Makrides, M.Best, K.Yelland, L.McPhee, A.Zhou, S.Quinlivan, J.Dodd, J.Atkinson, E.Safa, H.Van Dam, J.Khot, N.Dekker, G.Skubisz, M.Anderson, A.Kean, B.Bowman, A.McCallum, C.Cashman, K.Gibson, R.2025-07-232025-07-232020Obstetrical and Gynecological Survey, 2020; 75(2):79-800029-78281533-9866https://hdl.handle.net/2440/146259Editorial comment for original article in the New England Journal of Medical 2019;381:1035–1045.Preterm delivery (defined as delivery before 37 weeks' gestation) occurs in 15 million pregnancies each year. Of these, approximately 20% are early preterm deliveries, occurring before 34 weeks' gestation and accounting for the largest burden of neonatal death and childhood disability. The World Health Organization recommends that pregnant women include 300 mg/d of n-3 long-chain polyunsaturated fatty acids in their diets. However, Australian and American women of childbearing age consume only a third of the recommended dose. This dietary insufficiency may be a potential target for intervention of preterm delivery. The aim of this study is to assess if early supplementation with n-3 long-chain polyunsaturated fatty acids lowers the incidence of early preterm deliveries. This study was a multicenter, double-blind, randomized, controlled trial conducted in Australia. Pregnant women with single or multiple gestation pregnancies were recruited at their first prenatal appointment between November 1, 2013, and April 26, 2017. The study excluded women who were taking daily supplements containing more than 150 mg of n-3 long-chain polyunsaturated fatty acids. Women were also excluded if they had coagulopathy, were receiving anticoagulants, had a history of substance abuse, or if their fetus had a congenital abnormality. The pregnant women were randomly assigned to receive either fish oil capsules that contained approximately 900 mg of n-3 long-chain polyunsaturated fatty acids per day (the n-3 group) or vegetable oil capsules (the control group). The women began taking the capsules as soon as they entered the trial (before 20 weeks' gestation) until 34 weeks of gestation or delivery. Data from 5486 pregnancies were included in the analysis, with 2734 in the n-3 group and 2752 in the control group. Early preterm delivery occurred in 61 (2.2%) of 2734 pregnancies in the n-3 group and 55 (2.0%) of 2752 pregnancies in the control group; the difference between the 2 groups was not significant (adjusted relative risk, 1.13; 95% confidence interval, 0.79-1.63, P = 0.50). For both groups, the average gestation period was 273 days. No significant differences were noted between the 2 groups for maternal outcomes of preterm delivery, postterm interventions, and spontaneous early preterm delivery. Although no significant differences were noted for most neonatal outcomes, there were more infants born with birth weight, greater than 97th percentile for corresponding gestational age and sex to women in the n-3 group compared with the control group (adjusted relative risk, 1.30; 95% confidence interval, 1.02-1.65). The authors concluded that supplementation of n-3 long-chain polyunsaturated fatty acids during pregnancy did not lower the risk of early preterm delivery compared with placebo.en© 2020 Wolters Kluwer Health, Inc. All rights reserved.Preterm delivery; global public health problem; preterm birth (PTB); neonatal deaths; mortality; editorialJournal article10.1097/OGX.0000000000000772527799Makrides, M. [0000-0003-3832-541X]Best, K. [0000-0002-7653-5074]Yelland, L. [0000-0003-3803-8728]McPhee, A. [0000-0003-3820-5696]Zhou, S. [0000-0003-4012-983X]Dodd, J. [0000-0002-6363-4874]Dekker, G. [0000-0002-7362-6683]Bowman, A. [0000-0001-5371-7425]Gibson, R. [0000-0002-8750-525X]