Qualidade da dieta e efeitos da suplementação de ômega-3 em desfechos de saúde maternos e do recém-nascido: ensaio clínico aleatorizado placebo-cego

Abstract

Objectives: Characterize the pregnant women's diet quality and evaluate the effects of omega 3 supplementation on maternal and newborn health outcomes. Methods: The dissertation comprises two articles, one from the baseline (cross-sectional evaluation) and the other from a randomized, double-blind, placebo-controlled clinical trial with 60 pregnant women at usual risk, adults (20-40 years), with gestational age between 22 and 24 weeks. Sociodemographic; anthropometric; health, and food consumption data were collected in five periods - 4 during pregnancy and 1 postpartum. The pregnant were separated in two groups, the control group with olive oil supplementation and the intervention group with omega-3 supplementation - 260mg of eicosapentaenoic acid + 1440mg of docosahexaenoic acid, both groups with n=30. The intervention time was approximately 16 weeks, because was done until the end of the gestation. The assessment of food consumption was carried out with two 24-hour meal reminder - R24h - that enabled the calculation of the Adapted Diet Quality Index for Pregnant Women (IQDAG). It has nine components: vegetables, fresh fruits, legumes, fiber, folate, iron, calcium, omega-3, and ultra-processed foods. Birth and baby data were collected 15 days after childbirth. Results: The IQDAG obtained a total median of 68.3 (60.6-79.1) points, with higher values for pregnant women with paid work (71.6 vs. 64.6; p=0.050) and for multiparous women (72 .3 vs. 64.6; p=0.030). Among the index components, the highest scores were achieved for “legumes” (76.7%) and “iron” (58.3%). In contrast, the lowest scores were identified for “vegetables” (6.7%) and fibers (11.7%). At the end of the collection stages, 45 pregnant women concluded the study. Regardless of supplementation, the consumption of omega-3 was within the recommendation (1.4 g/day) in almost half of the sample (46.7%) as well as the omega 6/omega-3 ratio (80%). There was no difference between gestational weeks, maternal nutritional status, and weight gain, health complications at delivery, mode of delivery or nutritional status of the newborn after omega-3 supplementation. Conclusions: The diet quality showed similar characteristics to the Brazilian pattern of consumption, with greater adequacy of legumes and the need to increase the consumption of vegetables and fiber. Multiparous pregnant women with paid work had a better diet quality, when compared with primiparous and unpaid women, denoting the importance of nutritional guidance during prenatal care, especially for pregnant women in these conditions. Omega-3 supplementation did not provide differences in maternal and newborn health outcomes evaluated, probably due to the clinical characteristics and food consumption of the analysis group, in addition to the dosage used. Investigations with high-risk pregnant women with dietary deficiency of omega-3, as well as new formulations of the supplement, are suggested to expand the understanding of the interaction of this nutrient with maternal and child health.