Yelland L N, Gajewski B J, Colombo J, Gibson R A, Makrides M, Carlson S E
Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, University of Adelaide, South Australia 5005, Australia; The Discipline of Public Health, University of Adelaide, South Australia 5005, Australia.
The Department of Biostatistics, University of Kansas Medical Center, Kansas City, KS, USA.
Prostaglandins Leukot Essent Fatty Acids. 2016 Sep;112:44-9. doi: 10.1016/j.plefa.2016.08.007. Epub 2016 Aug 17.
The DHA to Optimize Mother Infant Outcome (DOMInO) and Kansas DHA Outcomes Study (KUDOS) were randomized controlled trials that supplemented mothers with 800 and 600mg DHA/day, respectively, or a placebo during pregnancy. DOMInO was conducted in Australia and KUDOS in the United States. Both trials found an unanticipated and statistically significant reduction in early preterm birth (ePTB; i.e., birth before 34 weeks gestation). However, in each trial, the number of ePTBs were small. We used a novel Bayesian approach to estimate statistically derived low, moderate or high risk for ePTB, and to test for differences between the DHA and placebo groups. In both trials, the model predicted DHA would significantly reduce the expected proportion of deliveries in the high risk group under the trial conditions of the parent studies. Among the next 300,000 births in Australia we estimated that 1112 ePTB (95% credible interval 51-2189) could be avoided by providing DHA. And in the USA we estimated that 106,030 ePTB (95% credible interval 6400 to 175,700) could be avoided with DHA.
优化母婴结局的二十二碳六烯酸（DHA）研究（DOMInO）和堪萨斯州DHA结局研究（KUDOS）是随机对照试验，在孕期分别为母亲补充每日800毫克和600毫克DHA或安慰剂。DOMInO在澳大利亚开展，KUDOS在美国开展。两项试验均发现早期早产（即妊娠34周前出生）出现意外且具有统计学意义的减少。然而，每项试验中早期早产的病例数都很少。我们采用一种全新的贝叶斯方法来估计早期早产经统计得出的低、中或高风险，并检验DHA组和安慰剂组之间的差异。在两项试验中，该模型预测在母研究的试验条件下，DHA会显著降低高风险组中预期的分娩比例。在澳大利亚接下来的30万例分娩中，我们估计通过提供DHA可避免1112例早期早产（95%可信区间51 - 2189）。在美国，我们估计使用DHA可避免106,030例早期早产（95%可信区间6400至175,700）。
