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Effect of n-3 long chain polyunsaturated fatty acid supplementation in pregnancy on infants' allergies in first year of life: randomised controlled trial

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dc.contributor.authorPalmer, D.
dc.contributor.authorSullivan, T.
dc.contributor.authorGold, M.
dc.contributor.authorPrescott, S.
dc.contributor.authorHeddle, R.
dc.contributor.authorGibson, R.
dc.contributor.authorMakrides, M.
dc.date.issued2012
dc.description.abstractObjective: To determine whether dietary n-3 long chain polyunsaturated fatty acid (LCPUFA) supplementation of pregnant women with a fetus at high risk of allergic disease reduces immunoglobulin E associated eczema or food allergy at 1 year of age. Design: Follow-up of infants at high hereditary risk of allergic disease in the Docosahexaenoic Acid to Optimise Mother Infant Outcome (DOMInO) randomised controlled trial. Setting: Adelaide, South Australia. Participants: 706 infants at high hereditary risk of developing allergic disease whose mothers were participating in the DOMInO trial. Interventions: The intervention group (n=368) was randomly allocated to receive fish oil capsules (providing 900 mg of n-3 LCPUFA daily) from 21 weeks’ gestation until birth; the control group (n=338) received matched vegetable oil capsules without n-3 LCPUFA. Main outcome measure: Immunoglobulin E associated allergic disease (eczema or food allergy with sensitisation) at 1 year of age. Results: No differences were seen in the overall percentage of infants with immunoglobulin E associated allergic disease between the n-3 LCPUFA and control groups (32/368 (9%) v 43/338 (13%); unadjusted relative risk 0.68, 95% confidence interval 0.43 to 1.05, P=0.08; adjusted relative risk 0.70, 0.45 to 1.09, P=0.12), although the percentage of infants diagnosed as having atopic eczema (that is, eczema with associated sensitisation) was lower in the n-3 LCPUFA group (26/368 (7%) v 39/338 (12%); unadjusted relative risk 0.61, 0.38 to 0.98, P=0.04; adjusted relative risk 0.64, 0.40 to 1.02, P=0.06). Fewer infants were sensitised to egg in the n-3 LCPUFA group (34/368 (9%) v 52/338 (15%); unadjusted relative risk 0.61, 0.40 to 0.91, P=0.02; adjusted relative risk 0.62, 0.41 to 0.93, P=0.02), but no difference between groups in immunoglobulin E associated food allergy was seen. Conclusion: n-3 LCPUFA supplementation in pregnancy did not reduce the overall incidence of immunoglobulin E associated allergies in the first year of life, although atopic eczema and egg sensitisation were lower. Longer term follow-up is needed to determine if supplementation has an effect on respiratory allergic diseases and aeroallergen sensitisation in childhood.
dc.description.statementofresponsibilityD J Palmer, T Sullivan, M S Gold, S L Prescott, R Heddle, R A Gibson, M Makrides
dc.identifier.citationThe BMJ, 2012; 344(7845):E184-1-E184-11
dc.identifier.doi10.1136/bmj.e184
dc.identifier.issn0959-535X
dc.identifier.issn1756-1833
dc.identifier.orcidSullivan, T. [0000-0002-6930-5406]
dc.identifier.orcidGold, M. [0000-0003-1312-5331]
dc.identifier.orcidGibson, R. [0000-0002-8750-525X]
dc.identifier.orcidMakrides, M. [0000-0003-3832-541X]
dc.identifier.urihttp://hdl.handle.net/2440/70081
dc.language.isoen
dc.publisherBritish Med Journal Publ Group
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/399389
dc.rights© The Authors
dc.source.urihttps://doi.org/10.1136/bmj.e184
dc.subjectFetal Blood
dc.subjectHumans
dc.subjectDermatitis, Atopic
dc.subjectHypersensitivity, Immediate
dc.subjectFood Hypersensitivity
dc.subjectFatty Acids, Omega-3
dc.subjectFish Oils
dc.subjectImmunoglobulin E
dc.subjectTreatment Outcome
dc.subjectRegression Analysis
dc.subjectBreast Feeding
dc.subjectPregnancy
dc.subjectInfant Formula
dc.subjectDietary Supplements
dc.subjectEggs
dc.subjectInfant
dc.subjectAustralia
dc.subjectFemale
dc.subjectMale
dc.subjectMaternal Nutritional Physiological Phenomena
dc.subjectIntention to Treat Analysis
dc.subjectConfounding Factors, Epidemiologic
dc.titleEffect of n-3 long chain polyunsaturated fatty acid supplementation in pregnancy on infants' allergies in first year of life: randomised controlled trial
dc.typeJournal article
pubs.publication-statusPublished

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