A Dose–Response Meta-Analysis Between Maternal Fish Oil Supplement And Risk of Asthma/Wheeze In Offspring

Abstract

\n Background: Prenatal exposure to omega-3 polyunsaturated fatty acids (n-3 PUFA) present in oily fish may prevent asthma or wheeze in childhood.Objective: By limiting this systematic review to fish oil intervention that commenced in the gestational period, we aim to find more clear evidences about the relationship between supplement with fish oil during pregnancy and the risk of asthma/wheeze in offspring, and to improve the life satisfaction of children who suffered asthma.Methods: A comprehensive literature search was conducted in the following database: PubMed, Medline, Web of Science, the Cochrane library, and Embase up to February 2021. Two reviewers independently selected studies, extracted data of the characteristics, and assessed risk of bias. Eight randomized controlled trials totaling 3,037 mother-infant pairs were analyzed in the end. “Allergic asthma” and “asthma and/or wheeze” were assessed in our meta-analysis. Subgroup analysis and sensitivity analysis were conducted. Dose–response data was examined using the robust-error meta-regression method.Results: This meta-analysis showed that n-3 PUFA during pregnancy did not significantly reduce the risk of asthma/wheeze (RR 0.93; 95% CI 0.82 to1.04, p=0.21) and allergic asthma (RR 0.66, 95% CI 0.24 to 1.86, p=0.44). Subgroup analyses revealed that the risk of childhood asthma/wheeze was significantly decreased: (1) in Europe (RR 0.69; 95% CI 0.53 to 0.89), (2) when the dose was ≥1200 mg/d (RR 0.69; 95% CI 0.55 to 0.88), (3) when supplementation started after gestational age 22 (RR 0.65; 95%CI 0.50 to 0.85), (4) when supplementation was from pregnancy to lactation (RR 0.69; 95% CI 0.51 to 0.95). Furthermore, the linear dose–response analysis showed that when maternal supplementation of n-3 PUFA increased by 100mg/d, the risk of asthma/wheeze was reduced by 2%.Conclusions: Although perinatal replenishment of n-3 PUFA did not prevent allergic disease in offspring, under some conditions, it could reduce the incidence of asthma/wheeze and allergic asthma in children, and the higher the dose, the better the protective effect it has. Additional research is needed to confirm the hypothesis of a link between n-3 PUFA intake and prevention of childhood asthma/wheeze.