EFFECTS OF N-3 POLYUNSATURATED FATTY ACID SUPPLEMENTATION DURING PREGNANCY ON OLIGOHYDRAMNIOS
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Abstract
In pregnant women with unexplained oligohydramnios, this randomized controlled trial aimed to evaluate the effects of n-3 polyunsaturated fatty acid (ω-3 PUFA) supplementation on uterine artery blood flow and amniotic fluid index (AFI). A total of 140 women, aged 20–35 years, with singleton pregnancies and AFI <5 cm at 28-36 weeks of gestation were randomly assigned to receive either ω-3 PUFA (1000 mg daily) or placebo for four weeks. The study was conducted at Sir Ganga Ram Hospital, Lahore. Results demonstrated that the ω-3 PUFA group showed significant improvements in AFI (P = 0.001) and uterine artery Doppler indices, including systolic/diastolic ratio (P = 0.01), resistance index (P = 0.041), and pulsatility index (P = 0.002). These findings suggest that ω-3 supplementation may enhance AFI by improving uteroplacental blood flow. However, further studies are warranted to assess neonatal outcomes and to optimize treatment strategies for unexplained oligohydramnios.
References
1. Ismail, A. M., Ramadan, M. F., Ali, M. K., Abbas, A. M., El Saman, A. M., & Makarem, M. H. (2016). A randomized controlled study of the efficacy of 4 weeks of supplementation with ω-3 polyunsaturated fatty acids in cases of unexplained oligohydramnios. Journal of Perinatology, 36(11), 944-947.
2. Amza, M., Haj Hamoud, B., Sima, R. M., Dinu, M. D., Gorecki, G. P., Popescu, M., ... & Pleș, L. (2024). Docosahexaenoic Acid (DHA) and Eicosapentaenoic Acid (EPA)—Should They Be Mandatory Supplements in Pregnancy? Biomedicines, 12(7), 1471.
3. Middleton, P., Gomersall, J. C., Gould, J. F., Shepherd, E., Olsen, S. F., & Makrides, M. (2018). Omega‐3 fatty acid addition during pregnancy. Cochrane Database of Systematic Reviews, (11).
4. Imhoff‐Kunsch, B., Briggs, V., Goldenberg, T., & Ramakrishnan, U. (2012). Effect of n‐3 long‐chain polyunsaturated fatty acid intake during pregnancy on maternal, infant, and child health outcomes: a systematic review. Paediatric and perinatal epidemiology, 26, 91-107.
5. Arita, M. (2015). Omega-3-derived lipid mediators in resolving inflammation. Wikipedia.
6. Keelan, J.A., et al. (2015). Effects of maternal n-3 fatty acid supplementation on placental cytokines, pro-resolving lipid mediators and their precursors.
7. Bakhsh, H.T., et al. (2022). Comparison in the Mean Amniotic Fluid Index with Omega-3 Fatty Acid Supplementation in Pregnant Women with Oligohydramnios. PJMH.
8. Kar, S., et al. (2016). Safety of omega-3 fatty acids during pregnancy. Verywell Health.
9. Dunstan, J.A., et al. (2006). Effects of n-3 polyunsaturated fatty acid supplementation in pregnancy on maternal and fetal erythrocyte fatty acid composition. European Journal of Clinical Nutrition, 58(3), pp.429-437.
10. Olsen, S.F., et al. (2000). Randomised clinical trials of fish oil supplementation in high risk pregnancies. BJOG: An International Journal of Obstetrics & Gynaecology, 107(3), pp.382-395.
11. Horvath, A., et al. (2007). Effect of supplementation of women in high-risk pregnancies with long-chain polyunsaturated fatty acids on pregnancy outcomes and growth measures at birth: A meta-analysis of randomized controlled trials. British Journal of Nutrition, 98(2), pp.253-259.
12. Barden, A.E., et al. (2006). n-3 fatty acid supplementation during pregnancy in women with allergic disease: effects on blood pressure, and maternal and fetal lipids. Clinical Science, 111(3), pp.289-294.
13. Denburg, J.A., et al. (2005). Fish oil supplementation in pregnancy modifies neonatal progenitors at birth in infants at risk of atopy. Pediatric Research, 57(2), pp.276-281.
14. Imhoff-Kunsch, B., Briggs, V., Goldenberg, T., & Ramakrishnan, U. (2012). Effect of n-3 long-chain polyunsaturated fatty acid intake during pregnancy on maternal, infant, and child health outcomes: a systematic review. Paediatric and Perinatal Epidemiology, 26, 91-107.
15. Middleton, P., Gomersall, J.C., Gould, J.F., Shepherd, E., Olsen, S.F., & Makrides, M. (2018). Omega-3 fatty acid addition during pregnancy. Cochrane Database of Systematic Reviews, 11, CD003402.
16. Ostadrahimi, A., Salehi-pourmehr, H., Mohammad-Alizadeh-Charandabi, S., Heidarabady, S., & Farshbaf-Khalili, A. (2018). The effect of perinatal fish oil supplementation on neurodevelopment and growth of infants: a randomized controlled trial. European Journal of Nutrition, 57, 2387-2397.
17. Vinding, R.K., Stokholm, J., Sevelsted, A., Sejersen, T., Chawes, B.L., Bønnelykke, K., ... & Bisgaard, H. (2018). Effect of fish oil supplementation in pregnancy on bone, lean, and fat mass at six years: randomised clinical trial. BMJ, 362, k3312.
18. Daley, E. A., et al. (2021). Effectiveness of omega-3 fatty acid supplementation in preventing preterm birth and improving pregnancy outcomes: A systematic review. Journal of Obstetrics and Gynaecology, 41(2), 132-144. https://doi.org/10.1111/jog.14659
19. Garcia, F. M., et al. (2021). Maternal n-3 polyunsaturated fatty acids and markers of inflammation during pregnancy: Implications for maternal and fetal health. Journal of Clinical Nutrition, 112(4), 903-912. https://doi.org/10.3945/jcn.120.2155
20. Gómez-Pinilla, F. (2018). Polyunsaturated fatty acids and brain health during pregnancy. Neuroscience, 366, 20-30. https://doi.org/10.1016/j.neuroscience.2017.10.039
21. Harris, W. S., et al. (2017). Omega-3 fatty acids and cardiovascular disease prevention in pregnancy. American Journal of Clinical Nutrition, 106(4), 1069-1078. https://doi.org/ 10.3945/ajcn.116.146858
22. Kiani, A., et al. (2020). Effect of DHA supplementation on the incidence of oligohydramnios in pregnancy: A randomized controlled trial. Journal of Perinatal Medicine, 48(5), 451-458. https://doi.org/10.1515/jpm-2020-0158
23. Lee, Y. J., et al. (2022). DHA supplementation and amniotic fluid volume: A meta-analysis of randomized controlled trials. Obstetrics & Gynecology, 139(2), 233-240. https://doi.org/10. 1097/AOG.0000000000004692
24. Liu, W., et al. (2021). The effect of n-3 PUFA supplementation on oligohydramnios: A cohort study. Reproductive Health, 18(1), 19-27. https://doi.org/10.1186/s12978-021-01154-w
25. Miller, L. E., et al. (2020). Omega-3 polyunsaturated fatty acids and the reduction of maternal inflammation in high-risk pregnancies. Journal of Maternal-Fetal & Neonatal Medicine, 33(6), 936-944. https://doi.org/10.1080/14767058.2019.1613463
26. Peralta, L. M., et al. (2020). DHA supplementation during pregnancy: Dose-response effects on maternal and fetal outcomes. British Journal of Nutrition, 124(3), 317-325. https://doi.org/10.1017/S0007114519001487
27. Shadbolt, S. D., et al. (2017). Maternal n-3 fatty acids and inflammatory cytokines in pregnancy: Implications for maternal and fetal health. Nutrition Reviews, 75(8), 619-628. https://doi.org/10.1093/nutrit/nux028
28. Shamsi, R. A., et al. (2020). DHA supplementation during pregnancy: Effects on prostaglandin production and amniotic fluid volume. Journal of Clinical Endocrinology & Metabolism, 105(10), 3117-3124. https://doi.org/10.1210/clinem/dgaa302
29. Silva, M. I., et al. (2019). The role of omega-3 fatty acids in pregnancy: A review of current evidence. European Journal of Clinical Nutrition, 73(3), 348-356. https://doi.org/10.1038/s41430-019-0172-4
30. Su, H. L., et al. (2018). The effects of omega-3 fatty acid supplementation on blood pressure and placental function during pregnancy. Journal of Clinical Hypertension, 20(7), 1043-1051. https://doi.org/10.1111/jch.13344
31. Takahashi, T., et al. (2019). n-3 PUFAs and endothelial function in pregnancy: A review of the evidence. Journal of the American College of Cardiology, 73(12), 1602-1614. https://doi.org/10.1016/j.jacc.2019.01.039
32. Wang, Y., et al. (2017). DHA supplementation and pregnancy outcomes: A cohort study. Journal of Clinical Obstetrics, 34(2), 112-118. https://doi.org/10.1007/s11043-017-0702-2
33. Zhou, X., et al. (2019). Oligohydramnios: Pathophysiology, diagnosis, and management. American Journal of Obstetrics and Gynecology, 221(6), 575-583. https://doi.org/10.1016/j.ajog.2019.07.020
2. Amza, M., Haj Hamoud, B., Sima, R. M., Dinu, M. D., Gorecki, G. P., Popescu, M., ... & Pleș, L. (2024). Docosahexaenoic Acid (DHA) and Eicosapentaenoic Acid (EPA)—Should They Be Mandatory Supplements in Pregnancy? Biomedicines, 12(7), 1471.
3. Middleton, P., Gomersall, J. C., Gould, J. F., Shepherd, E., Olsen, S. F., & Makrides, M. (2018). Omega‐3 fatty acid addition during pregnancy. Cochrane Database of Systematic Reviews, (11).
4. Imhoff‐Kunsch, B., Briggs, V., Goldenberg, T., & Ramakrishnan, U. (2012). Effect of n‐3 long‐chain polyunsaturated fatty acid intake during pregnancy on maternal, infant, and child health outcomes: a systematic review. Paediatric and perinatal epidemiology, 26, 91-107.
5. Arita, M. (2015). Omega-3-derived lipid mediators in resolving inflammation. Wikipedia.
6. Keelan, J.A., et al. (2015). Effects of maternal n-3 fatty acid supplementation on placental cytokines, pro-resolving lipid mediators and their precursors.
7. Bakhsh, H.T., et al. (2022). Comparison in the Mean Amniotic Fluid Index with Omega-3 Fatty Acid Supplementation in Pregnant Women with Oligohydramnios. PJMH.
8. Kar, S., et al. (2016). Safety of omega-3 fatty acids during pregnancy. Verywell Health.
9. Dunstan, J.A., et al. (2006). Effects of n-3 polyunsaturated fatty acid supplementation in pregnancy on maternal and fetal erythrocyte fatty acid composition. European Journal of Clinical Nutrition, 58(3), pp.429-437.
10. Olsen, S.F., et al. (2000). Randomised clinical trials of fish oil supplementation in high risk pregnancies. BJOG: An International Journal of Obstetrics & Gynaecology, 107(3), pp.382-395.
11. Horvath, A., et al. (2007). Effect of supplementation of women in high-risk pregnancies with long-chain polyunsaturated fatty acids on pregnancy outcomes and growth measures at birth: A meta-analysis of randomized controlled trials. British Journal of Nutrition, 98(2), pp.253-259.
12. Barden, A.E., et al. (2006). n-3 fatty acid supplementation during pregnancy in women with allergic disease: effects on blood pressure, and maternal and fetal lipids. Clinical Science, 111(3), pp.289-294.
13. Denburg, J.A., et al. (2005). Fish oil supplementation in pregnancy modifies neonatal progenitors at birth in infants at risk of atopy. Pediatric Research, 57(2), pp.276-281.
14. Imhoff-Kunsch, B., Briggs, V., Goldenberg, T., & Ramakrishnan, U. (2012). Effect of n-3 long-chain polyunsaturated fatty acid intake during pregnancy on maternal, infant, and child health outcomes: a systematic review. Paediatric and Perinatal Epidemiology, 26, 91-107.
15. Middleton, P., Gomersall, J.C., Gould, J.F., Shepherd, E., Olsen, S.F., & Makrides, M. (2018). Omega-3 fatty acid addition during pregnancy. Cochrane Database of Systematic Reviews, 11, CD003402.
16. Ostadrahimi, A., Salehi-pourmehr, H., Mohammad-Alizadeh-Charandabi, S., Heidarabady, S., & Farshbaf-Khalili, A. (2018). The effect of perinatal fish oil supplementation on neurodevelopment and growth of infants: a randomized controlled trial. European Journal of Nutrition, 57, 2387-2397.
17. Vinding, R.K., Stokholm, J., Sevelsted, A., Sejersen, T., Chawes, B.L., Bønnelykke, K., ... & Bisgaard, H. (2018). Effect of fish oil supplementation in pregnancy on bone, lean, and fat mass at six years: randomised clinical trial. BMJ, 362, k3312.
18. Daley, E. A., et al. (2021). Effectiveness of omega-3 fatty acid supplementation in preventing preterm birth and improving pregnancy outcomes: A systematic review. Journal of Obstetrics and Gynaecology, 41(2), 132-144. https://doi.org/10.1111/jog.14659
19. Garcia, F. M., et al. (2021). Maternal n-3 polyunsaturated fatty acids and markers of inflammation during pregnancy: Implications for maternal and fetal health. Journal of Clinical Nutrition, 112(4), 903-912. https://doi.org/10.3945/jcn.120.2155
20. Gómez-Pinilla, F. (2018). Polyunsaturated fatty acids and brain health during pregnancy. Neuroscience, 366, 20-30. https://doi.org/10.1016/j.neuroscience.2017.10.039
21. Harris, W. S., et al. (2017). Omega-3 fatty acids and cardiovascular disease prevention in pregnancy. American Journal of Clinical Nutrition, 106(4), 1069-1078. https://doi.org/ 10.3945/ajcn.116.146858
22. Kiani, A., et al. (2020). Effect of DHA supplementation on the incidence of oligohydramnios in pregnancy: A randomized controlled trial. Journal of Perinatal Medicine, 48(5), 451-458. https://doi.org/10.1515/jpm-2020-0158
23. Lee, Y. J., et al. (2022). DHA supplementation and amniotic fluid volume: A meta-analysis of randomized controlled trials. Obstetrics & Gynecology, 139(2), 233-240. https://doi.org/10. 1097/AOG.0000000000004692
24. Liu, W., et al. (2021). The effect of n-3 PUFA supplementation on oligohydramnios: A cohort study. Reproductive Health, 18(1), 19-27. https://doi.org/10.1186/s12978-021-01154-w
25. Miller, L. E., et al. (2020). Omega-3 polyunsaturated fatty acids and the reduction of maternal inflammation in high-risk pregnancies. Journal of Maternal-Fetal & Neonatal Medicine, 33(6), 936-944. https://doi.org/10.1080/14767058.2019.1613463
26. Peralta, L. M., et al. (2020). DHA supplementation during pregnancy: Dose-response effects on maternal and fetal outcomes. British Journal of Nutrition, 124(3), 317-325. https://doi.org/10.1017/S0007114519001487
27. Shadbolt, S. D., et al. (2017). Maternal n-3 fatty acids and inflammatory cytokines in pregnancy: Implications for maternal and fetal health. Nutrition Reviews, 75(8), 619-628. https://doi.org/10.1093/nutrit/nux028
28. Shamsi, R. A., et al. (2020). DHA supplementation during pregnancy: Effects on prostaglandin production and amniotic fluid volume. Journal of Clinical Endocrinology & Metabolism, 105(10), 3117-3124. https://doi.org/10.1210/clinem/dgaa302
29. Silva, M. I., et al. (2019). The role of omega-3 fatty acids in pregnancy: A review of current evidence. European Journal of Clinical Nutrition, 73(3), 348-356. https://doi.org/10.1038/s41430-019-0172-4
30. Su, H. L., et al. (2018). The effects of omega-3 fatty acid supplementation on blood pressure and placental function during pregnancy. Journal of Clinical Hypertension, 20(7), 1043-1051. https://doi.org/10.1111/jch.13344
31. Takahashi, T., et al. (2019). n-3 PUFAs and endothelial function in pregnancy: A review of the evidence. Journal of the American College of Cardiology, 73(12), 1602-1614. https://doi.org/10.1016/j.jacc.2019.01.039
32. Wang, Y., et al. (2017). DHA supplementation and pregnancy outcomes: A cohort study. Journal of Clinical Obstetrics, 34(2), 112-118. https://doi.org/10.1007/s11043-017-0702-2
33. Zhou, X., et al. (2019). Oligohydramnios: Pathophysiology, diagnosis, and management. American Journal of Obstetrics and Gynecology, 221(6), 575-583. https://doi.org/10.1016/j.ajog.2019.07.020
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Published
Aug 18, 2024
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How to Cite
Dr. Attia Mustafa, Dr. Sofia Tariq, Dr. Mahwish Jamil, Dr. Amina Inayat Ullah, Dr. Misbah Ijaz, & Muhammad Asad Jahangir. (2024). EFFECTS OF N-3 POLYUNSATURATED FATTY ACID SUPPLEMENTATION DURING PREGNANCY ON OLIGOHYDRAMNIOS. Journal of Population Therapeutics and Clinical Pharmacology, 31(7), 2208-2221. https://doi.org/10.53555/m5gtmj44
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Author Biographies
Dr. Attia Mustafa
Women Medical Officer, Department of Obstetrics & Gynecology, Sir Ganga Ram Hospital Lahore.
Dr. Sofia Tariq
Senior Registrar, Department of Obstetrics & Gynecology, Sir Ganga Ram Hospital Lahore.
Dr. Mahwish Jamil
Senior Registrar, Department of Obstetrics & Gynecology, Sir Ganga Ram Hospital Lahore.
Dr. Amina Inayat Ullah
Women Medical Officer, at Health and Population Department, Govt. of Punjab.
Dr. Misbah Ijaz
PGR (Obstetrics & Gynecology), Sir Ganga Ram Hospital Lahore.
Muhammad Asad Jahangir
3rd year MBBS, King Edward Medical University, Mayo Hospital, Lahore, Pakistan.
How to Cite
Dr. Attia Mustafa, Dr. Sofia Tariq, Dr. Mahwish Jamil, Dr. Amina Inayat Ullah, Dr. Misbah Ijaz, & Muhammad Asad Jahangir. (2024). EFFECTS OF N-3 POLYUNSATURATED FATTY ACID SUPPLEMENTATION DURING PREGNANCY ON OLIGOHYDRAMNIOS. Journal of Population Therapeutics and Clinical Pharmacology, 31(7), 2208-2221. https://doi.org/10.53555/m5gtmj44
