SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.
Department of Obstetrics and Gynaecology, Women's and Children's Hospital, North Adelaide, SA, Australia.
BJOG. 2020 Jul;127(8):975-981. doi: 10.1111/1471-0528.16168. Epub 2020 Mar 3.
To identify a polyunsaturated fatty acid (PUFA) biomarker able to detect which women with singleton pregnancies are most likely to benefit from omega-3 supplementation to reduce their risk of early preterm birth.
Exploratory analysis of a randomised controlled trial.
Six Australian hospitals.
Women with a singleton pregnancy enrolled in the ORIP trial.
Using maternal capillary whole blood collected ~14 weeks' gestation, the fatty acids in total blood lipids were quantified using gas chromatography. Interaction tests examined whether baseline PUFA status modified the effect of omega-3 supplementation on birth outcomes.
Early preterm birth (<34 weeks' gestation).
A low total omega-3 PUFA status in early pregnancy was associated with a higher risk of early preterm birth. Among women with a total omega-3 status ≤4.1% of total fatty acids, omega-3 supplementation substantially reduced the risk of early preterm birth compared with control (0.73 versus 3.16%; relative risk = 0.23, 95% confidence interval [CI] 0.07-0.79). Conversely, women with higher total omega-3 status in early pregnancy were at lower risk of early preterm birth. Supplementing women with a baseline status above 4.9% increased early preterm birth (2.20 versus 0.97%; relative risk = 2.27, 95% CI 1.13-4.58).
Women with singleton pregnancies and low total omega-3 PUFA status early in pregnancy have an increased risk of early preterm birth and are most likely to benefit from omega-3 supplementation to reduce this risk. Women with higher total omega-3 status are at lower risk and additional omega-3 supplementation may increase their risk.
Low total omega-3 fat status helps identify which women benefit from extra omega-3 to reduce early prematurity.
确定一种多不饱和脂肪酸（PUFA）生物标志物，以检测哪些单胎妊娠的女性最有可能受益于ω-3 补充剂来降低其早产风险。
随机对照试验的探索性分析。
澳大利亚的六家医院。
参加 ORIP 试验的单胎妊娠妇女。
使用妊娠 14 周左右采集的母体毛细血管全血，用气相色谱法定量测定总血脂质中的脂肪酸。交互检验检查了基础 PUFA 状态是否改变了 ω-3 补充剂对出生结局的影响。
早产（<34 周妊娠）。
妊娠早期总 ω-3 PUFA 状态较低与早产风险较高相关。在总 ω-3 状态≤4.1%总脂肪酸的女性中，与对照组相比，ω-3 补充剂显著降低了早产风险（0.73 比 3.16%；相对风险 0.23，95%置信区间 [CI] 0.07-0.79）。相反，妊娠早期总 ω-3 状态较高的女性早产风险较低。在基线状态高于 4.9%的女性中补充 ω-3 增加了早产（2.20 比 0.97%；相对风险 2.27，95%CI 1.13-4.58）。
妊娠早期总 ω-3 PUFA 状态较低的单胎妊娠妇女早产风险增加，最有可能受益于 ω-3 补充剂来降低这种风险。总 ω-3 状态较高的女性风险较低，额外补充 ω-3 可能会增加其风险。
总 ω-3 脂肪状态低有助于确定哪些女性受益于额外的 ω-3 来降低早产。
