(19-02-12) Effect of n-3 long chain polyunsaturated fatty acid supplementation in pregnancy on infants? allergies in first year of life:

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


1. D J Palmer, research fellow1,
2. T Sullivan, statistician2,
3. M S Gold, consultant paediatric allergist3,
4. S L Prescott, consultant paediatric allergist4,
5. R Heddle, clinical immunologist5,
6. R A Gibson, professor of functional foods6,
7. M Makrides, professor of human nutrition1
1.
Author Affiliations
1. 1Women?s and Children?s Health Research Institute, 72 King William Road, North Adelaide, South Australia, 5006, Australia
2. 2Data Management and Analysis Centre, University of Adelaide, Adelaide, South Australia, 5005, Australia
3. 3School of Paediatrics and Reproductive Health, University of Adelaide, North Adelaide, South Australia, 5006
4. 4Princess Margaret Hospital for Children, Perth, Western Australia, 6008, Australia
5. 5SA Pathology, Royal Adelaide Hospital, Adelaide, South Australia, 5005
6. 6School of Agriculture, Food and Wine, University of Adelaide, Glen Osmond, South Australia, 5064, Australia
1. Correspondence to: M  [email protected]
? Accepted 6 November 2011
Abstract
Objective 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.
Trial registration Australian New Zealand Clinical Trials Registry ACTRN12610000735055 (DOMInO trial: ACTRN12605000569606).

Source: BMJ 2012; 344 doi: 10.1136/bmj.e184 (Published 30 January 2012)
Cite this as: BMJ 2012;344:e184

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