Effect of DHA Supplementation During Pregnancy on Maternal Depression and Neurodevelopment of Young Children

Abstract

PIDEMIOLOGICAL INVESTIGAtions from the United States and Europe demonstrate that higher intakes of n-3 long-chain polyunsaturated fatty acids (LCPUFA) from fish and seafood during pregnancy are associated with a reduced risk of depressive symptoms in the postnatal period, 1 as well as improved developmental outcomes in the offspring. 2,3 Of the n-3 LCPUFA, it is hypothesized that docosahexaenoic acid (DHA) may be responsible for the observed associations based on estimates of dietary requirements during pregnancy and the results of experimental animal studies. 4 However, n-3 LCPUFA intervention trials in human pregnancy have reported mixed results and have not been conclusive largely because of methodological limitations. Studies focused on perinatal mood have had open-label designs, small sample sizes, or large attrition, and most did not analyze by intention-to-treat. 5 Similarly, trials focused on the developmental outcomes of the children have made post-See also p 1717 and Patient Page.

The Role of Nutrition in Children's Neurocognitive Development, From Pregnancy Through Childhood

“…Contrary to expectations, some studies did not find a relationship between LCPUFA supplementation during pregnancy and cognitive development in children (Tofail, 2006;Makrides et al, 2010;Campoy et al, 2011). One of these studies was conducted in a developing country, Bangladesh, where a high proportion of mothers suffer from undernutrition, and possibly from multiple micronutrient deficiencies important for brain development.…”

“…Makrides et al (2010) conducted a well-designed multicenter double-blind randomized controlled trial in Australia on 2399 women between 2005 and 2009 from 21 weeks of gestation until birth and did not find any difference on the Bayley Scales of Infant and Toddler Development at the age of 18 months between intervention (supplemented with 800 mg DHA) and control groups (supplemented with vegetable oil capsules), after adjustment for potential confounders. Given the size of this study, the Makrides et al (2010) investigation was certainly adequately powered to detect a statistically significant difference; yet, no such difference was observed.…”

“…The explanation offered was that the positive effect of prenatal supplementation may have been overshadowed by other important factors (not all of which it is possible to control for) including social stimulation, other nutrients taken, diet as a whole, illnesses, and drugs prescribed by the age of 6-7 years (Helland et al, 2008). Makrides et al (2010) conducted a well-designed multicenter double-blind randomized controlled trial in Australia on 2399 women between 2005 and 2009 from 21 weeks of gestation until birth and did not find any difference on the Bayley Scales of Infant and Toddler Development at the age of 18 months between intervention (supplemented with 800 mg DHA) and control groups (supplemented with vegetable oil capsules), after adjustment for potential confounders. Given the size of this study, the Makrides et al (2010) investigation was certainly adequately powered to detect a statistically significant difference; yet, no such difference was observed.…”

Maternal and fetal benefits of DHA supplementation during pregnancy

“…However, the DOMInO trial could not evidence a significant difference in the maternal postpartum depression rate between the supplemented and the non supplemented group [39].…”

Oxidative Stress and Antioxidants: Preterm Birth and Preterm Infants

“…In one study, five Australian maternity hospitals enrolled 2399 women <21 weeks' of gestation to determine if taking fish oil in the latter half of pregnancy reduced maternal depressive symptoms and improved developmental outcomes in the offspring. (Makrides, 2010) While there was no reduction of postpartum depression symptoms, the treated patients had a lower incidence of both preterm birth and low birth weight infants, which resulted in fewer admissions to the neonatal intensive care unit and a 67% reduction in infant death. (Makrides, 2009) In an accompanying editorial, Oken & Belfort, (2009), suggest supplementing 100-200mg of DHA in addition to diet, which seems to be appropriate.…”