Palmer, D.Sullivan, T.Gold, M.Prescott, S.Heddle, R.Gibson, R.Makrides, M.2012-03-272012-03-272012The BMJ, 2012; 344(7845):E184-1-E184-110959-535X1756-1833http://hdl.handle.net/2440/70081Objective: 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.en© The AuthorsFetal BloodHumansDermatitis, AtopicHypersensitivity, ImmediateFood HypersensitivityFatty Acids, Omega-3Fish OilsImmunoglobulin ETreatment OutcomeRegression AnalysisBreast FeedingPregnancyInfant FormulaDietary SupplementsEggsInfantAustraliaFemaleMaleMaternal Nutritional Physiological PhenomenaIntention to Treat AnalysisConfounding Factors, EpidemiologicJournal article002011638010.1136/bmj.e1840003000874000022-s2.0-8485752920025981Sullivan, T. [0000-0002-6930-5406]Gold, M. [0000-0003-1312-5331]Gibson, R. [0000-0002-8750-525X]Makrides, M. [0000-0003-3832-541X]