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孕期补充二十二碳六烯酸(DHA)可降低先兆早产时的早产风险。多中心随机对照试验。

Docosahexaenoic acid (DHA) Supplementation During Pregnancy Reduces the Risk of Preterm Birth in Threatened Preterm Labor. The Multicenter Randomized Controlled Trial.

作者信息

Phattharachindanuwong Wiphawi, Chaiyarach Sukanya, Komwilaisak Ratana, Saksiriwuttho Piyamas, Duangkum Chatuporn, Kongwattanakul Kiattisak, Kleebkaow Pilaiwan, Waidee Termtem, Pongsamakthai Manasicha, Chantanavilai Sathida, Srisataporn Tunyatorn

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

Department of Obstetrics and Gynecology, Khon Kaen Hospital, Khon Kaen, Thailand.

出版信息

Int J Womens Health. 2025 Mar 30;17:937-945. doi: 10.2147/IJWH.S518312. eCollection 2025.

Abstract

BACKGROUND

Threatened preterm labor is a common reason for hospital admission, and DHA supplementation may lower the risk of preterm labor.

OBJECTIVE

To compare the rates of premature birth between individuals with threatened preterm labor who received DHA and those who did not.

METHODS

In this multi-center randomized controlled trial, the sample size was calculated to be 60 participants. Pregnant individuals who experienced threatened preterm labor at 24 to 34 weeks gestation were given either 1000 milligrams of DHA daily or no DHA supplement. The criteria for inclusion consisted of singleton pregnancies that had been diagnosed with threatened preterm labor, with no cervical change present. DHA supplementation was initiated when threatened preterm labor was diagnosed and continued until 37 weeks of gestation or until delivery, whichever occurred first. The main outcome was to compare the rates of premature births between the two groups. Moreover, we intended to evaluate the side effects of the DHA supplement along with the outcomes for neonates.

RESULTS

Sixty-one pregnant individuals were enrolled and randomly assigned to two groups. Group 1 consisted of 30 participants, each receiving a daily intake of 1,000 milligrams of DHA supplement. Group 2, comprising 31 individuals, did not receive any supplemental DHA. The rate of preterm birth was 23.33% (7/30) and 25.81% (8/31) for the participant group receiving DHA and not receiving DHA, respectively, with a p-value of 0.82. The rate of low-birth-weight neonates was 13.33% (4/30) and 19.35% (6/31) for the participant group receiving DHA and not receiving DHA, respectively, with a p-value of 0.73. The overall results did not show any statistically significant differences. In addition, the rates of cesarean sections, peripartum infections, early postpartum hemorrhage, and NICU admissions did not show significant differences between the two groups.

CONCLUSION

Taking DHA supplements after a diagnosis of threatened preterm pregnancy does not decrease the actual rates of early or late preterm births. To reduce the risk of premature birth, DHA should be taken from the beginning of pregnancy, with a recommendation to start in the first trimester. This should ideally start in the second trimester, no later than around 20 weeks of gestation, and should continue until childbirth or approximately 37 weeks of gestation.

CLINICAL TRIAL REGISTRATION

https://register.clinicaltrials.gov/.

CLINICAL TRIALS

gov; ID: NCT06302023.

摘要

背景

先兆早产是住院的常见原因,补充二十二碳六烯酸(DHA)可能会降低早产风险。

目的

比较接受DHA治疗和未接受DHA治疗的先兆早产个体的早产率。

方法

在这项多中心随机对照试验中,计算得出样本量为60名参与者。妊娠24至34周出现先兆早产的孕妇,每天给予1000毫克DHA或不补充DHA。纳入标准包括已诊断为先兆早产的单胎妊娠,且宫颈无变化。确诊先兆早产时开始补充DHA,并持续至妊娠37周或分娩,以先发生者为准。主要结果是比较两组的早产率。此外,我们还打算评估DHA补充剂的副作用以及新生儿的结局。

结果

61名孕妇入组并随机分为两组。第1组有30名参与者,每人每天摄入1000毫克DHA补充剂。第2组有31人,未接受任何DHA补充。接受DHA和未接受DHA的参与者组的早产率分别为23.33%(7/30)和25.81%(8/31),p值为0.82。接受DHA和未接受DHA的参与者组的低体重新生儿率分别为13.33%(4/30)和19.35%(6/31),p值为0.73。总体结果未显示出任何统计学上的显著差异。此外,两组之间的剖宫产率、围产期感染率、产后早期出血率和新生儿重症监护病房(NICU)收治率均未显示出显著差异。

结论

诊断为先兆早产妊娠后服用DHA补充剂并不能降低早期或晚期早产的实际发生率。为降低早产风险,应从妊娠开始就服用DHA,建议在孕早期开始,理想情况下应在孕中期开始,不晚于妊娠约20周,并应持续至分娩或妊娠约37周。

临床试验注册

https://register.clinicaltrials.gov/。

临床试验

gov;标识符:NCT06302023。

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