孕期和产后超重和肥胖母亲补充鱼油以改善婴儿期身体成分和代谢健康：一项双盲随机对照试验。

Fish oil supplementation during pregnancy and postpartum in mothers with overweight and obesity to improve body composition and metabolic health during infancy: A double-blind randomized controlled trial.

机构信息

Liggins Institute, University of Auckland, Auckland, New Zealand.

Liggins Institute, University of Auckland, Auckland, New Zealand; Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Environmental - Occupational Health Sciences and Non-Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand.

出版信息

Am J Clin Nutr. 2023 May;117(5):883-895. doi: 10.1016/j.ajcnut.2023.02.007. Epub 2023 Feb 11.

DOI:10.1016/j.ajcnut.2023.02.007

PMID:36781129

Abstract

BACKGROUND

Maternal obesity during pregnancy is associated with an increased risk of obesity and metabolic disease in the offspring. Supplementation with fish oil (FO), which is insulin sensitizing, during pregnancy in mothers with overweight or obesity may prevent the development of greater adiposity and metabolic dysfunction in their children.

OBJECTIVES

To determine the effects of FO supplementation throughout the second half of pregnancy and lactation in mothers with overweight or obesity on infant body composition and metabolism.

METHODS

A double-blind randomized controlled trial of 6 g FO (3.55 g/d of n-3 PUFAs) compared with olive oil (control) from mid-pregnancy until 3 mo postpartum. Eligible women had singleton pregnancies at 12-20 wk of gestation, and BMI ≥ 25 kg/m. The primary outcome was the infant body fat percentage (DXA scans) at 2 wk of age. Secondary outcomes included maternal metabolic markers during pregnancy, infant anthropometry at 2 wk and 3 mo of age, and metabolic markers at 3 mo.

RESULTS

A total of 129 mothers were randomized, and 98 infants had a DXA scan at 2 wk.

PRIMARY OUTCOME

Imputed and nonimputed analyses showed no effects of FO supplementation on infant body fat percentage at age 2 wk.

SECONDARY OUTCOMES

There were no treatment effects on infant outcomes at 2 wk, but FO infants had a higher BMI z-score (P = 0.025) and ponderal index (P = 0.017) at age 3 mo. FO supplementation lowered maternal triglycerides by 17% at 30 wk of pregnancy (P = 0.0002) and infant triglycerides by 21% at 3 mo of age (P = 0.016) but did not affect maternal or infant insulin resistance. The rate of emergency cesarean section was lower with FO supplementation [aRR = 0.38 (95%CI 0.16, 0.90); P = 0.027].

CONCLUSIONS

FO supplementation of mothers with overweight or obesity during pregnancy did not impact infant body composition. There is a need to follow up the offspring to determine whether the observed metabolic effects persist.

CLINICAL TRIAL REGISTRY NUMBER

This study was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12617001078347p). In addition, the Universal Trial Number, WHO, was obtained (U1111-1199-5860).

摘要

背景

母亲孕期肥胖与后代肥胖和代谢疾病风险增加有关。在超重或肥胖的母亲怀孕期间补充鱼油（FO）可增加胰岛素敏感性，这可能预防其子女出现更大的肥胖和代谢功能障碍。

目的

确定在超重或肥胖的母亲妊娠后半期和哺乳期补充 FO（3.55 g/d 的 n-3 PUFAs）对婴儿身体成分和代谢的影响。

方法

这是一项双盲随机对照试验，比较了 FO（6 g，每天 3.55 g 的 n-3 多不饱和脂肪酸）与橄榄油（对照）对 12-20 孕周、BMI≥25 kg/m²的单胎妊娠母亲的影响。主要结局为婴儿出生后 2 周时的体脂肪百分比（DXA 扫描）。次要结局包括妊娠期间的母体代谢标志物、婴儿出生后 2 周和 3 个月的体格测量以及 3 个月时的代谢标志物。

结果

共有 129 名母亲被随机分组，98 名婴儿在出生后 2 周进行了 DXA 扫描。

主要结局

插补和非插补分析均显示 FO 补充对婴儿 2 周时的体脂肪百分比没有影响。

次要结局

在 2 周时，婴儿的结局没有治疗效果，但 FO 组婴儿的 BMI 标准差评分（P=0.025）和体脂指数（P=0.017）在 3 个月时更高。FO 补充在妊娠 30 周时降低了母亲的甘油三酯 17%（P=0.0002），在婴儿 3 个月时降低了 21%（P=0.016），但没有影响母亲或婴儿的胰岛素抵抗。FO 补充组的紧急剖宫产率较低[aRR=0.38（95%CI 0.16, 0.90）；P=0.027]。