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Malnutrition in Pregnancy

MIP: Omega-3

Intervention
In pregnant women, what are the effects of maternal diet or dietary supplements of long-chain omega-3 fatty acids on maternal serum or plasma eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and whole blood polyunsaturated fatty acids (PUFA)?
- Conclusion
  The evidence reviewed supports an association between pregnancy diet and maternal erythrocyte concentrations for DHA plus EPA (two studies) and that maternal diet or dietary supplements of long-chain omega-3 fatty acids (ranging from a daily dose of 150mg EPA plus 500mg DHA plus multi-nutrient supplement to 1,100mg EPA plus 2,200 DHA or salmon – two portions per week) during pregnancy in women with mixed health history increased maternal serum/plasma EPA, DHA and whole blood PUFA (six studies).
- Grade: II
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: In pregnant women, what are the effects of maternal diet or dietary supplements of long-chain omega-3 fatty acids on maternal serum or plasma eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and whole blood polyunsaturated fatty acids (PUFA)?
- Search Plan and Results: MIP: Omega-3 (2014)
In pregnant women, what are the effects of maternal diet or dietary supplements of long-chain omega-3 fatty acids on breastmilk fatty acids, eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA)?
- Conclusion
  The evidence reviewed supports an association between maternal EPA and DHA intakes in third trimester and EPA and DHA content in mature breastmilk (one study) and that maternal dietary supplements of long-chain omega-3 fatty acids (a daily dose of 1,100mg EPA plus 2,200mg) during pregnancy in women with a history of allergic rhinitis or asthma were associated with higher breastmilk EPA and DHA content at less than six months postpartum (one study).
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: In pregnant women, what are the effects of maternal diet or dietary supplements of long-chain omega-3 fatty acids on breastmilk fatty acids, eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA)?
- Search Plan and Results: MIP: Omega-3 (2014)
In pregnant women, what are the effects of maternal diet or dietary supplements of long-chain omega-3 fatty acids on maternal weight, weight gain or BMI?
- Conclusion
  The evidence reviewed did not support a role for dietary supplements of long-chain omega-3 fatty acids (ranging from a daily dose of 150mg EPA plus 500mg DHA plus multi-nutrient supplement to 1,100mg EPA plus 2,200mg DHA) during pregnancy in women with mixed health history on maternal weight at 36 weeks gestation and at delivery (two studies). However, one study reported higher second trimester median weight gain in those with no fish intake than those with fish intake above median.
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: In pregnant women, what are the effects of maternal diet or dietary supplements of long-chain omega-3 fatty acids on maternal weight, weight gain or BMI?
- Search Plan and Results: MIP: Omega-3 (2014)
In pregnant women, what are the effects of maternal diet or dietary supplements of long-chain omega-3 fatty acids on maternal depression?
- Conclusion
  The evidence reviewed does not support a role for maternal dietary supplements of long-chain omega-3 fatty acids (ranging from a daily dose of 150mg EPA plus 500mg DHA to 1,060mg EPA plus 274mg DHA and 180mg EPA plus 900mg DHA) during pregnancy in women with mixed health history on maternal depression both during pregnancy and postpartum (two studies).
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: In pregnant women, what are the effects of maternal diet or dietary supplements of long-chain omega-3 fatty acids on maternal depression?
- Search Plan and Results: MIP: Omega-3 (2014)
In pregnant women, what are the effects of maternal diet or dietary supplements of long-chain omega-3 fatty acids on Caesarean section?
- Conclusion
  The evidence reviewed does not support a role for maternal diet or dietary supplements of long-chain omega-3 fatty acids (ranging from a daily dose of 1,060mg EPA plus 274mg DHA or 900mg DHA plus 180mg EPA to 1,100mg EPA plus 2,200 DHA or salmon – two portions per week) during pregnancy in women with mixed health history on maternal Caesarean section (four studies).
- Grade: II
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: In pregnant women, what are the effects of maternal diet or dietary supplements of long-chain omega-3 fatty acids on pregnancy complications (e.g., C-section, mortality, miscarriage, pre-eclampsia)?
- Search Plan and Results: MIP: Omega-3 (2014)
In pregnant women, what are the effects of maternal diet or dietary supplements of long-chain omega-3 fatty acids on gestational hypertension/pre-eclampsia?
- Conclusion
  The evidence reviewed for a role for dietary supplements of long-chain omega-3 fatty acids (1,060mg EPA plus 274mg DHA; 900mg DHA plus 180mg EPA) during pregnancy in women with a history of depression on gestational hypertension or pre-eclampsia was inconsistent. One study did not observe a significant effect, while one study reported a positive and independent association between higher N-3 and N-6 fatty acids intakes and risk for pre-eclampsia.
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: In pregnant women, what are the effects of maternal diet or dietary supplements of long-chain omega-3 fatty acids on gestational hypertension or pre-eclampsia?
- Search Plan and Results: MIP: Omega-3 (2014)
In pregnant women, what are the effects of maternal diet or dietary supplements of long-chain omega-3 fatty acids on infant serum, plasma omega-3, eicosapentaenoic acid (EPA) aor docosahexaenoic acid (DHA)?
- Conclusion
  The evidence reviewed supports an association between maternal diet during pregnancy and cord blood EPA and DHA levels (two studies); and that maternal diet or dietary supplements of long-chain omega-3 fatty acids (ranging from a daily dose of 150mg EPA plus 500mg DHA to 1,100mg EPA plus 2,200mg DHA or salmon – two portions per week) during pregnancy, in women with mixed health history, increases cord blood EPA and DHA levels (four studies).
- Grade: II
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: In pregnant women, what are the effects of maternal diet or dietary supplements of long-chain omega-3 fatty acids on infant serum/plasma omega-3/eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA)?
- Search Plan and Results: MIP: Omega-3 (2014)
In pregnant women, what are the effects of maternal diet or dietary supplements of long-chain omega-3 fatty acids on pre-term birth or gestational age?
- Conclusion
  The evidence reviewed did not support a role for maternal dietary supplements of long-chain omega-3 fatty acids (ranging from a daily dose of 150mg EPA plus 500mg DHA to 1,100mg EPA plus 2,200 DHA) during pregnancy in women with mixed health history on pre-term birth or gestational age (three out of four studies). However, one study reported that women with moderate fish intake (up to three meals per week) before 22 weeks gestation had lower pre-term birth.
- Grade: II
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: In pregnant women, what are the effects of maternal diet or dietary supplements of long-chain omega-3 fatty acids on pre-term births?
- Search Plan and Results: MIP: Omega-3 (2014)
In pregnant women, what are the effects of maternal diet or dietary supplements of long-chain omega-3 fatty acids on infant anthropometrics (e.g., birth weight, length and head circumference)?
- Conclusion
  The evidence reviewed on the effects of maternal diet or dietary supplements of long-chain omega-3 fatty acids (ranging from a daily dose of 150mg EPA plus 500mg DHA plus multi-nutrient supplement to 1,100mg EPA plus 2,200 DHA or salmon – twp portions per week) during pregnancy in women with mixed health history on birth weight (and weight at 20 weeks of gestation) was inconsistent. Four studies did not observe any significant effects, while three studies did.
  
  The evidence reviewed did not support a role for maternal diet or dietary supplements of long-chain omega-3 fatty acids on birth length (except for femur length at 20 weeks gestation; four studies) and head circumference at birth and at 20 weeks gestation (five studies).
- Grade: II
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: In pregnant women, what are the effects of maternal diet or dietary supplements of long-chain omega-3 fatty acids on infant anthropometrics (e.g., birth weight, length and head circumference)?
- Search Plan and Results: MIP: Omega-3 (2014)
In pregnant women, what are the effects of maternal diet or dietary supplements of long-chain omega-3 fatty acids on infant APGAR score?
- Conclusion
  The evidence reviewed does not support a role for maternal dietary supplements of long-chain omega-3 fatty acids (ranging from a daily dose of 1,060mg EPA plus 274mg DHA or 900mg DHA plus 180mg EPA to 1,100mg EPA plus 2,200 DHA or salmon – two portions per week) during pregnancy in women with mixed health history on infant APGAR score (three studies). However, one study observed significant differences between APGAR scores for DHA-rich, EPA-rich and placebo groups.
- Grade: II
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: In pregnant women, what are the effects of maternal diet or dietary supplements of long-chain omega-3 fatty acids on infant APGAR score?
- Search Plan and Results: MIP: Omega-3 (2014)
In pregnant women, what are the effects of maternal diet or dietary supplements of long-chain omega-3 fatty acids on infant allergies?
- Conclusion
  The evidence reviewed did not support a role for maternal intake of omega-3 fatty acids on atopic eczema at six months (one study).
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: In pregnant women, what are the effects of maternal diet or dietary supplements of long-chain omega-3 fatty acids on infant allergies?
- Search Plan and Results: MIP: Omega-3 (2014)
In pregnant women, what are the effects of maternal diet or dietary supplements of long-chain omega-3 fatty acids on infant neurodevelopment?
- Conclusion
  The evidence reviewed did not observe a significant association between maternal dietary DHA intake and infant short latency brainstem auditory-evoked potentials (one study).
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: In pregnant women, what are the effects of maternal diet or dietary supplements of long-chain omega-3 fatty acids on infant neurodevelopment, learning or vision?
  - Detail
  - Quality Rating Summary
    For a summary of the Quality Rating results, click here.
  - Worksheets
    
    Parra-Cabrera S, Moreno-Macias H, Mendez-Ramirez I, Schnaas L, Romieu I. Maternal dietary omega fatty acid intake and auditory brainstem-evoked potentials in Mexican infants born at term: Cluster analysis. Early human development 2008; 84:51-7
- Search Plan and Results: MIP: Omega-3 (2014)