ω-3 LCPUFA supplementation during pregnancy and risk of allergic outcomes or sensitization in offspring

A systematic review and meta-analysis

Mariam Vahdaninia, Healther Mackenzie, Taraneh Dean, Suzannah Helps

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Allergic diseases have increased worldwide in the last 2 decades, with children suffering the highest burden of the condition. The ω-3 long-chain poly-unsaturated fatty acid (LCPUFA) possesses anti-inflammatory properties that could lead to a reduction in inflammatory mediators in allergies. Objective: A systematic review and meta-analysis of the most recent follow-ups of randomized clinical trials (RCTs) was conducted to assess the effectiveness of ω-3 LCPUFA supplementation started during pregnancy on allergic outcomes in offspring. Methods: The RCTs with a minimum of 1-month follow-up post gestation were eligible for inclusion. The CENTRAL, MEDLINE, SCOPUS, WHO's International Clinical Trials Register, E-theses, and Web of Science databases were searched. Study quality was evaluated using the Cochrane Collaboration's risk of bias tool. Results: Ten RCTs (3,637 children), from 9 unique trials, examined the effectiveness of ω-3 LCPUFA supplementation started during pregnancy on the development of allergic outcomes in offspring. Heterogeneities were seen between the trials in terms of their sample, type, and duration of intervention and follow-up. Pooled estimates showed a significant reduction in childhood “sensitization to egg” (relative risk [RR] = 0.54, 95% confidence interval [CI] = 0.32-0.90), and “sensitization to peanut” (RR = 0.62, 95% CI = 0.40-0.96). No statistical differences were found for other allergic outcomes (eg, eczema, asthma/wheeze). Conclusion: These results suggest that intake of ω-3 LCPUFA started during pregnancy can reduce the risk of sensitization to egg and peanut; however, the evidence is limited because of the small number of studies that contributed to the meta-analyses. The current evidence on the association between supplementation with ω-3 LCPUFA started during pregnancy and allergic outcomes is weak, because of the risk of bias and heterogeneities between studies.

Original languageEnglish
Pages (from-to)302-313
Number of pages12
JournalAnnals of Allergy, Asthma and Immunology
Volume122
Issue number3
DOIs
Publication statusPublished - 12 Dec 2018

Fingerprint

Unsaturated Fatty Acids
Meta-Analysis
Pregnancy
Randomized Controlled Trials
Ovum
Confidence Intervals
Eczema
Pregnancy Outcome
MEDLINE
Hypersensitivity
Anti-Inflammatory Agents
Asthma
Clinical Trials
Databases
Arachis

Keywords

  • Systematic Review
  • Meta-analysis
  • omega-3 Fatty acids
  • Fish oil
  • n-3 LCPUFA
  • Allergies
  • Childhood allergies
  • Asthma
  • Wheeze
  • Wheezing
  • Asthma/wheeze
  • Sensitisation
  • Food allergy
  • Eczema

Cite this

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title = "ω-3 LCPUFA supplementation during pregnancy and risk of allergic outcomes or sensitization in offspring: A systematic review and meta-analysis",
abstract = "Background: Allergic diseases have increased worldwide in the last 2 decades, with children suffering the highest burden of the condition. The ω-3 long-chain poly-unsaturated fatty acid (LCPUFA) possesses anti-inflammatory properties that could lead to a reduction in inflammatory mediators in allergies. Objective: A systematic review and meta-analysis of the most recent follow-ups of randomized clinical trials (RCTs) was conducted to assess the effectiveness of ω-3 LCPUFA supplementation started during pregnancy on allergic outcomes in offspring. Methods: The RCTs with a minimum of 1-month follow-up post gestation were eligible for inclusion. The CENTRAL, MEDLINE, SCOPUS, WHO's International Clinical Trials Register, E-theses, and Web of Science databases were searched. Study quality was evaluated using the Cochrane Collaboration's risk of bias tool. Results: Ten RCTs (3,637 children), from 9 unique trials, examined the effectiveness of ω-3 LCPUFA supplementation started during pregnancy on the development of allergic outcomes in offspring. Heterogeneities were seen between the trials in terms of their sample, type, and duration of intervention and follow-up. Pooled estimates showed a significant reduction in childhood “sensitization to egg” (relative risk [RR] = 0.54, 95{\%} confidence interval [CI] = 0.32-0.90), and “sensitization to peanut” (RR = 0.62, 95{\%} CI = 0.40-0.96). No statistical differences were found for other allergic outcomes (eg, eczema, asthma/wheeze). Conclusion: These results suggest that intake of ω-3 LCPUFA started during pregnancy can reduce the risk of sensitization to egg and peanut; however, the evidence is limited because of the small number of studies that contributed to the meta-analyses. The current evidence on the association between supplementation with ω-3 LCPUFA started during pregnancy and allergic outcomes is weak, because of the risk of bias and heterogeneities between studies.",
keywords = "Systematic Review, Meta-analysis, omega-3 Fatty acids, Fish oil, n-3 LCPUFA, Allergies, Childhood allergies, Asthma, Wheeze, Wheezing, Asthma/wheeze, Sensitisation, Food allergy, Eczema",
author = "Mariam Vahdaninia and Healther Mackenzie and Taraneh Dean and Suzannah Helps",
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ω-3 LCPUFA supplementation during pregnancy and risk of allergic outcomes or sensitization in offspring : A systematic review and meta-analysis. / Vahdaninia, Mariam; Mackenzie, Healther; Dean, Taraneh; Helps, Suzannah.

In: Annals of Allergy, Asthma and Immunology, Vol. 122, No. 3, 12.12.2018, p. 302-313.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - ω-3 LCPUFA supplementation during pregnancy and risk of allergic outcomes or sensitization in offspring

T2 - A systematic review and meta-analysis

AU - Vahdaninia, Mariam

AU - Mackenzie, Healther

AU - Dean, Taraneh

AU - Helps, Suzannah

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N2 - Background: Allergic diseases have increased worldwide in the last 2 decades, with children suffering the highest burden of the condition. The ω-3 long-chain poly-unsaturated fatty acid (LCPUFA) possesses anti-inflammatory properties that could lead to a reduction in inflammatory mediators in allergies. Objective: A systematic review and meta-analysis of the most recent follow-ups of randomized clinical trials (RCTs) was conducted to assess the effectiveness of ω-3 LCPUFA supplementation started during pregnancy on allergic outcomes in offspring. Methods: The RCTs with a minimum of 1-month follow-up post gestation were eligible for inclusion. The CENTRAL, MEDLINE, SCOPUS, WHO's International Clinical Trials Register, E-theses, and Web of Science databases were searched. Study quality was evaluated using the Cochrane Collaboration's risk of bias tool. Results: Ten RCTs (3,637 children), from 9 unique trials, examined the effectiveness of ω-3 LCPUFA supplementation started during pregnancy on the development of allergic outcomes in offspring. Heterogeneities were seen between the trials in terms of their sample, type, and duration of intervention and follow-up. Pooled estimates showed a significant reduction in childhood “sensitization to egg” (relative risk [RR] = 0.54, 95% confidence interval [CI] = 0.32-0.90), and “sensitization to peanut” (RR = 0.62, 95% CI = 0.40-0.96). No statistical differences were found for other allergic outcomes (eg, eczema, asthma/wheeze). Conclusion: These results suggest that intake of ω-3 LCPUFA started during pregnancy can reduce the risk of sensitization to egg and peanut; however, the evidence is limited because of the small number of studies that contributed to the meta-analyses. The current evidence on the association between supplementation with ω-3 LCPUFA started during pregnancy and allergic outcomes is weak, because of the risk of bias and heterogeneities between studies.

AB - Background: Allergic diseases have increased worldwide in the last 2 decades, with children suffering the highest burden of the condition. The ω-3 long-chain poly-unsaturated fatty acid (LCPUFA) possesses anti-inflammatory properties that could lead to a reduction in inflammatory mediators in allergies. Objective: A systematic review and meta-analysis of the most recent follow-ups of randomized clinical trials (RCTs) was conducted to assess the effectiveness of ω-3 LCPUFA supplementation started during pregnancy on allergic outcomes in offspring. Methods: The RCTs with a minimum of 1-month follow-up post gestation were eligible for inclusion. The CENTRAL, MEDLINE, SCOPUS, WHO's International Clinical Trials Register, E-theses, and Web of Science databases were searched. Study quality was evaluated using the Cochrane Collaboration's risk of bias tool. Results: Ten RCTs (3,637 children), from 9 unique trials, examined the effectiveness of ω-3 LCPUFA supplementation started during pregnancy on the development of allergic outcomes in offspring. Heterogeneities were seen between the trials in terms of their sample, type, and duration of intervention and follow-up. Pooled estimates showed a significant reduction in childhood “sensitization to egg” (relative risk [RR] = 0.54, 95% confidence interval [CI] = 0.32-0.90), and “sensitization to peanut” (RR = 0.62, 95% CI = 0.40-0.96). No statistical differences were found for other allergic outcomes (eg, eczema, asthma/wheeze). Conclusion: These results suggest that intake of ω-3 LCPUFA started during pregnancy can reduce the risk of sensitization to egg and peanut; however, the evidence is limited because of the small number of studies that contributed to the meta-analyses. The current evidence on the association between supplementation with ω-3 LCPUFA started during pregnancy and allergic outcomes is weak, because of the risk of bias and heterogeneities between studies.

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KW - Childhood allergies

KW - Asthma

KW - Wheeze

KW - Wheezing

KW - Asthma/wheeze

KW - Sensitisation

KW - Food allergy

KW - Eczema

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