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A possible preventive effect of low-dose fish oil on early delivery and pre-eclampsia: Indications from a 50-year-old controlled trial

Published online by Cambridge University Press:  09 March 2007

Sjúrður F. Olsen
Affiliation:
Institute of Social Medicine, University of Aarhus, Høegh-Guldbergsgade 8, DK-8000 Århus, Denmark
Niels J. Secher
Affiliation:
Department of Obstetrics and Gynaecology, Aarhus University Hospital, Nørebrogade 37, DK-8000 Århus, Denmark
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Abstract

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A preventive effect of dietary marine n−3 fatty acids on early delivery and toxaemia has recently been hypothesized. In only one published controlled trial fish oil has been given to pregnant women, namely in that conducted during 1938–9 in London by the People's League of Health with a dietary supplement containing vitamins, minerals, and halibut liver oil. Although it was of high quality and its findings are hitherto unexplained, neglect and misinterpretation of the trial seem to occur commonly in reviews. Of the 5644 women who were enrolled the 622 withdrawals were independent of treatment. Alternate allocation to treatment was used, producing two groups that were well balanced as to age and parity. The supplement was given from about week 20. The control group did not receive any supplement. Reductions of 20.4% (95% confidence interval 9–30%, P = 0.00083) and 31.5% (95% confidence interval 11–47%, P = 0.0047) were seen in odds of delivering before 40 weeks of gestation and pre-eclampsia respectively. No significant effects were seen on perinatal mortality, average birth weight, deliveries after 40 weeks, hypertension in the absence of oedema and proteinuria, duration of labour, sepsis or breast-feeding occurrence. Later controlled trials with vitamins or minerals given in the same amounts as in this trial have largely failed to show convincing effects as seen here. A controlled trial assessing the isolated effects of fish oil in pregnancy is warranted.

Type
Diet and Pregnancy
Copyright
Copyright © The Nutrition Society 1990

References

Ackmann, R. G. (1989). Birthweights in the Faroe Islands: possible role of isovaleric acid. Journal of Internal Medicine 255, 7375.CrossRefGoogle Scholar
Benigni, A., Gregorini, G., Frusca, T., Chiabrando, C., Ballerina, S., Valcamonica, A., Orisio, S., Piccinelli, A., Pincirolli, V., Fanelli, R., Gastaldi, A. & Remuzzi, G. (1989). Effect of low-dose aspirin on fetal and maternal generation of thromboxane by platelets in women at risk for pregnancy-induced hypertension. New England Journal of Medicine 321, 357362.CrossRefGoogle ScholarPubMed
Crawford, M. A., Doyle, W., Craft, I. L. & Laurence, B. M. (1986). A comparison of food intake during pregnancy and birthweight in high and low socioeconomic groups. Progress in Lipid Research 25, 249254.CrossRefGoogle Scholar
Davey, D. A. & MacGillivray, I. (1988). The classification and definition of the hypertensive disorders of pregnancy. American Journal of Obstetrics and Gynecology 158, 892989.CrossRefGoogle ScholarPubMed
Driss, F., Darcet, P., Delhaye, N. & Mendy, F. (1988). Effect of eicosapentaenoic acid on RBC filterability and fatty acid composition. Clinical Hemorheology 8, 679685.Google Scholar
Driss, F., Vericel, E., Lagarde, M., Dechavanne, M. & Darcet, P. (1984). Inhibition of platelet aggregation and thromboxane synthesis after intake of small amount of icosapentaenoic acid. Thrombosis Research 36, 389396.CrossRefGoogle ScholarPubMed
Dyerberg, J. & Bang, H. O. (1985). Pre-eclampsia and prostaglandins. Lancet i, 1267.CrossRefGoogle Scholar
Fisher, R. B. (1943). Dietetics of pregnancy. British Medical Journal i, 144145.CrossRefGoogle Scholar
Gibson, R. A. (1988). The effect of diets containing fish and fish oils on disease risk factors in humans. Australia and New Zealand Journal of Medicine 18, 713722.CrossRefGoogle ScholarPubMed
Green, J. (1989). Diet and the prevention of pre-eclampsia. In Effective Care in Pregnancy and Childbirth, pp. 290298 [Chalmers, I., Enkin, M. and Keirse, M. J. N. C., editors]. Oxford, New York, Toronto: Oxford University Press.Google Scholar
Hansen, H. S. & Olsen, S. F. (1988). Dietary n−3 fatty acids, prostaglandins, and prolonged gestation in humans. In Biological Membranes: Aberrations in Membrane Structure and Function, pp. 305317 [Karnovsky, M. L., Leaf, A. and Bolis, L., editors]. New York: A. R. Liss.Google Scholar
Haug, T., Ringø, E. & Pettersen, G. W. (1988). Total lipids and fatty acids composition of polar and neutral lipids in different tissues of Atlantic halibut, Hippoglossus hippoglossus (L). Sarcia 73, 163168.Google Scholar
Hemminki, E. (1982). Effects of routine haematine and vitamin administration in pregnancy. In Effectiveness and Satisfaction in Antenatal Care, pp. 114121 [Enkin, M. and Chalmers, I., editors]. London: William Heinemann Medical Books.Google Scholar
Hemminki, E. & Starfield, B. (1978). Routine administration of iron and vitamins during pregnancy: review of controlled clinical trials. British Journal of Obstetrics and Gynaecology 85, 404410.CrossRefGoogle ScholarPubMed
Kawasaki, N., Matsui, K., Ito, M., Nakamura, T., Yoshimura, T., Ushijima, H. & Maeyama, M. (1985). Effect of calcium supplementation on the vascular sensitivity to angiotensin II in pregnant women. American Journal of Obstetrics and Gynecology 153, 576582.CrossRefGoogle ScholarPubMed
Kramer, M. S. (1988). Determinants of low birth weight: methodological assessment and meta-analysis. World Health Organization Bulletin Health Organization Bull no. 65, pp. 663737. Geneva: World Health Organization.Google Scholar
Kristal, A. R. & Rush, D. (1984). Maternal nutrition and duration of gestation: a review. Clinical Obstetrics and Gynecology 27, 553561.CrossRefGoogle ScholarPubMed
Lopez-Jaramillo, P., Narvaez, M., Felix, C. & Lopez, A. (1990). Dietary calcium supplementation and prevention of pregnancy hypertension. Lancet i, 293.CrossRefGoogle Scholar
Lopez-Jaramillo, P., Narvaez, M., Weigel, R. M. & Yepez, R. (1989). Calcium supplementation reduces the risk of pregnancy-induced hypertension in an Andes population. British Journal of Obstetrics and Gynaecology 96, 648655.CrossRefGoogle Scholar
MacGillivray, I. (1981). Raised blood pressure in pregnancy: aetiology of pre-eclampsia. British Journal of Hospital Medicine August, 110114.Google Scholar
Martin, W. J. (1947). The range of blood-pressure among women who had a normal pregnancy and confinement. Journal of Obstetrics and Gynaecology of the British Empire 54, 37.CrossRefGoogle ScholarPubMed
Marya, R. K., Rathee, S. & Manrow, M. (1987). Effect of calcium and vitamin D supplementation on toxemia of pregnancy. Gynecological and Obstetrical Investigations 24, 3842.CrossRefGoogle Scholar
Nethersole, O. (1922). The People's League of Health: the Inception of the League. London: Metchim & Son.Google Scholar
Neuringer, M., Anderson, G. J. & Connor, W. E. (1988). The essentiality for n−3 fatty acids for the development and function of the retina and brain. Annual Reviews of Nutrition 8, 517541.CrossRefGoogle ScholarPubMed
Nutrition Society (1944). Nutrition in pregnancy. Proceedings of the Nutrition Society 2, 1236.Google Scholar
Olsen, S. F., Hansen, H. S., Sørensen, T. I. A., Jensen, B., Secher, N. J., Sommer, S. & Knudsen, L. B. (1986). Intake of marine fat, rich in (n−3)-polyunsaturated fatty acids, may increase birthweight by prolonging gestation. Lancet ii, 367369.CrossRefGoogle Scholar
People's League of Health (1942 a). Nutrition of expectant and nursing mothers. British Medical Journal ii, 7778.Google Scholar
People's League of Health (1942 b). Nutrition of expectant and nursing mothers. Lancet ii, 1012.Google Scholar
People's League of Health (1943). A Safe Milk Supply Memorandum: the Compulsory Pasteurisation of Milk. London: Hereford Times Ltd.Google Scholar
People's League of Health (1946). The nutrition of expectant and nursing mothers in relation to maternal and infant mortality and morbidity. Journal of Obstetrics and Gynaecology of the British Empire 53, 498509.CrossRefGoogle Scholar
Pocock, S. J. (1983). Clinical Trials: a Practical Approach. Chichester: John Wiley.Google Scholar
Räihä, C. E. (1968). Prevention of prematurity. Advances in Pediatrics 15, 137190.CrossRefGoogle ScholarPubMed
Recommended Dietary Intakes Around the World (1983). Nutrition Abstracts and Reviews in Clinical Nutrition. Series A, vol. 53, no. 11, part 1; p. 990 (data for United Kingdom (1979)).Google Scholar
Romero, R., Lockwood, C., Oyarzun, E. & Hobbins, J. C. (1988). Toxemia: new concepts in an old disease. Seminars in Perinatology 12, 302323.Google Scholar
Rowett Research Institute (1955). Family Diet and Health in Pre-war Britain: a Dietary and Clinical Survey. Report to the Carnegie United Kingdom Trust from the Rowett Research Institute. Dunfermline: Carnegie United Kingdom Trust.Google Scholar
Royal Society of Medicine (1942) Proceedings of the Royal Society of Medicine 36, 5968.CrossRefGoogle Scholar
Schiff, E., Peleg, E., Goldenberg, M., Rosenthal, T., Ruppin, E., Tamarkin, M., Barkai, G., Ben-Baruch, G., Yahal, I., Blankstein, J., Goldman, B. & Maschiach, S. (1989). The use of aspirin to prevent pregnancy-induced hypertension and lower the ratio of thromboxane A2 to prostacyclin in relatively high-risk pregnancies. New England Journal of Medicine 321, 351356.CrossRefGoogle ScholarPubMed
Secher, N. J. & Olsen, S. F. (1990). Fish oil and pre-eclampsia (commentary). British Journal of Obstetrics and Gynecology (In the Press.)CrossRefGoogle Scholar
Susser, M. (1981). Prenatal nutrition, birthweight and psychological development: an overview of experiments, quasi-experiments and natural experiments in the past decade. American Journal of Clinical Nutrition 34, 784803.CrossRefGoogle ScholarPubMed
Tenth Study Group of the Royal College of Obstetricians and Gynaecologists (1983). Nutrition in Pregnancy [Campbell, D. M. and Gillmer, D. G., editors]. London: Royal College of Obstetricians and Gynaecologists.Google ScholarPubMed
Worthington-Roberts, B. (1985). The role of nutrition in pregnancy course and outcome. Journal of Environmental Pathology, Toxicology, and Oncology 5, 180.Google ScholarPubMed