BMJ Open · 10 authors, 9 centres
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In exploratory analyses of the ORIP randomised trial of 5328 singleton pregnancies, omega-3 supplementation (900 mg/day) reduced early preterm birth risk in women with low total omega-3 status and reduced preterm birth risk in multiparous women and women who avoided alcohol pre-pregnancy.
This study conducted exploratory subgroup analyses of the ORIP multicentre, double-blind randomised controlled trial, which enrolled 5328 singleton pregnancies at six Australian tertiary care centres. Women received approximately 900 mg/day omega-3 long-chain polyunsaturated fatty acids (800 mg DHA and 100 mg EPA) or vegetable oil control capsules from enrolment until 34 weeks' gestation. Logistic regression models with interaction terms were used to test whether maternal characteristics modified the treatment effect on early preterm birth and preterm birth. The incidence of early preterm birth was 1.7% and preterm birth was 7.1%. Omega-3 supplementation reduced the odds of early preterm birth in women with low total omega-3 status (OR=0.30, 95% CI 0.10–0.93). For preterm birth, multiparous women (OR=0.65, 95% CI 0.49–0.87) and women who avoided alcohol in the lead-up to pregnancy (OR=0.62, 95% CI 0.45–0.86) were more likely to benefit. No other maternal characteristics predicted treatment benefit. Main limitations include the exploratory nature of the analyses with many comparisons, and relatively few outcome events restricting ability to examine multiple characteristics in combination.
