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Response

We thank Dr Schwalfenberg for his interest in Motherisk Update. Our recent review regarding -3 fatty acids during pregnancy¹ begins with a clinical question, as is customary with Motherisk Updates. The question was about whether -3 supplementation should be recommended to pregnant women and not whether it affects the human brain, photoreceptors, and cell functions in general. Therefore, the focus of the review was to look at the available interventional trials of -3 supplementation during pregnancy, which sometimes contradict what was previously believed based on observational studies.

Our review delineates the possible areas of benefit, but concludes, "Until evidence accumulates, no recommendation should be made to encourage pregnant women to take -3 fatty acid supplements." A similar conclusion was drawn in another recent, similar paper.² A meta-analysis of the highest-quality randomized control trials on -3 supplementation during pregnancy (published after the submission of our review and hence not included) concluded that -3 supplementation did not influence the rates of preterm deliveries, preeclampsia, eclampsia, or infants with low birth weights.³ There was also no influence on birth weight. Adding these findings to our discussion strengthens our conclusion that there is no clear benefit of -3 fatty acid supplementation to maternal or infant health.

To the specific points raised by Dr Schwalfenberg: reference 10 is used in the article for both observational and interventional trials because it is a review article describing both. The second point concerns the prevalence of preeclampsia in the paper by Smuts et al⁴; it is a matter of basic statistical analysis. The "50% risk reduction" in prevalence between groups is not statistically significant, with ² analysis yielding P=.3. Finally, the relevant sources of funding to the authors and the Motherisk program and potential conflicts of interest were fully disclosed in the article. These are routinely found at the end of the article in the Motherisk box.

	References

TOP References

 

1. Dubnov-Raz G, Finkelstein Y, Koren G. -3 fatty acid supplementation during pregnancy. For mother, baby, or neither? Can Fam Physician 2007;53:817-8.[Abstract/Free Full Text]
2. Eilander A, Hundscheid DC, Osendarp SJ, Transler C, Zock PL. Effects of n-3 long chain polyunsaturated fatty acid supplementation on visual and cognitive development throughout childhood: a review of human studies. Prostaglandins Leukot Essent Fatty Acids 2007;76:189-203.[Medline]
3. Szajewska H, Horvath A, Koletzko B. Effect of n-3 long-chain polyunsaturated fatty acid supplementation of women with low-risk pregnancies on pregnancy outcomes and growth measures at birth: a meta-analysis of randomized controlled trials. Am J Clin Nutr 2006;83:1337-44.[Abstract/Free Full Text]
4. Smuts CM, Huang M, Mundy D, Plasse T, Major S, Carlson SE. A randomized trial of docosahexaenoic acid supplementation during the third trimester of pregnancy. Obstet Gynecol 2003;101:469-79.[Medline]

This Article Full Text (PDF) Rapid Responses: Submit a response Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Dubnov-Raz, G. Articles by Koren, G. Search for Related Content PubMed Articles by Dubnov-Raz, G. Articles by Koren, G.