title: Effect of n-3 long chain polyunsaturated fatty acid supplementation in pregnancy on infants' allergies in first year of life: randomised controlled trial.
abstract: OBJECTIVE
  To determine whether dietary n-3 long chain polyunsaturated fatty acid (LCPUFA) supplementation of pregnant women with a fetus at high risk of allergic disease reduces immunoglobulin E associated eczema or food allergy at 1 year of age.
  
  
  METHODS
  Follow-up of infants at high hereditary risk of allergic disease in the Docosahexaenoic Acid to Optimise Mother Infant Outcome (DOMInO) randomised controlled trial.
  
  
  METHODS
  Adelaide, South Australia.
  
  
  METHODS
  706 infants at high hereditary risk of developing allergic disease whose mothers were participating in the DOMInO trial.
  
  
  METHODS
  The intervention group (n=368) was randomly allocated to receive fish oil capsules (providing 900 mg of n-3 LCPUFA daily) from 21 weeks' gestation until birth; the control group (n=338) received matched vegetable oil capsules without n-3 LCPUFA.
  
  
  METHODS
  Immunoglobulin E associated allergic disease (eczema or food allergy with sensitisation) at 1 year of age.
  
  
  RESULTS
  No differences were seen in the overall percentage of infants with immunoglobulin E associated allergic disease between the n-3 LCPUFA and control groups (32/368 (9%) v 43/338 (13%); unadjusted relative risk 0.68, 95% confidence interval 0.43 to 1.05, P=0.08; adjusted relative risk 0.70, 0.45 to 1.09, P=0.12), although the percentage of infants diagnosed as having atopic eczema (that is, eczema with associated sensitisation) was lower in the n-3 LCPUFA group (26/368 (7%) v 39/338 (12%); unadjusted relative risk 0.61, 0.38 to 0.98, P=0.04; adjusted relative risk 0.64, 0.40 to 1.02, P=0.06). Fewer infants were sensitised to egg in the n-3 LCPUFA group (34/368 (9%) v 52/338 (15%); unadjusted relative risk 0.61, 0.40 to 0.91, P=0.02; adjusted relative risk 0.62, 0.41 to 0.93, P=0.02), but no difference between groups in immunoglobulin E associated food allergy was seen.
  
  
  CONCLUSIONS
  n-3 LCPUFA supplementation in pregnancy did not reduce the overall incidence of immunoglobulin E associated allergies in the first year of life, although atopic eczema and egg sensitisation were lower. Longer term follow-up is needed to determine if supplementation has an effect on respiratory allergic diseases and aeroallergen sensitisation in childhood.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry ACTRN12610000735055 (DOMInO trial: ACTRN12605000569606).
authors.affiliation: Women's and Children's Health Research Institute, North Adelaide, South Australia, Australia.
authors.forename: D J
authors.initials: DJ
authors.lastname: Palmer
authors.forename: T
authors.initials: T
authors.lastname: Sullivan
authors.forename: M S
authors.initials: MS
authors.lastname: Gold
authors.forename: S L
authors.initials: SL
authors.lastname: Prescott
authors.forename: R
authors.initials: R
authors.lastname: Heddle
authors.forename: R A
authors.initials: RA
authors.lastname: Gibson
authors.forename: M
authors.initials: M
authors.lastname: Makrides
mesh_terms: D001315:Australia / Q000453:epidemiology; D001942:Breast Feeding; D015986:Confounding Factors, Epidemiologic; D003876:Dermatitis, Atopic / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control; D019587:Dietary Supplements; D004531:Eggs / Q000009:adverse effects; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D005260:Female; D005312:Fetal Blood / Q000378:metabolism; D005395:Fish Oils / Q000008:administration & dosage / Q000627:therapeutic use; D005512:Food Hypersensitivity / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control; D007073:Immunoglobulin E / Q000378:metabolism; D007223:Infant; D041943:Infant Formula; D057194:Intention to Treat Analysis; D008297:Male; D039382:Maternal Nutritional Physiological Phenomena; D011247:Pregnancy; D012044:Regression Analysis; D016896:Treatment Outcome
chemical_list: D015525:Fatty Acids, Omega-3; D005395:Fish Oils; D007073:Immunoglobulin E