Omega-3 Fatty Acid Deficiency in Infants before Birth Identified Using a Randomized Trial of Maternal DHA Supplementation in Pregnancy

PLoS ONE
Q1
Jan 2014
Citations:73
Influential Citations:7
Interventional (Human) Studies
82
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Methods
Double-blind, single-center randomized trial in Vancouver, Canada (enrolled 2004–2008). Pregnant women not taking lipid or fatty acid supplements; singleton, term gestation pregnancies; N=270 randomized to DHA supplementation or placebo from 16 weeks gestation to delivery; follow-up through 18 months with infant developmental assessments.
Intervention
400 mg/day DHA from 16 weeks gestation to delivery; DHA supplied as algal oil triglycerides; taken orally in capsules.
Results
DHA supplementation reduced risk of infants failing to achieve high language development scores through 18 months. At 14 months, placebo group had higher odds of not achieving top quartile for words understood (OR 3.22) and words produced (OR 2.61). At 18 months, higher odds for words understood (OR 2.77) and sentences produced (OR 2.60); BSID-III receptive language at 18 months (OR 2.23) and expressive language (OR 1.89); visual acuity at 2 months (OR 2.69). No significant differences in cognitive, fine motor, or gross motor outcomes at 18 months. Conclusion: Prenatal DHA supplementation reduces risk of language-development deficits in term infants; no group-level cognitive or motor benefits observed; results support the idea that fetal DHA insufficiency exists in some populations and can be mitigated by maternal DHA intake.
Limitations
High breastfeeding rates may mask greater constraints on CNS development; postnatal compensation or other nutrient deficits could dampen effects; arbitrary definition of top-quartile cutoffs; possible unmeasured home-environment differences; single-center design; limited generalizability; wide interindividual variability in maternal DHA response with RBC DHA overlap between groups at 36 weeks; dropout and incomplete follow-ups.

Abstract

Background DHA is accumulated in the central nervous system (CNS) before birth and is involved in early developmental processes, such as neurite outgrowth and gene expression. Objective To determine whether fetal DHA insufficiency occurs and constrai...