Preterm Birth Clinical Trial
Official title:
A Randomized Trial of Omega-3 Fatty Acid Supplementation to Prevent Preterm Birth in Pregnancies at High Risk
A recently completed trial of weekly injections of 17 alpha hydroxyprogesterone caproate (17P) found significant effectiveness for 17P in preventing recurrent preterm birth. However, the group who received 17P in this trial still had a high rate of preterm birth. Several reports have shown that dietary supplementation of fish oil, which is rich in Omega-3 fatty acids, reduces the risk of preterm birth. This trial tests whether adding the Omega-3 supplement to 17P therapy has the potential for further reducing the risk of preterm birth in women who have previously had a spontaneous preterm delivery. The trial will compare Omega-3 fatty acid with placebo in women receiving 17P therapy. The hypothesis being tested is: "Among women at high risk for preterm birth receiving weekly injections of 17P, the addition of Omega-3 nutritional supplement will further reduce the rate of preterm birth."
Preterm birth is the leading cause of perinatal mortality and morbidity. In a recently
completed trial of weekly injections of 17 alpha hydroxyprogesterone caproate (17P), the
National Institute of Child Health and Human Development (NICHD) Maternal Fetal Medicine
Units (MFMU) Network found the treatments significantly beneficial in the prevention of
recurrent preterm birth. Other studies have shown that fish oil supplementation can reduce
the risk for preterm birth. The purpose of this study is to determine whether Omega-3, a
polyunsaturated fatty acid nutritional supplement, in addition to injections of 17P, further
decreases the rate of preterm birth in women at risk.
This study is a randomized, double-masked clinical trial with two study arms: a daily
supplement of Omega-3 capsules containing 800 mg of DHA and 1200 mg of EPA or a daily
supplement of a matching placebo. All patients will also receive weekly injections of 17P.
Eight hundred pregnant women with a history of previous preterm delivery will be recruited
for this study. After successfully completing a compliance run-in, which can begin as early
as 15 weeks gestation, patients will be randomized and begin treatment between 16 and 22
weeks gestation. They will remain on study drug until 36 week and 6 days or delivery,
whichever occurs first. Blood will be drawn at randomization and at a monthly visit falling
between 25-29 weeks of gestation to test for compliance, to analyze genetic polymorphisms and
to determine whether Omega-3 affects the production of inflammatory cytokines.
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