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

Lisa Yelland, B. J. Gajewski, J. Colombo, R. A. Gibson, M. Makrides, S. E. Carlson

Research output: Contribution to journalArticle

9 Citations (Scopus)

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 to estimate statistically derived low, moderate or high risk for ePTB, and to test for differences between the DHA and placebo groups. In 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 1112 ePTB (95% credible interval 51-2189) could be avoided by providing DHA. And in the USA we estimated that 106,030 ePTB (95% credible interval 6400 to 175,700) could be avoided with DHA.

LanguageEnglish
Pages44-49
Number of pages6
JournalProstaglandins Leukotrienes and Essential Fatty Acids
Volume112
DOIs
Publication statusPublished - 1 Sep 2016

Keywords

  • Docosahexaenoic acid
  • Early preterm birth
  • Pregnancy
  • Randomized controlled trials

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Cell Biology

Cite this

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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 to estimate statistically derived low, moderate or high risk for ePTB, and to test for differences between the DHA and placebo groups. In 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 1112 ePTB (95{\%} credible interval 51-2189) could be avoided by providing DHA. And in the USA we estimated that 106,030 ePTB (95{\%} credible interval 6400 to 175,700) could be avoided with DHA.",
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