Prenatal Docosahexaenoic Acid Supplementation and Offspring Development at 18 Months: Randomized Controlled Trial

PLoS ONE
Q1
Aug 2015
Citations:35
Influential Citations:1
Interventional (Human) Studies
82
Low RoB
S2 IconPDF Icon

Enhanced Details

Methods
Design: randomized, double-blind, placebo-controlled trial. Participants: pregnant women aged 18–35 years in Cuernavaca, Mexico, at 18–22 weeks gestation; planned to deliver at IMSS General Hospital and to predominantly breastfeed for at least 3 months; Exclusions: high-risk pregnancy; lipid metabolism/absorption conditions; regular DHA or fish oil supplement use; chronic medications.
Intervention
Two capsules daily, each containing 200 mg DHA (total 400 mg/day), from 18–22 weeks gestation through delivery; algal-source DHA; taken together at the same time each day.
Results
Intention-to-treat analysis showed no significant differences between DHA and placebo for BSID-II MDI, PDI, or BRS at 18 months. MDI: 14.4% below 85% in DHA vs 10.1% in placebo; PDI: 17.9% vs 20.2%; BRS: 0.6% vs 0%. Post-hoc analysis revealed a significant interaction between HOME score at 12 months and DHA on PDI, suggesting DHA may attenuate the positive association between home environment quality and PDI in some children; this finding is exploratory and requires confirmation. Overall, prenatal DHA supplementation did not show a significant global improvement in infant development at 18 months; potential subgroup benefits in less stimulating home environments warrant further study.
Limitations
Limitations include loss to follow-up during the postnatal period (~15–16%), which may reduce power and affect generalizability; BSID-II may not detect subtle cognitive differences or long-term effects; post-hoc analyses are exploratory; measurement variability across testers and one psychologist's data led to exclusion in sensitivity analyses; results are from a population with very low baseline DHA intake, which may limit generalizability to other settings.

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 ...