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Impact of n-3 polyunsaturated fatty acid intake in pregnancy on maternal health and birth outcomes: systematic review and meta-analysis from randomized controlled trails

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Background

Maternal omega-3 consumption during pregnancy has been positively linked with a positive impact on maternal health and fetal growth. However, the results of individual studies are inconsistent and conflicting.

Objective

Examine the effect of supplementation with DHA, and/or EPA, and/or ALA throughout pregnancy on offspring’s growth and pregnancy outcomes.

Design

A systematic review and meta-analysis.

Population

Pregnant women.

Methods

According to (PRISMA) statement and the Cochrane Handbook guidelines. Human trials (RCT or quasi-RCT) which involved oral omega-3 supplementation at least twice a week during pregnancy were included and comparing it with control groups with no supplementation or placebo administration. Data were extracted and directed using RevMan software. Fifty-nine randomized controlled trials were eligible for inclusion in the meta-analysis. Performed in MEDLINE, PubMed, Scopus, Google Scholar, and the Cochrane Library comparing omega 3 with control groups, from 1990 to 2020.

The main outcome measures

The primary outcome measures were pregnancy-induced hypertension, preeclampsia, gestational duration, preterm birth, early preterm birth, birth weight, low birth weight, neonatal length, and head circumference. The secondary outcomes were neonatal intensive care unit, infant death, prenatal death, and cesarean section.

Results

In 24 comparisons (21,919 women) n-3 fatty acids played a protective role against the risk of preeclampsia (RR = 0.84, 95% CI 0.74–0.96 p = 0.008; I2 = 24%). In 46 comparisons (16,254 women) n-3 fatty acids were associated with a significantly greater duration of pregnancy (MD = 1.35, 95% CI 0.65–2.05, p = 0.0002; I2 = 59%). 27 comparisons (15,510 women) was accompanied by a significant decrease in pre-term birth less than 37 weeks (RR = 0.86, 95% CI 0.77–0.95, p = 0.005; I2 = 0%). 12 comparisons (11,774 women) was accompanied by a significant decrease in early pre-term birth less than 34 weeks (RR = 0.77, 95% CI 0.63–0.95, p = 0.01; I2 = 40%). 38 comparisons (16,505 infants) had a significant increase in birth weight (MD = 49.19, 95% CI 28.47–69.91, p < 0.00001; I2 = 100%). Finally, 14 comparisons (8,449 infants) had a borderline significance in increase in low birth weight (RR = 0.88, 95% CI 0.78–1.00, p = 0.05; I2 = 28%).

Conclusions

Supplementation with omega-3 in prgnancy can prevent preeclampsia, increase gestational duration, increase birth weight and decrease the risk of low birth weight and preterm birth.

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Acknowledgements

The success of this study required the help of various individuals. Without them, the researchers might not meet their objectives in doing this study.

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  1. Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt

    Mona A. Abdelrahman, Hasnaa Osama, Haitham Saeed, Yasmin M. Madney, Hadeer S. Harb & Mohamed E. A. Abdelrahim

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  1. Mona A. Abdelrahman
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Contributions

MAA is the first and corresponding author; MAA and MA conceived and designed the study; MAA, HO, HS, and MA acquired data; MAA, YMM, HSH, and MA analyzed and interpreted data; MAA, HO, HS, YMM, HSH, and MA drafted the initial and final manuscripts; MAA, HO, HS, YMM, HSH, and MA performed critical revisions of the manuscript. All authors approved the final version of the manuscript.

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Correspondence to Mona A. Abdelrahman.

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Abdelrahman, M.A., Osama, H., Saeed, H. et al. Impact of n-3 polyunsaturated fatty acid intake in pregnancy on maternal health and birth outcomes: systematic review and meta-analysis from randomized controlled trails. Arch Gynecol Obstet 307, 249–262 (2023). https://doi.org/10.1007/s00404-022-06533-0

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  • DOI: https://doi.org/10.1007/s00404-022-06533-0

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