The University of Kansas Medical Center, Department of Dietetics and Nutrition, Kansas City, KS, USA; The University of Kansas Medical Center, Hoglund Biomedical Imaging Center, Kansas City, KS, USA.
The University of Kansas Medical Center, Department of Dietetics and Nutrition, Kansas City, KS, USA.
Clin Nutr ESPEN. 2023 Feb;53:93-99. doi: 10.1016/j.clnesp.2022.12.004. Epub 2022 Dec 6.
Two randomized trials found women with low blood docosahexaenoic acid (DHA; an omega 3 fatty acid) had fewer early preterm births (<34 weeks gestation) if they were assigned to high dose DHA supplementation, however, there is currently no capacity for clinicians who care for pregnancies to obtain a blood assessment of DHA. Determining a way to identify women with low DHA intake whose risk could be lowered by high dose DHA supplementation is desired.
To determine if assessing DHA intake can identify pregnancies that benefit from high dose DHA supplementation.
This secondary analysis used birth data from 1310 pregnant women who completed a 7-question food frequency questionnaire (DHA-FFQ) at 16.8 ± 2.5 weeks gestation that is validated to assess DHA status. They were then randomly assigned to a standard (200 mg/day) or high dose (800 or 1000 mg/day) DHA supplement for the remainder of pregnancy. Bayesian logistic regressions were fitted for early preterm birth and preterm birth as a function of DHA intake and assigned DHA dose.
Participants who consumed less than 150 mg/day DHA prior to 20 weeks' gestation (n = 810/1310, 58.1%) had a lower Bayesian posterior probability (pp) of early preterm birth if they were assigned to high dose DHA supplementation (1.4% vs 3.9%, pp = 0.99). The effect on preterm birth (<37 weeks) was also significant (11.3% vs 14.8%, pp = 0.97).
The DHA-FFQ can identify pregnancies that will benefit most from high dose DHA supplementation and reduce the risk of preterm birth. The DHA-FFQ is low burden to providers and patients and could be easily implemented in obstetrical practice.
两项随机试验发现，血液二十二碳六烯酸（DHA；一种 ω-3 脂肪酸）水平较低的女性如果被分配到高剂量 DHA 补充组，那么她们的早期早产（<34 周妊娠）发生率会更低，然而，目前为妊娠提供护理的临床医生没有能力获得 DHA 的血液评估。因此，希望确定一种方法来识别 DHA 摄入水平较低的女性，这些女性的风险可以通过高剂量 DHA 补充来降低。
确定评估 DHA 摄入是否可以确定受益于高剂量 DHA 补充的妊娠。
本二次分析使用了 1310 名孕妇的分娩数据，这些孕妇在 16.8±2.5 周妊娠时完成了一份 7 题食物频率问卷（DHA-FFQ），该问卷经过验证可用于评估 DHA 状况。然后，她们被随机分配到标准（200mg/天）或高剂量（800 或 1000mg/天）DHA 补充剂，用于妊娠剩余时间。贝叶斯逻辑回归用于早期早产和早产作为 DHA 摄入和分配 DHA 剂量的函数。
在 20 周妊娠前摄入少于 150mg/天 DHA 的参与者（n=1310 中的 810 名，58.1%）如果被分配到高剂量 DHA 补充组，其早期早产的贝叶斯后验概率（pp）较低（1.4% vs 3.9%，pp=0.99）。早产（<37 周）的效果也很显著（11.3% vs 14.8%，pp=0.97）。
DHA-FFQ 可以识别最受益于高剂量 DHA 补充的妊娠，并降低早产风险。DHA-FFQ 对提供者和患者的负担较低，并且可以很容易地在产科实践中实施。
