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Docosahexaenoic Acid (DHA) Intake Estimated from a 7-Question Survey Identifies Pregnancies Most Likely to Benefit from High-Dose DHA Supplementation

CLINICAL NUTRITION ESPEN(2023)

Univ Kansas | Univ Arizona | Univ Cincinnati

Cited 3|Views16
Abstract
Background: Two randomized trials found women with low blood docosahexaenoic acid (DHA; an omega 3 fatty acid) had fewer early preterm births (<34 weeks gestation) if they were assigned to high dose DHA supplementation, however, there is currently no capacity for clinicians who care for preg-nancies to obtain a blood assessment of DHA. Determining a way to identify women with low DHA intake whose risk could be lowered by high dose DHA supplementation is desired. Objective: To determine if assessing DHA intake can identify pregnancies that benefit from high dose DHA supplementation. Study design: This secondary analysis used birth data from 1310 pregnant women who completed a 7 -question food frequency questionnaire (DHA-FFQ) at 16.8 ?? 2.5 weeks gestation that is validated to assess DHA status. They were then randomly assigned to a standard (200 mg/day) or high dose (800 or 1000 mg/day) DHA supplement for the remainder of pregnancy. Bayesian logistic regressions were fitted for early preterm birth and preterm birth as a function of DHA intake and assigned DHA dose. Results: Participants who consumed less than 150 mg/day DHA prior to 20 weeks??? gestation (n = 810/ 1310, 58.1%) had a lower Bayesian posterior probability (pp) of early preterm birth if they were assigned to high dose DHA supplementation (1.4% vs 3.9%, pp = 0.99). The effect on preterm birth (<37 weeks) was also significant (11.3% vs 14.8%, pp = 0.97). Conclusion: The DHA-FFQ can identify pregnancies that will benefit most from high dose DHA supple-mentation and reduce the risk of preterm birth. The DHA-FFQ is low burden to providers and patients and could be easily implemented in obstetrical practice. ?? 2022 The Author(s). Published by Elsevier Ltd on behalf of European Society for Clinical Nutrition and Metabolism. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).
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Key words
Docosahexaenoic acid,Diet,Prenatal supplements,Pregnancy,Preterm birth
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要点】:研究通过7问题食物频率问卷评估DHA摄入量,发现低摄入量孕妇可通过高剂量DHA补充降低早产风险,创新点在于提出了一种无需血液检测即可识别可能从高剂量DHA补充中受益的孕妇的方法。

方法】:使用经过验证的7问题食物频率问卷(DHA-FFQ)在孕16.8±2.5周时评估孕妇的DHA摄入量,并通过贝叶斯逻辑回归分析DHA摄入量与早产之间的关系。

实验】:研究对1310名孕妇进行了二次分析,这些孕妇完成了DHA-FFQ问卷,并随机分配接受标准剂量(200 mg/天)或高剂量(800或1000 mg/天)的DHA补充。结果显示,孕20周前DHA摄入量低于150 mg/天的孕妇,若接受高剂量DHA补充,早产风险显著降低。