Prenatal Docosahexaenoic Acid Supplementation and Offspring Development at 18 Months: Randomized Controlled Trial
What this study found
Prenatal DHA did not improve overall infant development at 18 months. On the Bayley Scales of Infant Development-II, the Mental Development Index was 94.3 (10.7) with DHA versus 95.2 (9.3) with placebo, with an adjusted difference of -1.00 (-2.42, 0.42); the Psychomotor Development Index was 93.0 (8.9) versus 93.3 (9.8), adjusted difference -0.46 (-1.80, 0.88). Behavior Rating Scale scores were essentially identical (111.5 vs 111.5; adjusted difference -0.01 [-0.95, 0.93]). Post-hoc analyses suggested possible benefit in less responsive or less stimulating home environments, but the primary…
- Study & population
- Randomized controlled trial in pregnant women receiving routine prenatal care in Cuernavaca, Mexico, with very low dietary intake of preformed DHA.
- Intervention
- Pregnant participants in the active arm received oral algal docosahexaenoic acid (DHA) at a dose of 2 capsules containing 200 mg each daily, taken together once per day.
- Key limitation
- The primary findings were null, and the subgroup signals were post-hoc and therefore hypothesis-generating only.
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Open PDFOriginal abstract
Objective We evaluated the effects of prenatal docosahexaenoic acid (DHA) supplementation on offspring development at 18 months of age. Design Randomized placebo double-blind controlled trial. Settings Cuernavaca, Mexico. Participants and Methods We followed up offspring (n = 730; 75% of the birth cohort) of women in Mexico who participated in a trial of DHA supplementation during the latter half of pregnancy. We assessed the effect of the intervention on child development and the potential modifying effects of gravidity, gender, SES, and quality of the home environment. Interventions or Main Exposures 400 mg/day of algal DHA. Outcome Measures Child development at 18 months of age measured using the Spanish version of the Bayley Scales of Infant Development-II. We calculated standardized psychomotor and mental development indices, and behavior rating scale scores. Results Intent-to-treat differences (DHA-control) were: Psychomotor Developmental Index -0.90 (95% CI: -2.35, 0.56), Mental Developmental Index -0.26 (95% CI: -1.63, 1.10) and Behavior Rating Scale -0.01 (95% CI: -0.95, 0.94). Prenatal DHA intake attenuated the positive association between home environment and psychomotor development index observed in the control group (p for interaction = 0.03) suggesting potential benefits for children living in home environments characterized by reduced caregiver interactions and opportunities for early childhood stimulation. Conclusions Prenatal DHA supplementation in a population with low intakes of DHA had no effects on offspring development at 18 months of age although there may be some benefit for infants from poor quality home environments. Trial Registration Clinicaltrials.gov NCT00646360