The relationship between the ratio of omega-6 and omega-3 consumption with caesarean section

Fitriana Mustikaningrum; Anindya Rahmaningtyas; Puput F.E. Ningtyas; Nur Lathifah Mardiyati; Tengku Farizan Izzi Binti Che Ku Jusoh

doi:10.21927/ijnd.2024.12(4).242-251

The relationship between the ratio of omega-6 and omega-3 consumption with caesarean section

Fitriana Mustikaningrum, Anindya Rahmaningtyas, Puput F.E. Ningtyas, Nur Lathifah Mardiyati, Tengku Farizan Izzi Binti Che Ku Jusoh

Abstract

Background : Many of research explained that Omega-3 and Omega-6 consumption during pregnancy affect delivery method. Omega-3 and omega-5 affect uterus contraction. The prevalence of caesarean section in 154 countries were 21.1%, and 43% in Primary health care. Caesarean section has a risk to get complication during and after parturition also could increase maternity cost.

Objectives: The aim of study was to determine the relationship between ratio omega-6: omega-3 intake and the incidence of cesarean section in postpartum mothers in the Bendosari Primary Health Care area.

Method: This was observational study with cross sectional approach. The subjects of the study were 66 postpartum mothers who met the inclusion and exclusion criteria and were selected using the purposive sampling method. Data of omega-3 and omega-6 intake during the 2-3rd semester tri pregnancy period were obtained by interview method using the Semi Quantitative Food Frequency (SQ_FFQ) form. The relationship between omega-3 intake and caesarean section was analyzed with the Chi-Square test (P<0,05), while Fisher’s exact test was used to analyzed the relationship between intake ratio of omega-6 and omega-3 (P<0,05).

Result: There was a relationship between omega-3 intake and ratio between omega-6: omega-3 intake with caesarean section with P-value 0.03. The mother who consume high omega-3 had prevalence ratio 3,6 times higher to have normal delivery compared than mother who had low consumption of omega-3. Moreover, mother who had sufficient ratio of omega 6: omega 3 in their diet had prevalence ratio 9 times higher to have normal delivery compared with mother who had high ratio of omega 6: omega 3in the diet during pregnancy. Pregnant women suggests to consume high omega-3 and sufficient ratio omega-6:omega-3 to prevent risk of caesarean section

Keywords

omega-3, omega-6, caesarean section

Full Text:

PDF

References

Yuliani, Sarigih. (2017). Asuhan Kehamilan. Yayasan Kita Menulis:Jakarta

Defrin D, Yerizel E, Suhaimi D. (2019). The Reactivity Levels of Progesterone, Nitric Oxide and Nuclear Factor Kappa-B on the Serum of Term and Post-Term Pregnancy, Clinical Study in Padang, West Sumatera, Indonesia. Open Access Macedonian Journal of Medical Sciences, 29;7(11):1729-1732.Doi: 10.3889/oamjms.2019.351.PMID:31316649;PMCID:PMC6614268

World Health Organization. Preterm birth. Geneva.(2018).

Department of Nutrition and Health Development

Riset Kesehatan Dasar (Riskesdas). (2018). Badan Penelitian dan Pengembangan Kesehatan Kementerian RI tahun 2018.

Ondang, M. C., Suparman, E., & M, H. M. 2016. Gambaran persalinan prematur pada kehamilan remaja di RSUP Prof . Dr. R. Kandao Manado. E-Journal Widya Kesehatan Dan Lingkungan, 2(2), 109–115

Lorthe E, Quere M, Sentilhes L, Delorme P, Kayem G. (2017) Incidence and risk factors of caesarean section in preterm breech births: A population-based cohort study. Eur J Obstet Gynecol Reprod Biol;212:37-43. doi: 10.1016/j.ejogrb.2017.03.019. PMID: 28334569.

Akerele Anthony Olatunji, Cheema Kaur Sukhinder. (2016). A balance of omega-3 and omega-6 polyunsaturated fatty acids is important in pregnancy. Journal of Nutrition & Intermediary Metabolism,Vol5: 23-33.doi.org/10.1016/j.nim.2016.008

Olsen S.F., J. Dalby Sørensen, N.J. Secher, M. Hedegaard, T. Brink Henriksen, H.S. Hansen, A. Grant. (1992). Randomised controlled trial of effect of fish-oil supplementation on pregnancy duration,The Lancet,Volume 339, Issue 8800,1003-1007. doi: 10.1016/0140-6736(92)90533-9. PMID: 1349049.

Smuts CM, Huang M, Mundy D, Plasse T, Major S, Carlson SE. (2003). A randomized trial of docosahexaenoic acid supplementation during the third trimester of pregnancy. Obstet Gynecol;101(3):469-79. doi: 10.1016/s0029-7844(02)02585-1. PMID: 12636950.

Cheng, Z., Abayasekara, D.R., Ward, F., Preece, D.M., Raheem, K.A., Wathes, D.C. (2013). Altering n-3 to n-6 polyunsaturated fatty acid ratios affects prostaglandin production by ovine uterine endometrium. Anim Reprod Sci 143(1-4), 38-47.

Elmes, M., Green, L.R., Poore, K., Newman, J., Burrage, D., Abayasekara, D.R., Cheng, Z., Hanson, M.A., Wathes, D.C. (2005). Raised dietary n-6 polyunsaturated fatty acid intake increases 2-series prostaglandin production during labour in the ewes. J Physiol 562(Pt 2), 583-592. 10.1113/jphysiol.2004.071969. Epub 2004 Oct 28. PMID: 15513945; PMCID: PMC1665502

Blanks, A., Thornton, S. (2003). The role of oxytocin in parturition. BJOG: An International Journal of Obstetrics and Gynaecology 110, 46-51.doi:10.1016/s1470-0328(03)00024-7.PMID:12763111

Soloff, M.S., Jeng, Y.-J., Copland, J.A., Strakova, Z., Hoare, S. (2000). Signal pathways mediating oxytocin stimulation of prostaglandin synthesis in select target cells. The Physiological Society No:51S-58S. doi: 10.1111/j.1469-445x.2000.tb00007.x. PMID: 10795906.

Lee E, Kim H, Kim H, Ha EH, Chang N. Association of maternal omega-6 fatty acid intake with infant birth outcomes: Korean Mothers and Children's Environmental Health (MOCEH). Nutrition Journal. Apr 21;17(1):47.2018. https://doi.org/10.1186/s12937-018-0353-y

Bakouei F, Delavar MA, Mashayekh-Amiri S, Esmailzadeh S, Taheri Z. (2020). Efficacy of n-3 fatty acids supplementation on the prevention of pregnancy induced hypertension or preeclampsia: A systematic review and meta-analysis. Taiwanese Journal of Obstetrics and Gynecology .;59(1):8-15

Mustikaningrum Fitriana. Elmes Matthew. The effect of improving dietary omega-3 polyunsaturated fatty acid on status on uterine expression of contractile associated protein at term pregnant rat. 25th European Congress on Obesity Vienna, Austria, May 23-26, Obesity Facts (Suppl 1): 1-364.2018. http://doi.org/10.1159/000489691

Badan Penyelenggara Jaminan Kesehatan Sosial. (2020). Kendalikan Kasus Persalinan Caesar, BPJS Kesehatan Perkuat Koordinasi dengan Tim Kendali Mutu dan Kendali Biasa.

Anonim (2017). Widyakarya Nasional Pangan dan Gizi X. LIPI Press

Rocha, Camilla & Kac, Gilberto. (2012). High dietary ratio of omega-6 to omega-3 polyunsaturated acids during pregnancy and prevalence of post-partum depression. Maternal & child nutrition. 8. 36-48. 10.1111/j.1740-8709.2010.00256.x.

Tamhane AR, Westfall AO, Burkholder GA, Cutter GR. (2016). Prevalence odds ratio versus prevalence ratio: choice comes with consequences ;35(30):5730-5735. doi: 10.1002/sim.7059.

Capelleti M, Della Bella S, Ferrazzi E, Mavilio D, Divanovic S. (2016). J. Leukoc Biol:Jan :99 (1) 67-78. Doi:10.1189/jlb.3MR0615-272RR.Epub.PMID 26538528

Meliana Ahila, Afziah Rahma Amelia Anastasya. Hasanutudhihyah.(2023). The effect of omega-3 fatty acids and vitamin e supplementation on lipid profiles and inflammatory markers in hemodialysis patients: A systematic review of current literature. Jurnal Gizi dan Dietetik Indonesia :vol 11, Issue 1:1-10

Iglesias J.L Benavides, Cedeno V.M Morales, Gonzalez Guerrero, Lopez Guzman. (2017). Labour trials in 300 patients with a previous cesarean section. Medicina Universitaria:77;166-169.https://doi.org/10.1016/j.rmu.2017.10.005

Kementerian Kelautan dan Perikanan. (2015). Statistik Kementerian Kelautan dan Perikanan

Rahmawaty Setyaningrum, Charlton Karen, Lyons-Wall Phillipa, Mayer J. Barbara. (2013). actors that influence consumption of fish and omega–3-enriched foods: A survey of Australian families with young children. Journal of Nutrition and Dietetics; Vol 7: issue 4:p 286-293. https://doi.org/10.1111/1747-0080.12022

Trumbo P, Schlicker S, Yates AA, Poos M. (2002). Food and Nutrition Board of the Institute of Medicine, The National Academies. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein and amino acids. Journal of the American Dietetic Association.;102(11):1621-30. doi: 10.1016/s0002-8223(02)90346-9

Siregar Mukhlidah & Koerniawati, Ratu. (2020). Analisis asupan omega-3 pada ibu hamil di wilayah puskesmas Cadasari, Padeglang. Jurnal Kesehatan. 6. 66-78. 10.47859/jmu.v6i02.210.

Siregar Mukhlidah Koerniawati R.D. (2021). Asupan omega-6 pada ibu hamil di wilayah Puskesmas Cadasari Padeglang. Jurnal Gizi dan Kesehatan vol 5, Issue 1 (1-9).

Cetin I, Carlson SE, Burden C, da Fonseca EB, di Renzo GC, Hadjipanayis A, Harris WS, Kumar KR, Olsen SF, Mader S, McAuliffe FM, Muhlhausler B, Oken E, Poon LC, Poston L, Ramakrishnan U, Roehr CC, Savona-Ventura C, Smuts CM, Sotiriadis A, Su KP, Tribe RM, Vannice G, Koletzko B. (2024). Omega-3 fatty acid supply in pregnancy for risk reduction of preterm and early preterm birth. American Journal of Obstetrics & Gynecology MFM;6(2):101251. doi: 10.1016/j.ajogmf.101251. PMID: 38070679.

Akerele, O.A., Cheema, S.K., (2016). A balance of omega-3 and omega-6 polyunsaturated fatty acids is important in pregnancy. Journal of Nutrition & Intermediary Metabolism 5, 23- 33.

Majkova, Z., Toborek, M., Hennig, B., (2010). The role of caveolae in endothelial cell dysfunction with a focus on nutrition and environmental toxicants. Journal of Cellular and Molecular Medicine 14(10), 2359-2370.

Elmes, M.J., Tan, D.S., Cheng, Z., Wathes, D.C., McMullen, S., (2011). The effects of a high- fat, high-cholesterol diet on markers of uterine contractility during parturition in the rat. Reproduction 141(2), 283-290.

Zuniga, J., Cancino, M., Medina, F., Varela, P., Vargas, R., Tapia, G., Videla, L.A., Fernandez, V.(2011). N-3 PUFA supplementation triggers PPAR-alpha activation and PPAR-alpha/NF- kappaB interaction: anti-inflammatory implications in liver ischemia-reperfusion injury. PLoS One 6(12), e28502.

Patterson, E., Wall, R., Fitzgerald, G.F., Ross, R.P., Stanton, C. (2012) Health implications of high dietary omega-6 polyunsaturated Fatty acids. Journal of Nutrition and Metabolisme doi: 10.1155/2012/539426. PMID: 22570770; PMCID: PMC3335257.

Lands B. (2015). Omega-3 PUFAs Lower the Propensity for Arachidonic Acid Cascade Overreactions. Biomed Research International Int.;2015:285135. doi: 10.1155/2015/285135. PMID: 26301244; PMCID: PMC4537720.

Serra, R.; Peñailillo, R.; Monteiro, L.J.; Monckeberg, M.; Peña, M.; Moyano, L.; Brunner, C.; Vega, G.; Choolani, M.; Illanes, S.E. (2021). Supplementation of Omega 3 during Pregnancy and the Risk of Preterm Birth: A Systematic Review and Meta-Analysis. Nutrients 13(5):1704. doi: 10.3390/nu13051704. PMID: 34069867; PMCID: PMC8157397.

Von Schacky C. (2022). Omega-3 Fatty Acids in Pregnancy—The Case for a Target Omega-3 Index. Nutrients ; 12(4):898. doi: 10.3390/nu12040898. PMID: 32224878; PMCID: PMC7230742.

Puebla, C., Retamal, M.A., Acuna, R., Saez, J.C. (2017). Regulation of Connexin-Based Channels by Fatty Acids. Front Physiol 8: 11. doi: 10.3389/fphys.2017.00011. PMID: 28174541; PMCID: PMC5258758.

Kirkup, S.E., Cheng, Z., Elmes, M., Wathes, D.C., Abayasekara, D.R. (2010). Polyunsaturated fatty acids modulate prostaglandin synthesis by ovine amnion cells in vitro. Reproduction Journal 140(6), 943-95. Doi : 10.1530/REP-09-0575

Elmes M, Green LR, Poore K, Newman J, Burrage D, Abayasekara DR, Cheng Z, Hanson MA, Wathes DC. (2004). Raised dietary n-6 polyunsaturated fatty acid intake increases 2-series prostaglandin production during labour in the ewes. J Physiol ;562(Pt 2):583-92. doi: 10.1113/jphysiol.2004.071969. PMID: 15513945; PMCID: PMC1665502

Amira, A.B.K., Zuki A. B. Z, Z., Goh, Y.M., Nordin M.M,Ebrahim M. (2010). Effects of varying levels of n-6:n-3 fatty acid ratio on plasma fatty acid composition and prostanoid synthesis in pregnant rats. African Journal of Biotechnology 9 (51), 8881-88

DOI: http://dx.doi.org/10.21927/ijnd.2024.12(4).242-251