to achieve an appropriate intake of docosahexaenoic acid or docosahexaenoic+eicosapentaenoic acid for women of childbearing age and pregnant women should be provided to women and their partners.
AB - This clinical practice guideline on the supply of the omega-3 docosahexaenoic acid and eicosapentaenoic acid in pregnant women for risk reduction of preterm birth and early preterm birth was developed with support from several medical-scientific organizations, and is based on a review of the available strong evidence from randomized clinical trials and a formal consensus process. We concluded the following. Women of childbearing age should obtain a supply of at least 250 mg/d of docosahexaenoic+eicosapentaenoic acid from diet or supplements, and in pregnancy an additional intake of ≥100 to 200 mg/d of docosahexaenoic acid. Pregnant women with a low docosahexaenoic acid intake and/or low docosahexaenoic acid blood levels have an increased risk of preterm birth and early preterm birth. Thus, they should receive a supply of approximately 600 to 1000 mg/d of docosahexaenoic+eicosapentaenoic acid, or docosahexaenoic acid alone, given that this dosage showed significant reduction of preterm birth and early preterm birth in randomized controlled trials. This additional supply should preferably begin in the second trimester of pregnancy (not later than approximately 20 weeks’ gestation) and continue until approximately 37 weeks’ gestation or until childbirth if before 37 weeks’ gestation. Identification of women with inadequate omega-3 supply is achievable by a set of standardized questions on intake. Docosahexaenoic acid measurement from blood is another option to identify women with low status, but further standardization of laboratory methods and appropriate cutoff values is needed. Information on how to achieve an appropriate intake of docosahexaenoic acid or docosahexaenoic+eicosapentaenoic acid for women of childbearing age and pregnant women should be provided to women and their partners.
KW - diet record
KW - docosahexaenoic acid
KW - fish oils
KW - omega-3 polyunsaturated fatty acids
KW - pregnancy nutrition
KW - preterm birth
UR - http://www.scopus.com/inward/record.url?scp=85182382132&partnerID=8YFLogxK
U2 - 10.1016/j.ajogmf.2023.101251
DO - 10.1016/j.ajogmf.2023.101251
M3 - Review article
C2 - 38070679
AN - SCOPUS:85182382132
SN - 2589-9333
VL - 6
JO - American Journal of Obstetrics and Gynecology MFM
JF - American Journal of Obstetrics and Gynecology MFM
IS - 2
M1 - 101251
ER -