Meta-analysis of Long-Chain Polyunsaturated Fatty Acid Supplementation of Formula and Infant Cognition

Pediatrics
Q1
Jun 2012
Citations:119
Influential Citations:2
Systematic Reviews / Meta-Analyses
80
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Enhanced Details

Methods
Design: randomized controlled trials (many double-blind, placebo-controlled). Participants: 1802 infants (term and preterm) fed formula; supplementation started within 1 month after birth; cognitive outcomes assessed with Bayley Scales of Infant Development (BSID) at around 8–16 months.
Intervention
Formula supplemented with long-chain polyunsaturated fatty acids (LCPUFAs) including DHA and often AA; start within days to 1 month after birth; duration typically 4–14 months; doses varied across trials; some regimens used DHA alone, others DHA+AA.
Results
LCPUFA supplementation of formula did not significantly improve cognitive development at ~12 months (BSID total score difference from meta-analysis: WMD 0.75; 95% CI -0.48 to 1.98; P=0.23). No significant dose–response or prematurity effects. Conclusion: No clear early cognitive benefit from LCPUFA-enriched formula; potential later cognitive or other neurodevelopmental effects remain uncertain and require further study.
Limitations
Use of different Bayley Scales versions across trials; Bayley may miss subtle cognitive differences; wide variation in LCPUFA formulations and doses; some trials had dropout or allocation concealment issues; inverse-variance weighting may overweight term infants; findings pertain to early cognition (~1 year) and not longer-term outcomes.

Abstract

BACKGROUND AND OBJECTIVE: Infant formula is supplemented with long-chain polyunsaturated fatty acids (LCPUFAs) because they are hypothesized to improve cognition. Several randomized controlled clinical trials have examined the effect of LCPUFA supple...