Ali 2017.

Methods	RCT: NCT02696577
Participants	80 women randomised Inclusion criteria: 20–35 years; 28‐30 weeks' gestation; pregnancy complicated with asymmetrical IUGR (diagnosed by 2D trans‐abdominal US when the abdominal circumference was reduced out of proportion to other fetal biometric parameters and was below the 10th percentile so there was an increased HC:AC ratio); with normal Doppler indices in uterine and umbilical arteries at time of recruitment (the normal value of S/D ratio was from 2.5 to 3.5; RI was from 0.60 to 0.75 and PI was from 0.96 to 1.270, respectively). Exclusion criteria: ≤ 20 and ≥ 35 years; any hypertensive disorder; diabetes mellitus; smokers; multiple gestations, low amniotic fluid volume; premature prelabour rupture of membranes; antepartum haemorrhage and fetal congenital anomalies; women with abnormal Doppler indices, absent diastolic flow or reversed flow. Setting: Assiut Woman’s Health Hospital, Egypt
Interventions	SUPPLEMENTATION + OTHER AGENT: DHA + EPA + wheat‐germ oil + aspirin versus aspirin Group 1: fish oil (1000 mg = DHA 9%, EPA 13%) plus 100 mg wheat‐germ oil (LA 52%‐59%) as a source of vitamin E, and aspirin 81 once daily: n = 40 Group 2: aspirin 81 once daily: n = 40 Timing of supplementation: 6 weeks (from ˜28‐30 weeks GA) DHA + EPA dose/day: low: 90 mg DHA + 130 mg EPA
Outcomes	Women/birth: gestational length; caesarean section; Doppler blood flow in uterine and umbilical arteries Babies/infants/children: birthweight; perinatal mortality; admission to NICU
Notes	Funding: not reported Declarations of interest: none declared
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Computer‐generated random number table
Allocation concealment (selection bias)	Low risk	Quote: "Allocation concealment was done using serially numbered closed opaque envelopes. Each envelope was labelled with a serial number and had a card noting the intervention type. Allocation never changed after opening the closed envelopes"
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Not reported
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Not reported
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	12/80 (15%) participants lost to follow‐up (6/40 in both intervention (2 failure of treatment and 4 lost to follow‐up) and control group (3 failure of treatment and 3 lost to follow‐up).
Selective reporting (reporting bias)	Unclear risk	With no access to a trial protocol it was not possible to assess selective reporting confidently.
Other bias	Low risk	Baseline characteristics appeared similar, no obvious source of other bias identified.