DHA, nutrient intake, and maternal characteristics as predictors of pregnancy outcomes in a randomised clinical trial of DHA supplementation
To investigate the relationships among docosahexaenoic acid (DHA) intake, nutrient intake, and maternal characteristics on pregnancy outcomes in a phase III randomised clinical trial designed to determine the effect of a DHA dose of 1000 mg/day compared to 200 mg/day on early preterm birth (
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| Veröffentlicht in: | Clinical nutrition (Edinburgh, Scotland) Scotland), 2023-11, Vol.42 (11), p.2229-2240 |
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| container_title | Clinical nutrition (Edinburgh, Scotland) |
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| creator | Wang, Yu Gajewski, Byron J. Valentine, Christina J. Crawford, Sarah A. Brown, Alexandra R. Mudaranthakam, Dinesh Pal Camargo, Juliana Teruel Carlson, Susan E. |
| description | To investigate the relationships among docosahexaenoic acid (DHA) intake, nutrient intake, and maternal characteristics on pregnancy outcomes in a phase III randomised clinical trial designed to determine the effect of a DHA dose of 1000 mg/day compared to 200 mg/day on early preterm birth ( |
| doi_str_mv | 10.1016/j.clnu.2023.09.005 |
| format | Article |
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A secondary aim of the phase III randomised trial was to explore the relationships among pregnancy outcomes (maternal red blood cell phospholipid (RBC-PL) DHA at delivery, preterm birth, gestational age at delivery, labor type, birth anthropometric measures, low birth weight, gestational diabetes, pre-eclampsia, and admission to a neonatal intensive care unit) in participants (n = 1100). We used Bayesian multiple imputation and linear and logistic regression models to conduct an analysis of five general classes of predictor variables collected during the trial: a) DHA intake, b) nutrient intake from food and supplements, c) environmental exposure to tobacco and alcohol, d) maternal demographics, and e) maternal medical history.
DHA supplementation lowered the risk of preterm birth and NICU admission, and increased gestation and birth weight as observed in the primary analysis. Higher maternal RBC-PL-DHA at delivery was associated with DHA supplementation and formal education of a bachelor's degree or higher. DHA supplementation and maternal age were associated with a higher risk of gestational diabetes. Total vitamin A intake was associated with longer gestation, while fructose and intake of the long chain omega-6 fatty acid, arachidonic acid, were associated with shorter gestation. Risk of preterm birth was associated with a history of low birth weight, preterm birth, pre-eclampsia, and NICU admission.
Bayesian models provide a comprehensive approach to relationships among DHA intake, nutrient intake, maternal characteristics, and pregnancy outcomes. We observed previously unreported relationships between gestation duration and fructose, vitamin A, and arachidonic acid that could be the basis for future research.
ClinicalTrials.gov (NCT02626299); December 10, 2015.</description><identifier>ISSN: 0261-5614</identifier><identifier>ISSN: 1532-1983</identifier><identifier>EISSN: 1532-1983</identifier><identifier>DOI: 10.1016/j.clnu.2023.09.005</identifier><identifier>PMID: 37806075</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Arachidonic Acid ; Bayes Theorem ; DHA ; Diabetes, Gestational - prevention & control ; Dietary Supplements ; Docosahexaenoic Acids ; Eating ; Female ; Fructose ; Humans ; Infant, Newborn ; Pre-Eclampsia ; Pregnancy ; Pregnancy Outcome ; Premature Birth ; Preterm birth ; Vitamin A</subject><ispartof>Clinical nutrition (Edinburgh, Scotland), 2023-11, Vol.42 (11), p.2229-2240</ispartof><rights>2023</rights><rights>Copyright © 2023. Published by Elsevier Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c407t-3d3c0eefb78e1b31ca2bafe5ec33e3630025170877cb1ce0780ebe0443da0bb53</cites><orcidid>0000-0002-4868-8057 ; 0000-0001-9767-1158 ; 0000-0003-0288-7744 ; 0000-0001-7589-8247 ; 0000-0003-3579-1685</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.clnu.2023.09.005$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,315,782,786,887,3552,27931,27932,46002</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37806075$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Yu</creatorcontrib><creatorcontrib>Gajewski, Byron J.</creatorcontrib><creatorcontrib>Valentine, Christina J.</creatorcontrib><creatorcontrib>Crawford, Sarah A.</creatorcontrib><creatorcontrib>Brown, Alexandra R.</creatorcontrib><creatorcontrib>Mudaranthakam, Dinesh Pal</creatorcontrib><creatorcontrib>Camargo, Juliana Teruel</creatorcontrib><creatorcontrib>Carlson, Susan E.</creatorcontrib><title>DHA, nutrient intake, and maternal characteristics as predictors of pregnancy outcomes in a randomised clinical trial of DHA supplementation</title><title>Clinical nutrition (Edinburgh, Scotland)</title><addtitle>Clin Nutr</addtitle><description>To investigate the relationships among docosahexaenoic acid (DHA) intake, nutrient intake, and maternal characteristics on pregnancy outcomes in a phase III randomised clinical trial designed to determine the effect of a DHA dose of 1000 mg/day compared to 200 mg/day on early preterm birth (<34 weeks gestation).
A secondary aim of the phase III randomised trial was to explore the relationships among pregnancy outcomes (maternal red blood cell phospholipid (RBC-PL) DHA at delivery, preterm birth, gestational age at delivery, labor type, birth anthropometric measures, low birth weight, gestational diabetes, pre-eclampsia, and admission to a neonatal intensive care unit) in participants (n = 1100). We used Bayesian multiple imputation and linear and logistic regression models to conduct an analysis of five general classes of predictor variables collected during the trial: a) DHA intake, b) nutrient intake from food and supplements, c) environmental exposure to tobacco and alcohol, d) maternal demographics, and e) maternal medical history.
DHA supplementation lowered the risk of preterm birth and NICU admission, and increased gestation and birth weight as observed in the primary analysis. Higher maternal RBC-PL-DHA at delivery was associated with DHA supplementation and formal education of a bachelor's degree or higher. DHA supplementation and maternal age were associated with a higher risk of gestational diabetes. Total vitamin A intake was associated with longer gestation, while fructose and intake of the long chain omega-6 fatty acid, arachidonic acid, were associated with shorter gestation. Risk of preterm birth was associated with a history of low birth weight, preterm birth, pre-eclampsia, and NICU admission.
Bayesian models provide a comprehensive approach to relationships among DHA intake, nutrient intake, maternal characteristics, and pregnancy outcomes. We observed previously unreported relationships between gestation duration and fructose, vitamin A, and arachidonic acid that could be the basis for future research.
ClinicalTrials.gov (NCT02626299); December 10, 2015.</description><subject>Arachidonic Acid</subject><subject>Bayes Theorem</subject><subject>DHA</subject><subject>Diabetes, Gestational - prevention & control</subject><subject>Dietary Supplements</subject><subject>Docosahexaenoic Acids</subject><subject>Eating</subject><subject>Female</subject><subject>Fructose</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Pre-Eclampsia</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome</subject><subject>Premature Birth</subject><subject>Preterm birth</subject><subject>Vitamin A</subject><issn>0261-5614</issn><issn>1532-1983</issn><issn>1532-1983</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1u1TAQhS0EopcLL8ACecmiCeM4vxISqlpokSqxgbXlTCatL4kdbKdS34GHxtEtFd2wGWvkM9_x-DD2VkAuQNQfDjlOds0LKGQOXQ5QPWM7UckiE10rn7MdFLXIqlqUJ-xVCAdICtm0L9lJqlBDU-3Y74urs1Nu1-gN2ciNjfonnXJtBz7rSN7qieOt9hpTY0I0GLgOfPE0GIzOB-7Grbux2uI9d2tEN1NIIK65Txg3m0ADx8lYgwmWjFJNQ8mYh3VZJpqTs47G2dfsxainQG8ezj378eXz9_Or7Prb5dfzs-sMS2hiJgeJQDT2TUuilwJ10euRKkIpSdYSoKhEA23TYC-QIC1LPUFZykFD31dyzz4ducvazzRg8vd6Uos3s_b3ymmjnt5Yc6tu3J0SUHWiKcpEeP9A8O7XSiGqtCbSNGlLbg2qaJuylXXX1UlaHKXoXQiexkcfAWrLUR3UlqPaclTQqS2lPXv37wsfR_4GlwQfjwJK_3RnyKuAKUFMsXjCqAZn_sf_AzgKszI</recordid><startdate>20231101</startdate><enddate>20231101</enddate><creator>Wang, Yu</creator><creator>Gajewski, Byron J.</creator><creator>Valentine, Christina J.</creator><creator>Crawford, Sarah A.</creator><creator>Brown, Alexandra R.</creator><creator>Mudaranthakam, Dinesh Pal</creator><creator>Camargo, Juliana Teruel</creator><creator>Carlson, Susan E.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-4868-8057</orcidid><orcidid>https://orcid.org/0000-0001-9767-1158</orcidid><orcidid>https://orcid.org/0000-0003-0288-7744</orcidid><orcidid>https://orcid.org/0000-0001-7589-8247</orcidid><orcidid>https://orcid.org/0000-0003-3579-1685</orcidid></search><sort><creationdate>20231101</creationdate><title>DHA, nutrient intake, and maternal characteristics as predictors of pregnancy outcomes in a randomised clinical trial of DHA supplementation</title><author>Wang, Yu ; Gajewski, Byron J. ; Valentine, Christina J. ; Crawford, Sarah A. ; Brown, Alexandra R. ; Mudaranthakam, Dinesh Pal ; Camargo, Juliana Teruel ; Carlson, Susan E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c407t-3d3c0eefb78e1b31ca2bafe5ec33e3630025170877cb1ce0780ebe0443da0bb53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Arachidonic Acid</topic><topic>Bayes Theorem</topic><topic>DHA</topic><topic>Diabetes, Gestational - prevention & control</topic><topic>Dietary Supplements</topic><topic>Docosahexaenoic Acids</topic><topic>Eating</topic><topic>Female</topic><topic>Fructose</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Pre-Eclampsia</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome</topic><topic>Premature Birth</topic><topic>Preterm birth</topic><topic>Vitamin A</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, Yu</creatorcontrib><creatorcontrib>Gajewski, Byron J.</creatorcontrib><creatorcontrib>Valentine, Christina J.</creatorcontrib><creatorcontrib>Crawford, Sarah A.</creatorcontrib><creatorcontrib>Brown, Alexandra R.</creatorcontrib><creatorcontrib>Mudaranthakam, Dinesh Pal</creatorcontrib><creatorcontrib>Camargo, Juliana Teruel</creatorcontrib><creatorcontrib>Carlson, Susan E.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical nutrition (Edinburgh, Scotland)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Yu</au><au>Gajewski, Byron J.</au><au>Valentine, Christina J.</au><au>Crawford, Sarah A.</au><au>Brown, Alexandra R.</au><au>Mudaranthakam, Dinesh Pal</au><au>Camargo, Juliana Teruel</au><au>Carlson, Susan E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>DHA, nutrient intake, and maternal characteristics as predictors of pregnancy outcomes in a randomised clinical trial of DHA supplementation</atitle><jtitle>Clinical nutrition (Edinburgh, Scotland)</jtitle><addtitle>Clin Nutr</addtitle><date>2023-11-01</date><risdate>2023</risdate><volume>42</volume><issue>11</issue><spage>2229</spage><epage>2240</epage><pages>2229-2240</pages><issn>0261-5614</issn><issn>1532-1983</issn><eissn>1532-1983</eissn><abstract>To investigate the relationships among docosahexaenoic acid (DHA) intake, nutrient intake, and maternal characteristics on pregnancy outcomes in a phase III randomised clinical trial designed to determine the effect of a DHA dose of 1000 mg/day compared to 200 mg/day on early preterm birth (<34 weeks gestation).
A secondary aim of the phase III randomised trial was to explore the relationships among pregnancy outcomes (maternal red blood cell phospholipid (RBC-PL) DHA at delivery, preterm birth, gestational age at delivery, labor type, birth anthropometric measures, low birth weight, gestational diabetes, pre-eclampsia, and admission to a neonatal intensive care unit) in participants (n = 1100). We used Bayesian multiple imputation and linear and logistic regression models to conduct an analysis of five general classes of predictor variables collected during the trial: a) DHA intake, b) nutrient intake from food and supplements, c) environmental exposure to tobacco and alcohol, d) maternal demographics, and e) maternal medical history.
DHA supplementation lowered the risk of preterm birth and NICU admission, and increased gestation and birth weight as observed in the primary analysis. Higher maternal RBC-PL-DHA at delivery was associated with DHA supplementation and formal education of a bachelor's degree or higher. DHA supplementation and maternal age were associated with a higher risk of gestational diabetes. Total vitamin A intake was associated with longer gestation, while fructose and intake of the long chain omega-6 fatty acid, arachidonic acid, were associated with shorter gestation. Risk of preterm birth was associated with a history of low birth weight, preterm birth, pre-eclampsia, and NICU admission.
Bayesian models provide a comprehensive approach to relationships among DHA intake, nutrient intake, maternal characteristics, and pregnancy outcomes. We observed previously unreported relationships between gestation duration and fructose, vitamin A, and arachidonic acid that could be the basis for future research.
ClinicalTrials.gov (NCT02626299); December 10, 2015.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>37806075</pmid><doi>10.1016/j.clnu.2023.09.005</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-4868-8057</orcidid><orcidid>https://orcid.org/0000-0001-9767-1158</orcidid><orcidid>https://orcid.org/0000-0003-0288-7744</orcidid><orcidid>https://orcid.org/0000-0001-7589-8247</orcidid><orcidid>https://orcid.org/0000-0003-3579-1685</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0261-5614 |
| ispartof | Clinical nutrition (Edinburgh, Scotland), 2023-11, Vol.42 (11), p.2229-2240 |
| issn | 0261-5614 1532-1983 1532-1983 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10591724 |
| source | MEDLINE; Access via ScienceDirect (Elsevier) |
| subjects | Arachidonic Acid Bayes Theorem DHA Diabetes, Gestational - prevention & control Dietary Supplements Docosahexaenoic Acids Eating Female Fructose Humans Infant, Newborn Pre-Eclampsia Pregnancy Pregnancy Outcome Premature Birth Preterm birth Vitamin A |
| title | DHA, nutrient intake, and maternal characteristics as predictors of pregnancy outcomes in a randomised clinical trial of DHA supplementation |
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