# Investigating N-3 Fatty Acids to prevent Neonatal Tobacco-related outcomeS (INFANTS)

> **NIH NIH R01** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2020 · $721,667

## Abstract

Project Summary
Smoking is the most important modifiable risk factor for adverse pregnancy outcomes including preterm birth,
neonatal death, and maternal complications. Smoking rates in pregnancy remain unacceptably high. Rates of
smoking cessation during pregnancy are low, particularly in underserved populations, and currently approved
pharmacotherapies for smoking cessation either are considered unsafe in pregnancy or have uncertain
effectiveness. Identifying safe and effective interventions, which might mitigate the adverse effects of smoking
on maternal-fetal outcomes, is a major public health priority. Our group has found that smokers, both pregnant
and non-pregnant, have a relative deficiency in n-3 long-chain polyunsaturated fatty acids (LCPUFAs). We
hypothesize that smoking-induced n-3 LCPUFA relative deficiencies may be an important mechanism
contributing to tobacco-related adverse pregnancy outcomes and that n-3 LCPUFA supplementation
specifically targeted to pregnant smokers may reduce these complications. Support for this hypothesis
comes from a recent secondary analysis of the Omega-3 Fatty Acids Supplementation to Prevent Preterm
Birth trial that found that only smokers taking n-3 LCPUFAs had a reduction in preterm labor risk as compared
to non-smokers. While compelling, this study was a post hoc analysis that included only a small sample of
smokers and did not collect data on smoking behaviors during follow up. Yet the ascertainment of longitudinal
smoking behavior is critical, as some clinical studies have found that supplemental n-3 LCPUFAs might also
reduce nicotine cravings, and lower daily cigarette use. Thus, smokers may doubly benefit from replenishing n-
3 LCPUFAs via lower risk of preterm labor and/or increased smoking cessation. To address these knowledge
gaps, we are proposing a multi-center, randomized, placebo-controlled, double-blinded study of n-3 LCPUFA
supplementation in 400 pregnant smokers. We will collect detailed information on smoking behavior, validated
biological markers of cigarette exposure (urinary cotinine, end-expiratory carbon monoxide) and biomarkers of
n-3 LCPUFA status (red blood cell phospholipid membrane fatty acids). Our specific aims of this proposal are
to 1) determine the effect of supplemental n-3 LCPUFAs on gestational age at delivery and preterm labor in
pregnant smokers and 2) determine the effect of n-3 LCPUFA supplementation on tobacco use in pregnant
smokers. Through our recently completed pilot study, we have optimized our recruitment and retention
strategies and determined the tolerability of our intervention. Our research team includes experienced
researchers with prior successes in recruiting pregnant women for clinical studies and performing
interventional studies for smoking cessation. We will recruit potential participants from eight obstetrics clinics
across the Middle-Tennessee area. This will be the first study of supplemental n-3 LCPUFAs conducted
exclusively in pregnant smok...

## Key facts

- **NIH application ID:** 10017308
- **Project number:** 5R01HD098719-02
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** Harvey J. Murff
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $721,667
- **Award type:** 5
- **Project period:** 2019-09-13 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10017308

## Citation

> US National Institutes of Health, RePORTER application 10017308, Investigating N-3 Fatty Acids to prevent Neonatal Tobacco-related outcomeS (INFANTS) (5R01HD098719-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10017308. Licensed CC0.

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