Identifying women who may benefit from higher dose omega-3 supplementation during pregnancy to reduce their risk of prematurity: Exploratory analyses from the ORIP trial

Lisa N. Yelland; Thomas R. Sullivan; Robert A. Gibson; Lucy A. Simmonds; Sagar K. Thakkar; Fang Huang; Surabhi Devaraj; Karen P. Best; Irma Silva Zolezzi; Maria Makrides

doi:10.1136/bmjopen-2022-070220

Identifying women who may benefit from higher dose omega-3 supplementation during pregnancy to reduce their risk of prematurity: Exploratory analyses from the ORIP trial

Lisa N. Yelland, Thomas R. Sullivan, Robert A. Gibson, Lucy A. Simmonds, Sagar K. Thakkar, Fang Huang, Surabhi Devaraj, Karen P. Best, Irma Silva Zolezzi, Maria Makrides

College of Business, Government and Law

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Abstract

Objectives: The risk factors for prematurity are multifactorial and include low omega-3 status. Omega-3 supplementation in pregnancy has been found to reduce prematurity risk, particularly among women with low omega-3 levels. This study aimed to identify maternal characteristics that predict whether women with a singleton pregnancy will benefit from omega-3 supplementation to reduce their risk of prematurity.

Design: Exploratory analyses of a multicentre, double-blind randomised trial.

Setting: 6 tertiary care centres in four states in Australia.

Participants: 5328 singleton pregnancies in 5305 women recruited before 20 weeks of gestation.

Interventions: Fish oil capsules containing 900 mg omega-3 long-chain polyunsaturated fatty acids per day versus vegetable oil capsules consumed from enrolment until 34 weeks' gestation.

Outcome measures: Early preterm birth (EPTB, <34 weeks' gestation) and preterm birth (PTB, <37 weeks' gestation) analysed using logistic regression models with interactions between treatment group and a range of maternal biological, clinical and demographic characteristics.

Results: Omega-3 supplementation reduced the odds of EPTB for women with low total omega-3 status in early pregnancy (OR=0.30, 95% CI 0.10-0.93). No additional maternal characteristics influenced whether omega-3 supplementation reduced the odds of EPTB. For PTB, women were more likely to benefit from omega-3 supplementation if they were multiparous (OR=0.65, 95% CI 0.49-0.87) or avoided alcohol in the lead up to pregnancy (OR=0.62, 95% CI 0.45-0.86).

Conclusions: Our results support previous findings that women with low total omega-3 levels in early pregnancy are most likely to benefit from taking omega-3 supplements to reduce their risk of EPTB. Understanding how other maternal characteristics influence the effectiveness of omega-3 supplementation on reducing PTB requires further investigation.

Trial registration number: ACTRN12613001142729.

Original language	English
Article number	e070220
Number of pages	7
Journal	BMJ Open
Volume	13
Issue number	4
DOIs	https://doi.org/10.1136/bmjopen-2022-070220
Publication status	Published - 17 Apr 2023

Keywords

Neonatology
Nutrition & Dietetics
Obstetrics
Public Health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Yelland, L. N., Sullivan, T. R., Gibson, R. A., Simmonds, L. A., Thakkar, S. K., Huang, F., Devaraj, S., Best, K. P., Zolezzi, I. S., & Makrides, M. (2023). Identifying women who may benefit from higher dose omega-3 supplementation during pregnancy to reduce their risk of prematurity: Exploratory analyses from the ORIP trial. BMJ Open, 13(4), Article e070220. https://doi.org/10.1136/bmjopen-2022-070220

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title = "Identifying women who may benefit from higher dose omega-3 supplementation during pregnancy to reduce their risk of prematurity: Exploratory analyses from the ORIP trial",

abstract = "Objectives: The risk factors for prematurity are multifactorial and include low omega-3 status. Omega-3 supplementation in pregnancy has been found to reduce prematurity risk, particularly among women with low omega-3 levels. This study aimed to identify maternal characteristics that predict whether women with a singleton pregnancy will benefit from omega-3 supplementation to reduce their risk of prematurity. Design: Exploratory analyses of a multicentre, double-blind randomised trial. Setting: 6 tertiary care centres in four states in Australia. Participants: 5328 singleton pregnancies in 5305 women recruited before 20 weeks of gestation.Interventions: Fish oil capsules containing 900 mg omega-3 long-chain polyunsaturated fatty acids per day versus vegetable oil capsules consumed from enrolment until 34 weeks' gestation. Outcome measures: Early preterm birth (EPTB, <34 weeks' gestation) and preterm birth (PTB, <37 weeks' gestation) analysed using logistic regression models with interactions between treatment group and a range of maternal biological, clinical and demographic characteristics. Results: Omega-3 supplementation reduced the odds of EPTB for women with low total omega-3 status in early pregnancy (OR=0.30, 95% CI 0.10-0.93). No additional maternal characteristics influenced whether omega-3 supplementation reduced the odds of EPTB. For PTB, women were more likely to benefit from omega-3 supplementation if they were multiparous (OR=0.65, 95% CI 0.49-0.87) or avoided alcohol in the lead up to pregnancy (OR=0.62, 95% CI 0.45-0.86). Conclusions: Our results support previous findings that women with low total omega-3 levels in early pregnancy are most likely to benefit from taking omega-3 supplements to reduce their risk of EPTB. Understanding how other maternal characteristics influence the effectiveness of omega-3 supplementation on reducing PTB requires further investigation. Trial registration number: ACTRN12613001142729.",

keywords = "Neonatology, Nutrition & Dietetics, Obstetrics, Public Health",

author = "Yelland, {Lisa N.} and Sullivan, {Thomas R.} and Gibson, {Robert A.} and Simmonds, {Lucy A.} and Thakkar, {Sagar K.} and Fang Huang and Surabhi Devaraj and Best, {Karen P.} and Zolezzi, {Irma Silva} and Maria Makrides",

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Yelland, LN, Sullivan, TR, Gibson, RA, Simmonds, LA, Thakkar, SK, Huang, F, Devaraj, S, Best, KP, Zolezzi, IS & Makrides, M 2023, 'Identifying women who may benefit from higher dose omega-3 supplementation during pregnancy to reduce their risk of prematurity: Exploratory analyses from the ORIP trial', BMJ Open, vol. 13, no. 4, e070220. https://doi.org/10.1136/bmjopen-2022-070220

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T1 - Identifying women who may benefit from higher dose omega-3 supplementation during pregnancy to reduce their risk of prematurity

T2 - Exploratory analyses from the ORIP trial

AU - Yelland, Lisa N.

AU - Sullivan, Thomas R.

AU - Gibson, Robert A.

AU - Simmonds, Lucy A.

AU - Thakkar, Sagar K.

AU - Huang, Fang

AU - Devaraj, Surabhi

AU - Best, Karen P.

AU - Zolezzi, Irma Silva

AU - Makrides, Maria

PY - 2023/4/17

Y1 - 2023/4/17

N2 - Objectives: The risk factors for prematurity are multifactorial and include low omega-3 status. Omega-3 supplementation in pregnancy has been found to reduce prematurity risk, particularly among women with low omega-3 levels. This study aimed to identify maternal characteristics that predict whether women with a singleton pregnancy will benefit from omega-3 supplementation to reduce their risk of prematurity. Design: Exploratory analyses of a multicentre, double-blind randomised trial. Setting: 6 tertiary care centres in four states in Australia. Participants: 5328 singleton pregnancies in 5305 women recruited before 20 weeks of gestation.Interventions: Fish oil capsules containing 900 mg omega-3 long-chain polyunsaturated fatty acids per day versus vegetable oil capsules consumed from enrolment until 34 weeks' gestation. Outcome measures: Early preterm birth (EPTB, <34 weeks' gestation) and preterm birth (PTB, <37 weeks' gestation) analysed using logistic regression models with interactions between treatment group and a range of maternal biological, clinical and demographic characteristics. Results: Omega-3 supplementation reduced the odds of EPTB for women with low total omega-3 status in early pregnancy (OR=0.30, 95% CI 0.10-0.93). No additional maternal characteristics influenced whether omega-3 supplementation reduced the odds of EPTB. For PTB, women were more likely to benefit from omega-3 supplementation if they were multiparous (OR=0.65, 95% CI 0.49-0.87) or avoided alcohol in the lead up to pregnancy (OR=0.62, 95% CI 0.45-0.86). Conclusions: Our results support previous findings that women with low total omega-3 levels in early pregnancy are most likely to benefit from taking omega-3 supplements to reduce their risk of EPTB. Understanding how other maternal characteristics influence the effectiveness of omega-3 supplementation on reducing PTB requires further investigation. Trial registration number: ACTRN12613001142729.

AB - Objectives: The risk factors for prematurity are multifactorial and include low omega-3 status. Omega-3 supplementation in pregnancy has been found to reduce prematurity risk, particularly among women with low omega-3 levels. This study aimed to identify maternal characteristics that predict whether women with a singleton pregnancy will benefit from omega-3 supplementation to reduce their risk of prematurity. Design: Exploratory analyses of a multicentre, double-blind randomised trial. Setting: 6 tertiary care centres in four states in Australia. Participants: 5328 singleton pregnancies in 5305 women recruited before 20 weeks of gestation.Interventions: Fish oil capsules containing 900 mg omega-3 long-chain polyunsaturated fatty acids per day versus vegetable oil capsules consumed from enrolment until 34 weeks' gestation. Outcome measures: Early preterm birth (EPTB, <34 weeks' gestation) and preterm birth (PTB, <37 weeks' gestation) analysed using logistic regression models with interactions between treatment group and a range of maternal biological, clinical and demographic characteristics. Results: Omega-3 supplementation reduced the odds of EPTB for women with low total omega-3 status in early pregnancy (OR=0.30, 95% CI 0.10-0.93). No additional maternal characteristics influenced whether omega-3 supplementation reduced the odds of EPTB. For PTB, women were more likely to benefit from omega-3 supplementation if they were multiparous (OR=0.65, 95% CI 0.49-0.87) or avoided alcohol in the lead up to pregnancy (OR=0.62, 95% CI 0.45-0.86). Conclusions: Our results support previous findings that women with low total omega-3 levels in early pregnancy are most likely to benefit from taking omega-3 supplements to reduce their risk of EPTB. Understanding how other maternal characteristics influence the effectiveness of omega-3 supplementation on reducing PTB requires further investigation. Trial registration number: ACTRN12613001142729.

KW - Neonatology

KW - Nutrition & Dietetics

KW - Obstetrics

KW - Public Health

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ER -

Identifying women who may benefit from higher dose omega-3 supplementation during pregnancy to reduce their risk of prematurity: Exploratory analyses from the ORIP trial

Abstract

Keywords

UN SDGs

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