Summary of findings 3. Child/adult outcomes.
| Omega‐3 LCPUFA compared with no omega‐3 during pregnancy: child/adult outcomes | ||||||
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Population: children of women randomised to omega‐3 or no omega‐3 during pregnancy Settings: Australia (2 RCTs), Bangladesh (1 RCT), Canada (1 RCT), Denmark (1 RCT), Hungary (1 RCT), Germany (1 RCT), Spain (2 RCTs), Mexico (1 RCT), Netherlands (1 RCT) Intervention: omega‐3 Comparison: no omega‐3 | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Risk with no omega‐3 | Risk with omega‐3 | |||||
| Cognition: BSID II score at < 24 months |
The mean BSID II score at 24 months in the intervention group was 0.37 points lower in the intervention group (1.47 lower to 0.76 higher) | MD ‐0.37 (‐1.49 to 0.76) | 1154 (4) | ⊕⊕⊝⊝ LOW11 |
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| Cognition: BSID III score at < 24 months |
The mean BSID III score at 24 months in the intervention group was 0.04 points higher (1.59 lower to 1.68 higher) | MD 0.04 (‐1.59 to 1.68) | 809 (2) | ⊕⊕⊝⊝ LOW12 |
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| IQ: WASI at 7 years | The mean WASI at 7 years in the intervention group was identical to the mean in the control group (0.79 points lower to 2.79 higher) | MD 1.00 (‐0.79 to 2.79) | 543 (1) | ⊕⊕⊝⊝ LOW12 |
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| IQ: WISC‐IV at 12 years | The WISC‐IV at 12 years in the intervention group was identical to in the control group (5.16 points lower to 7.16 higher) | MD 1.00 (‐5.16 to 7.16) | 50 (1) | ⊕⊝⊝⊝ VERY LOW13 |
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| Behaviour: BSID III adaptive behaviour score at 12‐18 months | The mean BSID III adaptive behaviour score in the intervention group at 12‐18 months was 1.20 points lower (3.12 lower to 0.72 higher) | MD ‐1.20 (‐3.12 to 0.72) | 809 (2) | ⊕⊕⊝⊝ LOW14 |
At 12 months (one study), 18 months (one study) | |
| Behaviour: SDQ Total Difficulties at 7 years | The mean SDQ total difficulties score at 7 years in the intervention group was 1.08 higher (0.18 higher to 1.98 higher) | MD 1.08 (0.18 to 1.98) | 543 (1) | ⊕⊕⊝⊝ LOW12 |
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| BMI at 19 years | The mean BMI at 19 years in the intervention group was identical to that in the control group (0.83 lower to 0.83 higher) | MD 0 (‐0.83 to 0.83) | 243 (1) | ⊕⊝⊝⊝ VERY LOW15 |
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| Diabetes | Not reported | |||||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). BMI: body mass index; BSID: Bayley Scales of Infant Development; CI: confidence interval; IQ: Intelligence Quotient; MD: mean difference; SDQ: Strengths and Difficulties Questionnaire; WASI: Weschler Abbreviated Scale of Intelligence; WISC: Weschler Intelligence Scale for Children | ||||||
| GRADE Working Group grades of evidence High quality: further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: we are very uncertain about the estimate. | ||||||
11 Design limitations (‐1): downgraded one level due to unclear randomisation in 3 studies (that contributed 40% to meta‐analysis) and some studies at high risk of attrition bias; Imprecision (‐1): downgraded one level for wide confidence intervals including line of no effect
12 Imprecision (‐2): downgraded one level for confidence intervals including line of no effect; and one level for small number of studies/single study
13 Design limitations (‐1): downgraded one level for unclear selection bias (not clear if random sequence generated), possible attrition and/or reporting bias; Imprecision (‐2): downgraded two levels for wide confidence intervals including line of no effect and 1 study with small number of participants
14 Design limitations (‐1): downgraded one level for unclear randomisation (possible lack of allocation concealment), possible attrition and/or selective bias in 1 of the trials (contributing 15% to analysis); Imprecision (‐1): downgraded one level for confidence intervals including line of no effect and few studies
Design limitations (‐1): downgraded one level for unclear sequence generation and unclear blinding: Imprecision (‐2): downgraded two levels for confidence intervals including line of no effect and 1 study with small number of participants