Predicting the effect of maternal docosahexaenoic acid (DHA) supplementation to reduce early preterm birth in Australia and the United States using results of within country randomized controlled trials

Abstract The DHA to Optimize Mother Infant Outcome (DOMInO) and Kansas DHA Outcomes Study (KUDOS) were randomized controlled trials that supplemented mothers with 800 and 600 mg DHA/day, respectively, or a placebo during pregnancy. DOMInO was conducted in Australia and KUDOS in the United States. Bo...

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Bibliographic Details
Published in:Prostaglandins, leukotrienes and essential fatty acids leukotrienes and essential fatty acids, 2016-09, Vol.112, p.44-49
Main Authors: Yelland, L.N, Gajewski, B.J, Colombo, J, Gibson, R.A, Makrides, M, Carlson, S.E
Format: Article
Language:English
Subjects:
Advanced Basic Science
Australia - epidemiology
Bayes Theorem
Dietary Supplements
Docosahexaenoic acid
Docosahexaenoic Acids - administration & dosage
Double-Blind Method
Early preterm birth
Endocrinology & Metabolism
Female
Gestational Age
Humans
Multicenter Studies as Topic
Pregnancy
Premature Birth - epidemiology
Premature Birth - prevention & control
Randomized controlled trials
Randomized Controlled Trials as Topic
Treatment Outcome
United States - epidemiology
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Summary:Abstract The DHA to Optimize Mother Infant Outcome (DOMInO) and Kansas DHA Outcomes Study (KUDOS) were randomized controlled trials that supplemented mothers with 800 and 600 mg DHA/day, respectively, or a placebo during pregnancy. DOMInO was conducted in Australia and KUDOS in the United States. Both trials found an unanticipated and statistically significant reduction in early preterm birth (ePTB; i.e., birth before 34 weeks gestation). However, in each trial, the number of ePTBs were small. We used a novel Bayesian approach and an arbitrary sample of 120,000 pregnancies to estimate statistically derived low, moderate or high risk for ePTB, and to test for differences between the DHA and placebo groupsIn both trials, the model predicted DHA would significantly reduce the expected proportion of deliveries in the high risk group under the trial conditions of the parent studies. Among the next 300,000 births in Australia we estimated that 1,112 ePTB (95% credible interval 51 to 2,189) could be avoided by providing DHA. And in the USA we estimated that 106,030 ePTB (95% credible interval 6,400 to 175,700) could be avoided with DHA.
ISSN:0952-3278
1532-2823
DOI:10.1016/j.plefa.2016.08.007