Original research
A randomized trial of docosahexaenoic acid supplementation during the third trimester of pregnancy

https://doi.org/10.1016/S0029-7844(02)02585-1Get rights and content

Abstract

Objective

To hypothesize that higher intake of docosahexaenoic acid, an n-3 long chain polyunsaturated fatty acid, would increase duration of gestation and birth weight in US women.

Methods

This was a randomized, double-blind, controlled, clinical trial. Subjects were enrolled in an ambulatory clinic where they received prenatal care. This was a population-based sample. Most subjects received government assistance for medical care and most were black (73%). Subjects were enrolled between the 24th and 28th week of pregnancy and consumed docosahexaenoic acid (33 or 133 mg) from eggs until parturition. Gestational age and birth weight were the main study outcomes. Infant length and head circumference, preterm birth, and low birth weight were secondary outcomes.

Results

Eighty-three percent of subjects completed the study (291 of 350 enrolled). No subject was discontinued for an adverse event. After controlling for important predefined risk factors and confounding variables, gestation increased by 6.0 ± 2.3 days (P = .009) in the higher docosahexaenoic acid group. Birth weight, length, and head circumference increased, but did not reach statistical significance (P = .06–.18), although the increases could be clinically important indications of enhanced intrauterine growth. No safety concerns were raised by the study.

Conclusion

Duration of gestation increased significantly when docosahexaenoic acid intake was increased during the last trimester of pregnancy. The increase in gestation was similar to that reported for interventions with much larger amounts of n-3 long chain polyunsaturated fatty acids.

Section snippets

Materials and methods

This study was a randomized, double-blind, controlled, clinical trial to determine the effects of increasing docosahexaenoic acid intake during the third trimester of pregnancy on pregnancy and birth outcomes. Subjects were supplied with docosahexaenoic acid-enriched eggs (mean of 133 mg of docosahexaenoic acid per egg) or ordinary eggs (mean of 33 mg of docosahexaenoic acid per egg). The primary outcome variables of interest were gestational age and birth weight. Secondary outcomes included

Results

A total of 347 women participated in this study. However, information was collected on 350 pregnancies, as three women were pregnant twice during the enrollment period. In two of these cases, both pregnancies were completed. To maintain independence among the study data, the second pregnancy was excluded from the analysis. An additional 57 pregnancies were not included in the analysis because the subjects were study dropouts (Figure 1). In sum, 291 subjects completed the study and were

Discussion

The current study found a 6-day longer period of gestation when docosahexaenoic acid intake was increased during the last trimester of pregnancy. The mechanism of action is not known, but it is plausible that dietary docosahexaenoic acid could increase gestational age by several mechanisms. Prostaglandins E2 and F are required for labor and delivery.22, 23 These two-series prostaglandins are derived from the n-6 long chain polyunsaturated fatty acid, arachidonic acid, whereas the less potent

Acknowledgements

The authors are grateful to Mary Van Elswyk, Deanna McCarthy, and OmegaTech Inc. for support of this study, and to Nadene Hausmann of AQUAL Clinical Research Services Inc., whose outstanding organizational skills and oversight were invaluable to the study team. Minati Dhar and Amanda Schraegle provided excellent technical help. The authors also thank the faculty and staff of Truman Medical Center for assisting on many occasions.

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    CMS is currently affiliated with the Medical Research Council, Tygerberg, South Africa.

    This work was carried out at the University of Kansas Medical Center, Kansas City, Kansas, and the University of Missouri, Kansas City, Missouri.

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