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妊娠期补充鱼油
Fish Oil Supplementation in Pregnancy


Ramya Ramaswami ... 呼吸系统疾病 围产医学和儿科 • 2016.12.29
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• 补充维生素D可降低黑种人早产儿的哮鸣风险

本互动栏目讨论一个临床问题的解决方法。文中先提供一份病例摘要,后面是具体的治疗选项,其中任何一个选项都没有绝对的对错。之后,该领域的专家将撰写短文论证每个选项。读者可参与其中,形成群体意见,他们可以选择一个选项,如果愿意,还可以说明理由。


病例摘要

一名考虑补充n-3长链多不饱和脂肪酸的妊娠妇女

Ramya Ramaswami, M.B., B.S., M.P.H.

 

富兰克林(Franklin)女士是一名妊娠20周的30岁女性,这是她的第二胎,今天来找您进行常规产前检查。她身体健康,有哮喘病史,但控制良好。她自诉当前无症状,并且目前没有使用哮喘药;她前一次妊娠期间也没有使用哮喘药。富兰克林女士每日服用1片产前维生素,未发生过敏。她的妊娠早期超声筛查结果显示胎儿无异常。她与伴侣及4岁的儿子查理一起居住在美国中部。她的饮食平衡,其中包含瘦肉,偶尔有鱼。

查理经常因持续性哮鸣发作和下呼吸道感染到急诊科就诊,富兰克林女士今天想与您讨论一下尚未出生的孩子发生相似症状的危险。她向您询问近期发表的一项随机对照试验的结果,该试验探讨了补充n-3长链多不饱和脂肪酸(n-3 LCPUFA)对妊娠妇女及其子女产生的影响。试验结论认为,妊娠妇女在妊娠末三个月补充n-3 LCPUFA可以降低儿童发生哮喘症状和下呼吸道感染的危险。富兰克林女士征求您的意见——她是否应该开始服用n-3 LCPUFA补充剂?

 

治疗选项

您会向该患者推荐以下哪一个选项?

1. 开始补充n-3 LCPUFA。

2. 不要开始补充n-3 LCPUFA。

为了帮助您做出决策,其中每种方法均由该领域的一名专家撰写短文提供支持。根据您对于该患者的了解以及专家提出的观点,您会选择哪一个选项?请做出选择,在NEJM.org投票并留言。





作者信息

Ramya Ramaswami, M.B., B.S., M.P.H., Charles N. Serhan, Ph.D., D.Sc., Bruce D. Levy, M.D., and Maria Makrides, B.N.D., Ph.D.

 

参考文献

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10. Hansen S, Strøm M, Maslova E, et al. Fish oil supplementation during pregnancy and allergic respiratory disease in the adult offspring. J Allergy Clin Immunol 2016 April 25 (Epub ahead of print)

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13. Gunaratne AW, Makrides M, Collins CT. Maternal prenatal and/or postnatal n-3 long chain polyunsaturated fatty acids (LCPUFA) supplementation for preventing allergies in early childhood. Cochrane Database Syst Rev 2015:CD010085-CD010085

14. Palmer DJ, Sullivan T, Gold MS, et al. Effect of n-3 long chain polyunsaturated fatty acid supplementation in pregnancy on infants’ allergies in first year of life: randomised controlled trial. BMJ 2012;344:e184-e184

15. Palmer DJ, Sullivan T, Gold MS, et al. Randomized controlled trial of fish oil supplementation in pregnancy on childhood allergies. Allergy 2013;68:1370-1376

16. Bush A, Fleming L. Diagnosis and management of asthma in children. BMJ 2015;350:h996-h996

17. Makrides M, Gibson RA, McPhee AJ, Yelland L, Quinlivan J, Ryan P. Effect of DHA supplementation during pregnancy on maternal depression and neurodevelopment of young children: a randomized controlled trial. JAMA 2010;304:1675-1683

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