Bournemouth University, Faculty of Health and Social Sciences, United Kingdom; University of Portsmouth School of Health Sciences and Social Work, Portsmouth, Hampshire, United Kingdom.
University of Portsmouth School of Health Sciences and Social Work, Portsmouth, Hampshire, United Kingdom.
Ann Allergy Asthma Immunol. 2019 Mar;122(3):302-313.e2. doi: 10.1016/j.anai.2018.12.008. Epub 2018 Dec 12.
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.
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.
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.
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).
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.
在过去的 20 年中，过敏性疾病在全球范围内有所增加，儿童是该疾病的主要负担人群。ω-3 长链多不饱和脂肪酸（LCPUFA）具有抗炎特性，可减少过敏中的炎症介质。
对最近的随机临床试验（RCT）的随访进行系统评价和荟萃分析，以评估在怀孕期间开始补充 ω-3 LCPUFA 对后代过敏结局的有效性。
符合纳入标准的 RCT 必须有至少 1 个月的妊娠后随访。检索了 CENTRAL、MEDLINE、SCOPUS、世界卫生组织国际临床试验注册平台、E-theses 和 Web of Science 数据库。使用 Cochrane 协作风险偏倚工具评估研究质量。
来自 9 项独特试验的 10 项 RCT（3637 名儿童）研究了在怀孕期间开始补充 ω-3 LCPUFA 对后代过敏结局的发展的有效性。这些试验在样本、干预和随访的类型和持续时间方面存在异质性。汇总估计显示，儿童“对鸡蛋过敏”（相对风险 [RR] = 0.54，95%置信区间 [CI] = 0.32-0.90）和“对花生过敏”（RR = 0.62，95% CI = 0.40-0.96）的发生率显著降低。其他过敏结局（例如湿疹、哮喘/喘息）没有统计学差异。
这些结果表明，在怀孕期间摄入 ω-3 LCPUFA 可以降低对鸡蛋和花生过敏的风险；然而，由于对荟萃分析有贡献的研究数量较少，证据有限。由于研究之间存在偏倚和异质性，目前关于在怀孕期间开始补充 ω-3 LCPUFA 与过敏结局之间关联的证据较弱。
