Plasma Concentrations of Long Chain N-3 Fatty Acids in Early and Mid-Pregnancy and Risk of Early Preterm Birth

S. F. Olsen; T. I. Halldorsson; A. L. Thorne-Lyman; M. Strøm; S. Gørtz; C. Granstrøm; P. H. Nielsen; J. Wohlfahrt; J. A. Lykke; J. Langhoff-Roos; A. S. Cohen; J. D. Furtado; E. L. Giovannucci; W. Zhou

doi:10.1016/j.ebiom.2018.07.009

Plasma Concentrations of Long Chain N-3 Fatty Acids in Early and Mid-Pregnancy and Risk of Early Preterm Birth

S. F. Olsen, T. I. Halldorsson, A. L. Thorne-Lyman, M. Strøm, S. Gørtz, C. Granstrøm, P. H. Nielsen, J. Wohlfahrt, J. A. Lykke, J. Langhoff-Roos, A. S. Cohen, J. D. Furtado, E. L. Giovannucci, W. Zhou

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Abstract

Background: Fish oil supplementation has been shown to delay spontaneous delivery, but the levels and clinical
significance remain uncertain. We examined the association between plasma fatty acids quantified in pregnancy
and subsequent risk of early preterm birth.
Methods: In a case-control design nested in the Danish National Birth Cohort, we identified 376 early preterm
cases (acid plus docosahexaenoic acid (EPA+DHA% of total fatty acids), were measured twice in pregnancy, at gestation
weeks 9 and 25 (medians). Odds ratios and 95% confidence intervals (CI's) for associations between EPA+DHA
and early preterm risk were estimated by logistic regression, adjusted for the woman's age, height, pre-pregnancy BMI, parity, smoking, and socioeconomic factors. Hypotheses and analytical plan were defined and archived a priori.
Findings: Analysis using restricted cubic splines of the mean of 1st and 2nd sample measurements showed a
strong and significant non-linear association (p < 0.0001) in which the risk of early preterm birth steeply increased when EPA+DHA concentrations were lower than 2% and flattened out at higher levels. Women in the
lowest quintile (EPA+DHA < 1.6%) had 10.27 times (95% confidence interval 6.80–15.79, p < 0.0001) increased
risk, and women in the second lowest quintile had 2.86 (95% CI 1.79–4.59, p < 0.0001) times increased risk,
when compared to women in the three aggregated highest quintiles (EPA+DHA ≥ 1.8%).
Interpretation: Low plasma concentration of EPA and DHA during pregnancy is a strong risk factor for subsequent
early preterm birth in Danish women.

Original language	English
Pages (from-to)	325-333
Number of pages	9
Journal	EBioMedicine
Volume	35
DOIs	https://doi.org/10.1016/j.ebiom.2018.07.009
Publication status	Published - 2018

Keywords

Biomarkers
Danish National Birth Cohort
Early preterm birth
Long chained n-3 fatty acids
Prospective study

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Olsen, S. F., Halldorsson, T. I., Thorne-Lyman, A. L., Strøm, M., Gørtz, S., Granstrøm, C., Nielsen, P. H., Wohlfahrt, J., Lykke, J. A., Langhoff-Roos, J., Cohen, A. S., Furtado, J. D., Giovannucci, E. L., & Zhou, W. (2018). Plasma Concentrations of Long Chain N-3 Fatty Acids in Early and Mid-Pregnancy and Risk of Early Preterm Birth. EBioMedicine, 35, 325-333. https://doi.org/10.1016/j.ebiom.2018.07.009

@article{b9c7c1702f7d43c5abe1902fe91c2516,

title = "Plasma Concentrations of Long Chain N-3 Fatty Acids in Early and Mid-Pregnancy and Risk of Early Preterm Birth",

abstract = "Background: Fish oil supplementation has been shown to delay spontaneous delivery, but the levels and clinicalsignificance remain uncertain. We examined the association between plasma fatty acids quantified in pregnancyand subsequent risk of early preterm birth.Methods: In a case-control design nested in the Danish National Birth Cohort, we identified 376 early pretermcases (acid plus docosahexaenoic acid (EPA+DHA% of total fatty acids), were measured twice in pregnancy, at gestationweeks 9 and 25 (medians). Odds ratios and 95% confidence intervals (CI's) for associations between EPA+DHAand early preterm risk were estimated by logistic regression, adjusted for the woman's age, height, pre-pregnancy BMI, parity, smoking, and socioeconomic factors. Hypotheses and analytical plan were defined and archived a priori.Findings: Analysis using restricted cubic splines of the mean of 1st and 2nd sample measurements showed astrong and significant non-linear association (p < 0.0001) in which the risk of early preterm birth steeply increased when EPA+DHA concentrations were lower than 2% and flattened out at higher levels. Women in thelowest quintile (EPA+DHA < 1.6%) had 10.27 times (95% confidence interval 6.80–15.79, p < 0.0001) increasedrisk, and women in the second lowest quintile had 2.86 (95% CI 1.79–4.59, p < 0.0001) times increased risk,when compared to women in the three aggregated highest quintiles (EPA+DHA ≥ 1.8%).Interpretation: Low plasma concentration of EPA and DHA during pregnancy is a strong risk factor for subsequentearly preterm birth in Danish women.",

keywords = "Biomarkers, Danish National Birth Cohort, Early preterm birth, Long chained n-3 fatty acids, Prospective study",

author = "Olsen, {S. F.} and Halldorsson, {T. I.} and Thorne-Lyman, {A. L.} and M. Str{\o}m and S. G{\o}rtz and C. Granstr{\o}m and Nielsen, {P. H.} and J. Wohlfahrt and Lykke, {J. A.} and J. Langhoff-Roos and Cohen, {A. S.} and Furtado, {J. D.} and Giovannucci, {E. L.} and W. Zhou",

note = "Correction: https://doi.org/10.1016/j.ebiom.2019.102619",

year = "2018",

doi = "10.1016/j.ebiom.2018.07.009",

language = "English",

volume = "35",

pages = "325--333",

journal = "EBioMedicine",

issn = "2352-3964",

publisher = "Elsevier BV",

}

Olsen, SF, Halldorsson, TI, Thorne-Lyman, AL, Strøm, M, Gørtz, S, Granstrøm, C, Nielsen, PH, Wohlfahrt, J, Lykke, JA, Langhoff-Roos, J, Cohen, AS, Furtado, JD, Giovannucci, EL & Zhou, W 2018, 'Plasma Concentrations of Long Chain N-3 Fatty Acids in Early and Mid-Pregnancy and Risk of Early Preterm Birth', EBioMedicine, vol. 35, pp. 325-333. https://doi.org/10.1016/j.ebiom.2018.07.009

TY - JOUR

T1 - Plasma Concentrations of Long Chain N-3 Fatty Acids in Early and Mid-Pregnancy and Risk of Early Preterm Birth

AU - Olsen, S. F.

AU - Halldorsson, T. I.

AU - Thorne-Lyman, A. L.

AU - Strøm, M.

AU - Gørtz, S.

AU - Granstrøm, C.

AU - Nielsen, P. H.

AU - Wohlfahrt, J.

AU - Lykke, J. A.

AU - Langhoff-Roos, J.

AU - Cohen, A. S.

AU - Furtado, J. D.

AU - Giovannucci, E. L.

AU - Zhou, W.

N1 - Correction: https://doi.org/10.1016/j.ebiom.2019.102619

PY - 2018

Y1 - 2018

N2 - Background: Fish oil supplementation has been shown to delay spontaneous delivery, but the levels and clinicalsignificance remain uncertain. We examined the association between plasma fatty acids quantified in pregnancyand subsequent risk of early preterm birth.Methods: In a case-control design nested in the Danish National Birth Cohort, we identified 376 early pretermcases (acid plus docosahexaenoic acid (EPA+DHA% of total fatty acids), were measured twice in pregnancy, at gestationweeks 9 and 25 (medians). Odds ratios and 95% confidence intervals (CI's) for associations between EPA+DHAand early preterm risk were estimated by logistic regression, adjusted for the woman's age, height, pre-pregnancy BMI, parity, smoking, and socioeconomic factors. Hypotheses and analytical plan were defined and archived a priori.Findings: Analysis using restricted cubic splines of the mean of 1st and 2nd sample measurements showed astrong and significant non-linear association (p < 0.0001) in which the risk of early preterm birth steeply increased when EPA+DHA concentrations were lower than 2% and flattened out at higher levels. Women in thelowest quintile (EPA+DHA < 1.6%) had 10.27 times (95% confidence interval 6.80–15.79, p < 0.0001) increasedrisk, and women in the second lowest quintile had 2.86 (95% CI 1.79–4.59, p < 0.0001) times increased risk,when compared to women in the three aggregated highest quintiles (EPA+DHA ≥ 1.8%).Interpretation: Low plasma concentration of EPA and DHA during pregnancy is a strong risk factor for subsequentearly preterm birth in Danish women.

AB - Background: Fish oil supplementation has been shown to delay spontaneous delivery, but the levels and clinicalsignificance remain uncertain. We examined the association between plasma fatty acids quantified in pregnancyand subsequent risk of early preterm birth.Methods: In a case-control design nested in the Danish National Birth Cohort, we identified 376 early pretermcases (acid plus docosahexaenoic acid (EPA+DHA% of total fatty acids), were measured twice in pregnancy, at gestationweeks 9 and 25 (medians). Odds ratios and 95% confidence intervals (CI's) for associations between EPA+DHAand early preterm risk were estimated by logistic regression, adjusted for the woman's age, height, pre-pregnancy BMI, parity, smoking, and socioeconomic factors. Hypotheses and analytical plan were defined and archived a priori.Findings: Analysis using restricted cubic splines of the mean of 1st and 2nd sample measurements showed astrong and significant non-linear association (p < 0.0001) in which the risk of early preterm birth steeply increased when EPA+DHA concentrations were lower than 2% and flattened out at higher levels. Women in thelowest quintile (EPA+DHA < 1.6%) had 10.27 times (95% confidence interval 6.80–15.79, p < 0.0001) increasedrisk, and women in the second lowest quintile had 2.86 (95% CI 1.79–4.59, p < 0.0001) times increased risk,when compared to women in the three aggregated highest quintiles (EPA+DHA ≥ 1.8%).Interpretation: Low plasma concentration of EPA and DHA during pregnancy is a strong risk factor for subsequentearly preterm birth in Danish women.

KW - Biomarkers

KW - Danish National Birth Cohort

KW - Early preterm birth

KW - Long chained n-3 fatty acids

KW - Prospective study

U2 - 10.1016/j.ebiom.2018.07.009

DO - 10.1016/j.ebiom.2018.07.009

M3 - Article

SN - 2352-3964

VL - 35

SP - 325

EP - 333

JO - EBioMedicine

JF - EBioMedicine

ER -

Plasma Concentrations of Long Chain N-3 Fatty Acids in Early and Mid-Pregnancy and Risk of Early Preterm Birth

Abstract

Keywords

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