ISSFAL声明7号- Omega-3脂肪酸在怀孕期间减少早产

K P Best , R A Gibson , M Makrides
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引用次数: 10

摘要

在全球范围内,早产是5岁以下儿童死亡的主要原因,幸存者可能遭受终身后果。经过多年的调查,有强有力的证据表明,在怀孕期间增加母亲饮食中的omega-3长链多不饱和脂肪酸(LCPUFA)摄入量可以预防一部分早产。本声明提供了关于omega-3 LCPUFA在预防早产中的作用的现代证据的综合,旨在为医生、助产士、卫生服务机构、专业机构和政策制定者提供脂肪酸特异性知识和指导,以考虑他们的背景情况。支持这一观点的证据综合是基于2018年Cochrane系统综述,以及自那时以来完成的随机对照试验和其他系统综述的补充证据。研究之间的异质性是为了了解补充omega-3的效果在不同的人群中以及补充omega-3的剂量和类型是如何变化的。大多数试验是在中高收入或高收入国家进行的,证据最适用于这些情况。证据合成证实,omega-3 LCPUFA,特别是二十二碳六烯酸(DHA)和二十碳五烯酸(EPA),在单胎妊娠中起重要作用。妊娠早期摄入足够的omega-3 LCPUFA,符合现有的营养指南,与单胎妊娠妇女早产和早期早产的风险降低有关。因此,在怀孕早期摄入足量omega-3的女性应该保持这些摄入量。omega-3脂肪酸含量低的妇女将从omega-3 LCPUFA补充剂中获益最多,以降低早产的风险。在这种情况下,总共补充约1000毫克DHA加EPA可有效降低早产风险,最好在妊娠20周之前开始补充。
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ISSFAL statement number 7 – Omega-3 fatty acids during pregnancy to reduce preterm birth

Globally, preterm birth is the leading cause of death in children under the age of 5 years and survivors may suffer life-long consequences. Following many years of investigation, there is strong evidence that a proportion of preterm births can be prevented by increasing maternal dietary omega-3 long chain polyunsaturated fatty acid (LCPUFA) intake during pregnancy. This Statement provides a synthesis of contemporary evidence on the role of omega-3 LCPUFA on prevention of preterm birth and is designed to provide fatty acid-specific knowledge and guidance for medical practitioners, midwives, health services, professional bodies and policy makers to consider for their contextual situations. The evidence synthesis, which underpins this statement, is based on the 2018 Cochrane systematic review with supplemental evidence from RCTs completed since that time as well as other systematic reviews. Heterogeneity between studies was explored to understand how the effect of omega-3 supplementation may vary in different population groups and by dose and type of omega-3 supplementation. Most trials were conducted in upper-middle or high-income countries and the evidence are most applicable in those settings. The evidence synthesis confirmed that omega-3 LCPUFA, particularly docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), have an important role to play in determining gestational length in singleton pregnancies. Adequate intake of omega-3 LCPUFA in early pregnancy, consistent with existing nutritional guidelines, is associated with a lower risk of preterm and early preterm births for women with singleton pregnancies. Therefore, women with adequate omega-3 intakes in early pregnancy should maintain these intakes. Women who are low in omega-3 fatty acids will benefit most from omega-3 LCPUFA supplementation to reduce their risk of early birth. In such cases supplementation with a total of about 1000 mg of DHA plus EPA is effective at reducing risk of early birth, preferably with supplementation commencing before 20 weeks’ gestation.

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来源期刊
Prostaglandins, leukotrienes, and essential fatty acids
Prostaglandins, leukotrienes, and essential fatty acids Clinical Biochemistry, Endocrinology, Diabetes and Metabolism
CiteScore
5.30
自引率
0.00%
发文量
0
审稿时长
64 days
期刊最新文献
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