The Effect of Omega-3 Docosahexaenoic Acid Supplementation on Gestational Length: Randomized Trial of Supplementation Compared to Nutrition Education for Increasing n-3 Intake from Foods.

OBJECTIVE: DHA supplementation was compared to nutrition education to increase DHA consumption from fish and DHA fortified foods. DESIGN: This two-part intervention included a randomized double-blind placebo controlled DHA supplementation arm and a nutrition education arm designed to increase intake of DHA from dietary sources by 300 mg per day. SETTING: Denver Health Hospitals and Clinics, Denver, Colorado, USA. POPULATION: 871 pregnant women aged 18-40 were recruited between 16 and 20 weeks of gestation of whom 564 completed the study and complete delivery data was available in 505 women and infants. METHODS: Subjects received either 300 or 600 mg DHA or olive oil placebo or nutrition education. MAIN OUTCOME VARIABLE: Gestational length. RESULTS: Gestational length was significantly increased by 4.0-4.5 days in women supplemented with 600 mg DHA per day or provided with nutrition education. Each 1% increase in RBC DHA at delivery was associated with a 1.6-day increase in gestational length. No significant effects on birth weight, birth length, or head circumference were demonstrated. The rate of early preterm birth (1.7%) in those supplemented with DHA (combined 300 and 600 mg/day) was significantly lower than in controls. CONCLUSION: Nutrition education or supplementation with DHA can be effective in increasing gestational length.

Readily treatable reproductive tract infections and preterm birth among black women.

OBJECTIVE: This study sought to quantify the risks of preterm birth that are ascribable to potentially treatable reproductive tract infections among black women in Denver, Colorado. STUDY DESIGN: A secondary analysis was conducted of 4 prospective studies in Denver, Colorado, that included 1038 women who were enrolled at < 29 weeks of gestation and whose cases were followed through delivery. Rates of preterm birth, preterm labor, and preterm premature rupture of membranes were the primary outcomes that were examined. RESULTS: Bacterial vaginosis, infection with Chlamydia trachomatis, Trichomonas vaginalis, Mycoplasma hominis, Neisseria gonorrhoeae, and group B streptococcal colonization were more common among black women (P < .01) than among comparators. Preterm birth occurred more often among black women with infections that were being studied (20.4%), compared with uninfected black women (9.5%; relative risk, 2.2; 95% CI, 1.1-4.1). Up to 42% of preterm births among black women were attributable to the presence of bacterial vaginosis, T vaginalis, or C trachomatis alone or in combinations. The risk for preterm birth among infected black women who received Centers for Disease Control and Prevention recommended treatment was reduced significantly (relative risk, 0.16; 95% CI, 0.04-0.66). CONCLUSION: Black women have increased risks of prematurity that are associated with prevalent reproductive tract infections during pregnancy. Preterm birth among similar urban black women could be reduced by > 40% by the screening and treatment of common genitourinary tract infections in pregnancy.