Prenatal Maternal Docosahexaenoic Acid (DHA) Supplementation and Newborn Anthropometry in India: Findings from DHANI

• Type of Material: Article
• Authors: Shweta Khandelwal, Public Health Foundation of India; Dimple Kondal, Emory University; Monica Chaudhry, Public Health Foundation of India; Kamal Patil, KAHER’s J. N. Medical College; Mallaiah Kenchaveeraiah Swamy, KAHER’s J. N. Medical College; Gangubai Pujeri, KAHER’s J. N. Medical College; Swati Babu Mane, KAHER’s J. N. Medical College; Yashaswi Kudachi, KAHER’s J. N. Medical College; Ruby Gupta, Public Health Foundation of India; Usha Ramakrishnan, Emory University; Aryeh Stein, Emory University; Dorairaj Prabhakaran, Emory University; Nikhil Tandon, All India Institute of Medical Sciences
• Language: English
• Date: 2021-02-26
• Publisher: MDPI AG
• Publication Version: Final Published Version
• Copyright Statement: © 2021 by the authors.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.3390/nu13030730
• Title of Journal or Parent Work: Nutrients
• Volume: 13
• Issue: 3
• Grant/Funding Information: The trial was funded by India Alliance IA/CPHE/14/1/501498. The DST Young Scientist Award (SR/FT/LS-156/2011) also provided partial funding for setting up a part of the cohort. The supplements were donated by DSM Nutritional Products via their Mumbai office.
• Keywords: head circumference; anthropometry; birth weight; maternal supplementation; docosahexaenoic acid (DHA); long chain omega-3 fatty acids; pregnancy outcomes; birth length
• Research Categories: Chemistry, Pharmaceutical; Health Sciences, Nutrition

Abstract

Long-chain omega-3 fatty acid status during pregnancy may influence newborn anthropometry and duration of gestation. Evidence from high-quality trials from low- and middle-income countries (LMICs) is limited. We conducted a double-blind, randomized, placebo-controlled trial among 957 pregnant women (singleton gestation, 14–20 weeks’ gestation at enrollment) in India to test the effectiveness of 400 mg/day algal docosahexaenoic acid (DHA) compared to placebo provided from enrollment through delivery. Among 3379 women who were screened, 1171 were found eligible; 957 were enrolled and were randomized. The intervention was two microencapsulated algal DHA (200 × 2 = 400 mg/day) or two microencapsulated soy and corn oil placebo tablets to be consumed daily from enrollment (≤20 weeks) through delivery. The primary outcome was newborn anthropometry (birth weight, length, head circumference). Secondary outcomes were gestational age and 1 and 5 min Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score. The groups (DHA; n = 478 and placebo; n = 479) were well balanced at baseline. There were 902 live births. Compliance with the intervention was similar across groups (DHA: 88.5%; placebo: 87.1%). There were no significant differences between DHA and placebo groups for birth weight (2750.6 ± 421.5 vs. 2768.2 ± 436.6 g, p = 0.54), length (47.3 ± 2.0 vs. 47.5 ± 2.0 cm, p = 0.13), or head circumference (33.7 ± 1.4 vs. 33.8 ± 1.4 cm, p = 0.15). The mean gestational age at delivery was similar between groups (DHA: 38.8 ± 1.7 placebo: 38.8 ± 1.7 wk, p = 0.54) as were APGAR scores at 1 and 5 min. Supplementing mothers through pregnancy with 400 mg/day DHA did not impact the offspring‘s birthweight, length, or head circumference.