The effect of omega-3 supplementation on pregnancy outcomes by smoking status
The effect of omega-3 supplementation on pregnancy outcomes by smoking status
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DOI：
10.1016/j.ajog.2017.05.033
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发表时间：
2017-10-01
影响因子：
9.8
通讯作者：
Tita, Alan T.
中科院分区：
文献类型：
--
作者：
Kuper, Spencer G.;Abramovici, Adi R.;Tita, Alan T.
背景技术背景：怀孕期间吸烟与不良的母亲和新生儿结局有关，如早产、宫内生长受限、死产和低出生体重。由于吸烟会导致氧化应激，一些人建议使用抗氧化剂来抵消氧化应激的影响。吸烟者的血清中omega-3脂肪酸水平较低，omega-3脂肪酸是一种重要的抗氧化剂，因此，研究补充omega-3脂肪酸是否能降低吸烟者不良的母亲和新生儿结局是一个重要的研究领域。目的：研究补充omega-3脂肪酸对吸烟者和非吸烟者不良妊娠结局发生率的抗氧化作用是否不同。一项多中心随机对照试验的二次分析，该试验旨在对单胎妊娠和既往单胎自发性早产史的女性补充omega-3预防早产。受试者在22周前被随机分配到开始omega-3或安慰剂组，并一直持续到分娩。所有妇女接受17 α-羟孕酮己酸肌内注射每周开始之间的16和20周的妊娠，并持续到36周的妊娠或分娩，以先发生。主要结局为自发性早产。次要结局为早产、任何早产（自发性和指征性）、妊娠相关高血压（妊娠期高血压和先兆子痫）、新生儿复合终点（早产儿视网膜病变、脑室内出血III或IV级、动脉导管未闭、坏死性小肠结肠炎、败血症、呼吸道疾病或围产期死亡）、低出生体重（
BACKGROUND: Smoking during pregnancy is associated with adverse maternal and neonatal outcomes such as preterm delivery, intrauterine growth restriction, stillbirth, and low birth weight. Because smoking causes oxidative stress, some have suggested using antioxidants to counteract the effects of oxidative stress. Smokers have lower serum levels of omega-3 fatty acids, an important antioxidant, and thus, investigating whether omega-3 supplementation in smokers reduces adverse maternal and neonatal outcomes represents an important area of research.OBJECTIVE: To investigate whether the antioxidant effect of omega-3 fatty acid supplementation on the incidence of adverse pregnancy outcomes differs between smokers and nonsmokers.STUDY DESIGN: Secondary analysis of a multicenter randomized controlled trial of omega-3 supplementation for preterm delivery prevention in women with a singleton pregnancy and a history of a previous singleton spontaneous preterm delivery. Subjects were randomized to begin omega-3 or placebo before 22 weeks, which was continued until delivery. All women received 17 alphahydroxyprogesterone caproate intramuscularly weekly beginning between 16 and 20 weeks of gestation and continued until 36 weeks of gestation or delivery, whichever occurred first. The primary outcome was spontaneous preterm delivery. Secondary outcomes were indicated preterm delivery, any preterm delivery (spontaneous and indicated), pregnancy-associated hypertension (gestational hypertension and preeclampsia), a neonatal composite (retinopathy of prematurity, intraventricular hemorrhage grade III or IV, patent ductus arteriosus, necrotizing enterocolitis, sepsis, respiratory morbidity, or perinatal death), low birth weight (