Supplementary Material for: Effect of Prenatal Omega-3 Polyunsaturated Fatty Acid Supplementation on Childhood Eczema: A Systematic Review and Meta-Analysis

It is uncertain about the effect of omega-3 polyunsaturated fatty acid (ω-3 PUFA) supplementation during pregnancy on the incidence of eczema among children. The aim of this review was to test if there is an effect of ω-3 PUFA supplementation during pregnancy on the risk of eczema among children of different ages. Two authors independently carried out the selection of published works, data extraction, and evaluation of the likelihood of bias. The PubMed, Medline, the Cochrane Library, Web of Science, and Embase databases updated to the date of March 2021 have been researched thoroughly for literature review. Quality Assessment of studies was evaluated using the updated tool (Rob2) provided by the Cochrane collaboration group. Six unique randomized controlled trials from 7 studies including 1,646 mother-infant pairs were contained in this review. Pooled data showed no pronounced decline in the incidence of eczema (RR = 1.09, 95% CI = 0.82~1.46, <i>p</i> = 0.54) or IgE-associated eczema (RR = 0.67; 95% CI = 0.29~1.57; <i>p</i> = 0.34). However, the subgroup analyses on “IgE-associated eczema” showed a significant decrease among the “≤3-year-old children” (RR = 0.70; 95% CI = 0.50~0.96; <i>p</i> = 0.03) in the ω-3 PUFAs group compared with the placebo. Supplementing the maternal diet with ω-3 PUFAs during pregnancy cannot reduce the danger of eczema or IgE-associated eczema among all children; however, there may be a subgroup-specific effect on 3-year-old or even younger children in reducing the incidence of IgE-associated eczema.

目前学界对于妊娠期补充ω-3多不饱和脂肪酸（omega-3 polyunsaturated fatty acid, ω-3 PUFA）对儿童湿疹发病率的影响尚未明确。本综述旨在探究妊娠期补充ω-3 PUFA对不同年龄段儿童湿疹发病风险的影响。两名研究者独立完成了文献筛选、数据提取及偏倚风险评估工作。本研究全面检索了截至2021年3月更新的PubMed、Medline、Cochrane图书馆、Web of Science及Embase数据库，以获取相关文献。采用考克兰协作组更新的偏倚风险评估工具（Rob2）对纳入研究的质量进行评价。本次综述共纳入7项研究中的6项独立随机对照试验，共计1646对母婴研究对象。合并数据分析结果显示，儿童总体湿疹发病率（RR=1.09，95%CI=0.82~1.46，p=0.54）及IgE相关性湿疹发病率（RR=0.67；95%CI=0.29~1.57；p=0.34）均无显著降低。不过，针对"IgE相关性湿疹"的亚组分析显示，在≤3岁儿童亚组中，妊娠期补充ω-3 PUFA组较安慰剂组的IgE相关性湿疹发病率显著降低（RR=0.70；95%CI=0.50~0.96；p=0.03）。综上，妊娠期母体补充ω-3 PUFA无法降低所有儿童的湿疹或IgE相关性湿疹发病风险，但针对3岁及以下儿童，或可在降低IgE相关性湿疹发病率方面存在亚组特异性效应。