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

• Type of Material: Article
• Authors: Usha Ramakrishnan, Emory University; Amanda Stinger, University of Washington; Ann M. DiGirolamo, Georgia State University; Reynaldo Martorell, Emory University; Lynnette M. Neufeld, Global Alliance for Improved Nutrition (GAIN); Juan A. Rivera, Instituto Nacional de Salud Publica; Lourdes Schnaas, National Institute of Perinatology; Aryeh Stein, Emory University; Meng Wang, Family Health International 360
• Language: English
• Date: 2015-08-11
• Publisher: Public Library of Science
• Publication Version: Final Published Version
• Copyright Statement: © 2015 Ramakrishnan et al.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1371/journal.pone.0120065
• Title of Journal or Parent Work: PLoS ONE
• ISSN: 1932-6203
• Volume: 10
• Issue: 8
• Start Page: e0120065
• End Page: e0120065
• Grant/Funding Information: This study was supported by NIH (HD 043099) and the March of Dimes Foundation.
• Research Categories: Health Sciences, General; Health Sciences, Nutrition

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.