Mozurkewich 2013.

Methods	RCT: NCT00711971: Mothers, Omega‐3, and Mental Health Study 3 arms
Participants	126 women randomised (2 omega‐3 groups and 1 control group) Inclusion criteria: a past history of depression (EPDS score 9‐19), singleton gestation, a maternal age of ≥18 years, and a GA of 12‐20 weeks Exclusion criteria: women with history of a bleeding disorder, thrombophilia requiring anticoagulation, multiple gestation, bipolar disorder, current major depressive disorder, current substance abuse, lifetime substance dependence or schizophrenia. Women were also ineligible if they were taking omega‐3 fatty acid supplements or antidepressant medications or eating more than 2 fish meals per week. The Mini‐International Neuropsychiatric Interview was also used to exclude current major depressive disorder, bipolar disorder, current substance abuse or dependence, suicidal ideation or schizophrenia. Setting: The University of Michigan Health System and St Joseph’s Mercy Hospital Health System, in southeastern Michigan, USA from October 2008 to May 2011
Interventions	SUPPLEMENTATION: EPA versus DHA versus placebo (soy oil) Group 1: EPA‐rich fish oil supplementation (1060 mg EPA plus 274 mg DHA): 2 large EPA‐rich fish oil capsules and 4 small placebo capsules (double‐dummy design); total number randomised: n = 42 (39) Group 2: DHA‐rich fish oil supplementation (900 mg DHA plus 180 mg EPA): 2 large placebo capsules and 4 small DHA‐rich fish oil capsules; total number randomised: n = 42 (38) Group 3: soy oil placebo (98% soybean oil and 1% each of lemon and fish oil): 2 large and 4 small placebo capsules; total number randomised: n = 42 (41) Timing of supplementation: from 12‐20 weeks GA to 6‐8 weeks postpartum DHA + EPA dose/day: Group 1: high: 274 mg DHA + 1060 mg EPA Group 2: high: 900 mg DHA + 80 mg EPA
Outcomes	Women/birth: PE/hypertension; caesarean section; induction of labour; PPH (blood loss); adverse effects; cessation of the intervention; gestational diabetes; postnatal depression; length of gestation; spontaneous vaginal birth; operative vaginal birth; birthweight; cytokines Babies/infants/children: admission to NICU; cytokines (cord blood) (Allergy (childhood eczema at 36 months) was reported, but is covered by another Cochrane review, Gunaratne 2015)
Notes	Funding: NIH grant R21 AT004166‐03S1 (National Center for Complementary and Alternative Medicine) and a University of Michigan Clinical Research Initiatives grant and by the University of Michigan General Clinical Research Center, now the Michigan Clinical Research Unit. This study was also supported (in part) by the NIH through the University of Michigan’s Cancer Center Support Grant (P30 CA046592), and by the National Center for Research Resources and the National Center for Advancing Translational Sciences, NIH, through grant 8UL1TR000041, for the Clinical and Translational Science Center, University of New Mexico. The Nordic Naturals Corporation donated both active supplements and placebos to the trial. Declarations of interest: “E.L.M. was an invited speaker at the Nutracon 2012 Conference, sponsored by the Global Organization for EPA and DHA Omega‐3s (GOED), Anaheim, CA, March 7–8, 2012, and received reimbursement for travel expenses. The remaining authors report no conflict of interest”
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: “Randomization was carried out using a random number table maintained in the University of Michigan Investigational Drug Service.”
Allocation concealment (selection bias)	Low risk	Quote: “Randomization was carried out using a random number table maintained in the University of Michigan Investigational Drug Service.” (central randomisation)
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Quote: “The placebos were formulated to be identical in appearance to both the EPA‐ and DHA‐rich supplements … Because the EPA and DHA capsules were not identical in appearance, we used a double‐dummy design to maintain blinding.”
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Not specifically detailed
Incomplete outcome data (attrition bias) All outcomes	Low risk	Loss to follow‐up (and exclusion from analyses): EPA group: 3/42 DHA group: 4/42 Placebo group 1/42 (7/8 women were lost to follow‐up; 1 woman in the DHA group had a second‐trimester pregnancy loss attributed to cervical insufficiency).
Selective reporting (reporting bias)	Low risk	Trial protocol available; no evidence of selective reporting (though data on adverse effects reported in text only).
Other bias	Low risk	Baseline characteristics reported were well balanced across the 3 groups.