54; 95% confidence interval [CI], 0.30�C0.98; P < .05). Interestingly, this trial blog of sinaling pathways also found an increased rate of post-term pregnancies in the group supplemented with fish oil with a relative risk (RR) of 2.5 (95% CI, 1.2�C4.97; P < .01). In a trial in the United States, pregnant women were randomly assigned to consume DHA-enriched eggs or standard eggs starting at 24 to 28 weeks of gestation to delivery.34 The initial analysis did not find a statistical difference in mean gestational age at delivery between groups (271.6 vs 274.1 days, respectively). However, when the data were adjusted for confounders such as maternal body mass index at enrollment and number of prior pregnancies, there was a 6-day increase in gestational age at delivery (from 270.5 to 276.5 days; P = .009).

This study was particularly interesting because it demonstrated that even small amounts of omega-3 fatty acids (up to 284 mg/d) could be of benefit during pregnancy. A recent randomized, controlled trial powered to evaluate the effect of DHA supplementation during pregnancy on maternal depression and child neurodevelopment randomized pregnant women to fish oil or vegetable oil capsules from 19 weeks of gestation to delivery.21 Although there was no difference between the groups in depressive symptoms or neurodevelopmental outcome, the group that received fish oil had a significantly lower risk of preterm birth < 34 weeks of gestation in secondary analysis: 1.09% versus 2.25% (adjusted RR, 0.49; 95% CI, 0.25�C0.94). This trial also found that fish oil supplementation was associated with an increased rate of postterm births: 17.

6% versus 13.7% (adjusted RR, 1.28; 95% CI, 1.06�C1.54). On the other hand, an equal number of trials have found no impact of fish oil or omega-3 fatty acid supplementation on the rate of preterm birth or length of gestation (Table 3): Table 3 Omega-3 Fatty Acid Supplementation Versus Placebo and Gestational Age at Delivery: Studies Demonstrating No Pregnancy Prolongation Primigravid Mexican women (n = 1094) supplemented with 400 mg of DHA from 18 weeks until delivery did not have longer gestations or a reduced risk of preterm birth compared with placebo.35 However, women supplemented with DHA delivered babies who weighed more and had larger head circumferences. Prepregnancy DHA intake was inadequate in this population, only about 55 mg per day.

Thus, small amounts of DHA may Carfilzomib be helpful to improve fetal growth in populations with low baseline DHA intake. Bulstra-Ramakers and colleagues conducted a randomized, controlled trial in 68 pregnant women who received either fish oil or control capsules.36 The study was powered to look specifically at the effects of fatty acid supplementation on intrauterine growth restriction and pregnancy-induced hypertension. A secondary analysis examined gestational age at delivery, and no significant difference was observed between the 2 groups.