Susanne Hansen1, Marin Strøm2, Ekaterina Maslova3, Ronald Dahl4, Hans Jürgen Hoffmann5, Dorte Rytter6, Bodil Hammer Bech6, Tine Brink Henriksen7, Charlotta Granström3, Thorhallur I Halldorsson8, Jorge E Chavarro9, Allan Linneberg10, Sjurdur F Olsen11. 1. Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark. Electronic address: suu@ssi.dk. 2. Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark; Faculty of Natural and Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands. 3. Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark. 4. Department of Pulmonary Medicine and Allergy, Aarhus University Hospital, Aarhus, Denmark; Allergy Centre, Odense University Hospital, Odense, Denmark. 5. Department of Pulmonary Medicine and Allergy, Aarhus University Hospital, Aarhus, Denmark. 6. Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark. 7. Department of Pediatrics, Aarhus University Hospital, Skejby, Denmark. 8. Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark; Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland; Unit for Nutrition Research, Landspitali University Hospital, Reykjavik, Iceland. 9. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Mass; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Mass; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass. 10. Research Centre for Prevention and Health, Capital Region of Denmark, Copenhagen, Denmark; Department of Clinical Experimental Research, Glostrup University Hospital, Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. 11. Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Mass.
Abstract
BACKGROUND:Maternal supplementation with long-chain n-3 polyunsaturated fatty acids can have immunologic effects on the developing fetus through several anti-inflammatory pathways. However, there is limited knowledge of the long-term programming effects. OBJECTIVE: In a randomized controlled trial from 1990 with 24 years of follow-up, our aim was to determine whether supplementation with 2.7 g of long-chain n-3polyunsaturated fatty acids in pregnancy can reduce the risk of asthma in offspring and allergic respiratory disease. METHODS: The randomized controlled trial included 533 women who were randomly assigned toreceive fish oil during the third trimester of pregnancy, olive oil, or no oil in the ratio 2:1:1. The offspring were followed in a mandatory national prescription register, with complete follow-up for prescriptions related to the treatment of asthma and allergic rhinitis as primary outcomes. Furthermore, the offspring were invited to complete a questionnaire (74% participated) and attend a clinical examination (47% participated) at age 18 to 19 years. RESULTS: In intention-to-treat analyses the probability of having had asthma medication prescribed was significantly reduced in the fish oil group compared with the olive oil group (hazard ratio, 0.54, 95% CI, 0.32-0.90; P = .02). The probability of having had allergic rhinitis medication prescribed was also reduced in the fish oil group compared with the olive oil group (hazard ratio, 0.70, 95% CI, 0.47-1.05; P = .09), but the difference was not statistically significant. Self-reported information collected at age 18 to 19 years supported these findings. No associations were detected with respect to lung function outcomes or allergic sensitization at 18 to 19 years of age. CONCLUSION:Maternal supplementation with fish oil might have prophylactic potential for long-term prevention of asthma in offspring.
RCT Entities:
BACKGROUND: Maternal supplementation with long-chain n-3 polyunsaturated fatty acids can have immunologic effects on the developing fetus through several anti-inflammatory pathways. However, there is limited knowledge of the long-term programming effects. OBJECTIVE: In a randomized controlled trial from 1990 with 24 years of follow-up, our aim was to determine whether supplementation with 2.7 g of long-chain n-3 polyunsaturated fatty acids in pregnancy can reduce the risk of asthma in offspring and allergic respiratory disease. METHODS: The randomized controlled trial included 533 women who were randomly assigned to receive fish oil during the third trimester of pregnancy, oliveoil, or no oil in the ratio 2:1:1. The offspring were followed in a mandatory national prescription register, with complete follow-up for prescriptions related to the treatment of asthma and allergic rhinitis as primary outcomes. Furthermore, the offspring were invited to complete a questionnaire (74% participated) and attend a clinical examination (47% participated) at age 18 to 19 years. RESULTS: In intention-to-treat analyses the probability of having had asthma medication prescribed was significantly reduced in the fish oil group compared with the oliveoil group (hazard ratio, 0.54, 95% CI, 0.32-0.90; P = .02). The probability of having had allergic rhinitis medication prescribed was also reduced in the fish oil group compared with the oliveoil group (hazard ratio, 0.70, 95% CI, 0.47-1.05; P = .09), but the difference was not statistically significant. Self-reported information collected at age 18 to 19 years supported these findings. No associations were detected with respect to lung function outcomes or allergic sensitization at 18 to 19 years of age. CONCLUSION: Maternal supplementation with fish oil might have prophylactic potential for long-term prevention of asthma in offspring.
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