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<strong>KCE</strong> reports vol. 6A Prenatale zorg 242 3. Fatty acids 3.a. n-3 polyunsaturated fatty acids Does routine n-3 polyunsaturated fatty acids supplementation during pregnancy improve maternal and perinatal outcomes? Outcome = atopy Study Ref Population Intervention Outcomes Results Comments Stud y type EL Barden et 135 83 Australian 4 g daily of either fish Cord & urine lowered plasma (p < There is not enough evidence to evaluate RCT 1b al, 2004 atopic oil (n = 40) or olive isoprostanes 0.0001) and urinary (p = pyridoxine supplementation during pregnancies oil (n = 43) capsules in 0.06) F2-isoprostanes. pregnancy, although the results of one trial from 20 weeks Clinical follow-up: on- suggest that it may have a beneficial effect on gestation until delivery going for atopy dental decay. 3.b. Fish oil Does routine fish oil supplementation during pregnancy improve maternal and perinatal outcomes? Outcome = Preterm birth; fetal growth retardation, pre-eclampsie Study Ref Population Intervention Outcomes Results Comments Study type EL Olsen et al, 136 19 hospitals 6 MC trials, high risk pregnancies PTL OR 0.54 (95% CI Fish oil supplementation reduced the RCT 1b 2000 in Europe randomly assigned to receive fish 0.30 to 0.98) recurrence risk of pre-term delivery, oil (Pikasol) or olive oil from but had no effect on pre-term delivery around 20 weeks (prophylactic IUGR NS in twin pregnancies trials) or 33 weeks (therapeutic trials) until delivery. PIH NS Smuts et al, 2003 137 350 pregnancy women Consumed docosahexaenoic acid 33 vs. 133 mg Gestational age and birth weigh Infant length and head circumference, preterm birth, and LBW Gestation increased by 6.0 +/- 2.3 days (P =.009) in the higher docosahexaenoic Birth weight, length, and head circumference increased, but did not reach statistical significance (P =.06- .18), RCT 1b
<strong>KCE</strong> reports vol. 6A Prenatale zorg 243 Study Ref Population Intervention Outcomes Results acid group Comments Study type 4. Multi-vitamins and micronutrients Does multi-vitamins and micronutrients supplementation during pregnancy improve maternal and perinatal outcomes? Study Ref Population Intervention Outcomes Results Comments Study Hininger et al., 2004 138 France (Lyon Grenoble) 100 apparently healthy pregnant women recruited at 14+/-2 Friis et al., 2004 139 Zimbabwe 1669 pregnancies 33% lost to follow-up 33% HIV+ Makola et al., 2003 140 Tanzania 259 pregnancies for 8 weeks Christian P et al., 2003 141 Nepal 4926 pregnant women) Daily consumption over gestation of a micronutrients supplement or placebo Birth weight Biological values Multimicronutrient vs placebo Gestational age Birth weight Micronutrient-fortified beverage containing 11 micronutrients In addition to vitamin A (1000 microg retinol equivalents), the intervention groups received either folic acid (FA; 400 microg), FA + iron (60 mg), FA + iron + Biological measures Fetal loss Neonatal mortality Increase NS Increase NS NS trend NS trend All increased NS Vit A + folic acid ( with or without EL Power type RCT 1b Insufficient power? P=0.06 RCT DB RCT DB Multivitamins less good outcome Doubleblind, cluster- RCT EL 1b 1b 1b
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