Efficacy of Omega-3, -6, and -9 Fatty Acids, Alone or in Combination With Low Dose Aspirin, in Improvement of Uterine Blood Flow in Women With History of Recurrent Miscarriage: A Prospective, Randomized, Clinical Trial

S. Ala, Sepideh Payvandi, M. Barzin, Mahdieh Tavajoh, Hamidreza Samaei
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Abstract

Background: Much evidence suggests that increased uterine blood flow resistance (reduced uterine perfusion) raises the risk of Recurrent Miscarriage (RM). Objectives: This study aimed at evaluating the efficacy of omega-3, -6, and -9 fatty acids, alone or in combination with aspirin, in reducing uterine blood flow resistance in women with a history of RM. Methods: A total of 45 women with a history of two or more miscarriages and increased uterine artery blood flow resistance were included in this randomized clinical trial. They were randomly assigned to aspirin (80 mg/d) (group A, n=15), omega-3, -6, and -9 fatty acids (4800 mg/d) (group O, n=15), or combination therapy (group AO, n=15). The patients were visited after two months, and the uterine artery blood flow resistance was measured by Doppler sonography. Results: The Mean±SD age of participants was 32±3.5 years in group A, 32±3 years in group O, and 32.4±3 years in group AO. There was no significant difference between three groups in age (P=0.7), duration of marriage (P=0.55), duration of infertility (P=0.43) and number of previous miscarriages (P= 0.51). In all three groups, after two months of treatment, the average uterine artery blood flow resistance reduced considerably compared with the beginning of the trial (P=0.0001); however, there was no significant difference between the three groups (P=0.56). Conclusion: According to the study results, omega-3, -6, and -9 fatty acids can reduce uterine artery blood flow resistance and improve the uterine blood flow in women with RM, with equal efficacy to aspirin. Also, combination therapy offers no advantages over monotherapy.
Omega-3、-6和-9脂肪酸单独或联合低剂量阿司匹林改善复发性流产妇女子宫血流的疗效:一项前瞻性、随机、临床试验
背景:大量证据表明,子宫血流阻力增加(子宫灌注减少)会增加复发性流产(RM)的风险。目的:本研究旨在评估omega-3、-6和-9脂肪酸单独或联合阿司匹林降低有RM病史妇女子宫血流阻力的疗效。方法:本随机临床试验纳入45例有两次及以上流产史且子宫动脉血流阻力增高的妇女。他们被随机分配到阿司匹林(80 mg/d) (A组,n=15), omega-3, -6和-9脂肪酸(4800 mg/d) (O组,n=15),或联合治疗(AO组,n=15)。术后2个月随访,采用多普勒超声检测子宫动脉血流阻力。结果:A组患者平均±SD年龄为32±3.5岁,O组为32±3岁,AO组为32.4±3岁。三组间年龄(P=0.7)、婚姻持续时间(P=0.55)、不孕持续时间(P=0.43)、既往流产次数(P= 0.51)差异无统计学意义。在所有三组中,治疗两个月后,平均子宫动脉血流阻力与试验开始时相比显著降低(P=0.0001);但三组间差异无统计学意义(P=0.56)。结论:研究结果显示,omega-3、-6、-9脂肪酸可降低RM女性子宫动脉血流阻力,改善子宫血流,其疗效与阿司匹林相当。同时,联合治疗也没有单一治疗的优势。
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