1. Omega-3 long-chain PUFA intake during pregnancy and allergic disease outcomes in the offspring: a systematic review and meta-analysis of observational studies and randomized controlled trials.
- Author
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Best, Karen P., Gold, Michael, Kennedy, Declan, Martin, James, and Makrides, Maria
- Subjects
RESEARCH methodology evaluation ,ALLERGIES ,ASTHMA in children ,ATOPIC dermatitis ,CHILDREN'S health ,CINAHL database ,CONFIDENCE intervals ,DIET ,DIETARY supplements ,ECZEMA in children ,EXPERIMENTAL design ,FISH oils ,FISHES ,FOOD allergy in children ,INFORMATION storage & retrieval systems ,MEDICAL databases ,MEDICAL information storage & retrieval systems ,LONGITUDINAL method ,MEDLINE ,META-analysis ,MOTHERS ,NUTRITIONAL assessment ,NUTRITIONAL requirements ,SCIENTIFIC observation ,OMEGA-3 fatty acids ,ONLINE information services ,POPULATION geography ,PROBABILITY theory ,QUESTIONNAIRES ,RESEARCH funding ,SINUSITIS ,SKIN tests ,WOMEN'S health ,SYSTEMATIC reviews ,EVIDENCE-based medicine ,PROFESSIONAL practice ,STATISTICAL significance ,RANDOMIZED controlled trials ,RESEARCH bias ,DATA analysis software ,DESCRIPTIVE statistics ,ODDS ratio ,ALLERGIC conjunctivitis ,EVALUATION ,PREGNANCY - Abstract
Background: There is some evidence that increased maternal intake of omega-3 (n-3) long-chain polyunsaturated fatty acids (LC-PUFAs) during pregnancy may reduce the incidence of immunoglobulin E (IgE)-mediated allergic disease. Objective: We aimed to evaluate prenatal n-3 LC-PUFA dietary exposure in observational studies and n-3 LC-PUFA supplementation in randomized controlled trials (RCTs) on outcomes of IgE-mediated allergic disease. Design: We conducted searches of the Cochrane Central Register of Controlled Trials, PubMed, Ovid MEDLINE, EMBASE, CINAHL, SCOPUS, and Web of Science to 30 July 2015. We included prospective cohort studies that showed an association between maternal fish or n-3 LC-PUFA intake during pregnancy and RCTs with a prenatal intervention to modify maternal n-3 LC-PUFA intake and outcomes of allergic disease (eczema, rhino-conjunctivitis, asthma) or sensitization in the offspring. Results: A total of 13 publications from 10 prospective cohort studies and 7 publications representing 5 unique RCTs were included. Three RCTs were combined in a meta-analysis for selected outcomes. Nine of 13 observational study publications and 5 of 7 publications from RCTs found a protective association between increased prenatal n-3 LC-PUFA or fish intake and incidence of allergic disease symptoms in the child. Meta-analysis was limited because of the heterogeneity of the RCTs. Pooled results showed a significant reduction in the incidence of "atopic eczema," "any positive SPT [skin-prick test]," "sensitization to egg," and "sensitization to any food" in the first 12 mo of life [RRs (95% CIs): 0.53 (0.35, 0.81), P = 0.004; 0.68 (0.52-0.89), P = 0.006; 0.55 (0.39-0.76), P = 0.0004; and 0.59 (0.46, 0.76), P < 0.0001, respectively]. Conclusions: Our systematic review and meta-analysis was suggestive of benefits of increased n-3 LC-PUFAs in the maternal diet and outcomes of childhood allergic disease. However, due to the inconsistency in results, the hypothesis linking maternal n-3 LC-PUFA intake to childhood allergic disease cannot unequivocally be confirmed or rejected. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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