Saccone G, Berghella V, Maruotti G M, Sarno L, Martinelli P
Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Ultrasound Obstet Gynecol. 2015 Dec;46(6):659-64. doi: 10.1002/uog.14910. Epub 2015 Nov 4.
To evaluate the efficacy of omega-3 supplementation during pregnancy in preventing intrauterine growth restriction (IUGR) in women with apparently uncomplicated singleton pregnancy and previous IUGR pregnancy.
For this systematic review, the research protocol was designed a priori. Searches were performed in electronic databases for studies published from inception of each database to December 2014. A combination of search terms was used including 'fish oil', 'long chain polyunsaturated fatty acids', 'intrauterine growth restriction', 'small for gestational age' and 'omega-3'. We included all randomized controlled trials (RCTs) of women with an uncomplicated singleton pregnancy and a prior IUGR pregnancy who were randomized to receive prophylactic treatment with omega-3 supplementation or either placebo or no treatment (control). Trials that included women with multiple gestations and those with only biochemical outcomes available were excluded. Pooled estimates were based on relative risk (RR) with 95% CI. Primary outcome was incidence of IUGR as defined in the RCTs.
Three RCTs including 575 women with uncomplicated singleton pregnancy with prior IUGR were analyzed. Women who received omega-3 supplementation during pregnancy had the same incidence of IUGR, defined as estimated fetal weight < 5(th) or < 3(rd) centiles, as had controls (22.8% vs 20.2%, respectively; RR, 1.13 (95% CI, 0.83-1.54)). Compared to controls, women who received omega-3 supplementation delivered later (mean difference, 1.4 (95% CI, 1.28-1.63) weeks), had a longer latency (mean difference, 2 (95% CI, 1.73-2.08) weeks), had a similar incidence of perinatal death (2.1% vs 3.3%, respectively; RR, 0.60 (95% CI, 0.15-2.42)) and similar birth weight (mean difference, 50 g (95% CI, -26 to 246 g)).
Omega-3 supplementation during pregnancy does not prevent recurrence of IUGR in women with uncomplicated singleton pregnancy and a previous IUGR pregnancy.
评估孕期补充ω-3对预防单胎妊娠无明显并发症且既往有胎儿生长受限（IUGR）史的孕妇发生胎儿生长受限的疗效。
对于本系统评价，预先设计了研究方案。在电子数据库中检索自各数据库建库至2014年12月发表的研究。使用了包括“鱼油”“长链多不饱和脂肪酸”“胎儿生长受限”“小于胎龄儿”和“ω-3”等在内的检索词组合。我们纳入了所有单胎妊娠无并发症且既往有IUGR史、被随机分配接受ω-3补充剂预防性治疗或安慰剂或不治疗（对照）的孕妇的随机对照试验（RCT）。排除包括多胎妊娠孕妇以及仅有生化指标结果的试验。合并估计值基于相对危险度（RR）及95%置信区间（CI）。主要结局为RCT中定义的IUGR发生率。
分析了3项RCT，共纳入575名单胎妊娠无并发症且既往有IUGR史的孕妇。孕期接受ω-3补充剂的孕妇发生IUGR（定义为估计胎儿体重<第5百分位数或<第3百分位数）的发生率与对照组相同（分别为22.8%和20.2%；RR，为1.13（95%CI，0.83 - 1.54））。与对照组相比，接受ω-3补充剂的孕妇分娩时间更晚（平均差值，1.4（95%CI，1.28 - 1.63）周），潜伏期更长（平均差值，2（95%CI，1.73 - 2.08）周），围产期死亡发生率相似（分别为2.1%和3.3%；RR，0.60（95%CI，0.
