Can Prenatal Fish Oil Reduce AD Risk in Children?

TOPLINE:

A secondary analysis of a randomized trial shows that the impact of prenatal fish oil supplementation on the risk of childhood atopic dermatitis varies based on the mother’s specific cyclooxygenase-1 (COX1) genotype.

METHODOLOGY:

• Researchers conducted a secondary analysis of the n-3 long-chain polyunsaturated fatty acid (LCPUFA) randomized clinical trial within the Copenhagen Prospective Studies on Asthma in Childhood (COPSAC) 2010 birth cohort from March 2009 to March 2014.
• A total of 635 mother-child pairs between 2019 and 2021 were included; pregnant women were enrolled between 22 and 26 gestational weeks and were randomly assigned to receive either n-3 LCPUFAs (fish oil) or placebo (olive oil) until 1 week after delivery.
• The study outcome was the onset of AD in their children through age 10 years.

TAKEAWAY:

• Among children with urinary eicosanoid data available, prenatal fish oil supplementation was associated with lower levels of thromboxane A2 eicosanoids in the urine of children at age 1 (beta coefficient, −0.46; P = .006).
• Prenatal fish oil supplementation was not associated with AD risk based on the child’s COX1 genotype.
• Prenatal fish oil supplementation was only associated with a reduced risk for AD in children born to mothers with the COX1 TT genotype (hazard ratio [HR], 0.70; 95% CI, 0.50-0.98; P = .04). There was no overall association for those born to mothers with the COX1 CT genotype (HR, 1.29; 95% CI, 0.79-2.10; P = .30).
• Compared with placebo, fish oil supplementation was associated with a higher risk for AD in children born to mothers with the COX1 CC genotype (HR, 5.77; 95% CI, 1.63-20.47; P = .007).

IN PRACTICE:

“These findings support use of a personalized prevention strategy for reducing the burden of AD in childhood by only providing n-3 LCPUFA supplementation to pregnant mothers carrying the COX1 rs1330344 TT genotype,” the authors concluded. In future studies, they added, results “should be replicated…to test the potential for personalized prevention.”

SOURCE:

This study was led by Liang Chen, MSc, University of Copenhagen, Copenhagen, Denmark, and was published online on August 28, 2024, in JAMA Dermatology. 

LIMITATIONS:

Limitations included absence of a validation cohort, the small number of mothers with the CC genotype, and lack of COX1 gene expression and/or enzyme protein data.

DISCLOSURES:

This study was supported by grants from the European Research Council. Four authors reported financial ties outside this work. No other disclosures were reported. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.