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Does Omega-3 Fatty Acid Supplementation During Pregnancy Prevent Childhood Atopic Disease?
Sunday, March 2, 2014
Exhibit Hall B (Convention Center)
Manika Girdhar, DO, Christina E. Ciaccio, MD FAAAAI
Rationale: Making a causal link between exposure and disease is one of the biggest challenges in epidemiology.  Certain criteria have been developed to assist judgment of cause-effect relations. We used Hennekens’ criteria to attempt to clarify the roll of long chain omega-3 polyunsaturated fatty acids (n-3 PUFA) in maternal diets on the development of atopic disease in children

Methods: A literature review was performed using MEDLINE (Ovid and Pubmed) and Google Scholar. Hennekens' criteria were applied to the selected studies. 

Results: Three randomized controlled trials of n-3 PUFA supplementation during high risk pregnancies for development of atopy were found and all three were included for review.  All three studies were subject to insensitive measure and contamination bias.  Significant confounders were well controlled in each.  The strength of association for egg sensitization was significant in 2 of 3 studies and eczema or severe eczema in all 3 studies.  Peanut sensitization after supplementation was not decreased in any of the 3 studies.  The biologic plausibility is well developed in the literature and temporality is clear and appropriate.  Across studies, a dose response was observed. Of note, one subanalysis of mothers without a history of atopic disease revealed that no infants developed food allergy in the group who received supplementation, as compared to 25% of the group that did not supplement their diets. 

Conclusions: Application of Hennekens’ criteria to these three studies reveals n-3 PUFA deficiency in mothers as a plausible risk factor for the development of allergic sensitization in high risk newborns.