Effect of fatty acid status in cord blood serum on children's behavioral difficulties at 10 y of age: results from the LISAplus Study

Kohlboeck, Gabriele; Glaser, Claudia; Tiesler, Carla M. T.; Demmelmair, Hans; Standl, Marie; Romanos, Marcel; Koletzko, Berthold; Lehmann, Irina; Heinrich, Joachim

doi:10.3945/ajcn.111.015800

Cited by 54 publications

(37 citation statements)

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“…Our results are generally not in line with those from Kohlboeck et al (11), who found higher levels of AA in cord blood to be associated with fewer emotional problems at the age of 10 y based on parent report using the Strength and Difficulties Questionnaire. Whether statistically significant or not, all associations of maternal AA with child problem behavior in our study suggest effect estimates in the opposite direction, as do results from other studies (9,10,12).…”

Section: Discussioncontrasting

confidence: 99%

“…Several maternal and child characteristics were considered as possible confounding variables, based on previous studies of perinatal LC-PUFA status and child emotional and behavioral development (9)(10)(11)(12). These were: family income, maternal educational level, prepregnancy BMI, age at enrollment, smoking and alcohol consumption during pregnancy, national origin, general psychiatric symptoms in mid-pregnancy (highest prevalence for anxious and depressive symptoms), parity, and marital status.…”

Section: Covariatesmentioning

confidence: 99%

“…In humans, there is some indication that perinatal LC-PUFA status (either measured in cord blood or maternal blood during gestation) is associated with child behavior. However, results are inconsistent, ranging from null findings to associations with both emotional and behavioral problems (9)(10)(11)(12). Most studies were small and probably underpowered to detect subtle effects of nutrition, as expected in a multicausal phenomenon such as development of the brain and behavior.…”

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Maternal LC-PUFA status during pregnancy and child problem behavior: the Generation R Study

et al. 2014

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Background: Omega 3 (n-3) and 6 (n-6) long-chain polyunsaturated fatty acids (LC-PUFAs) and the n-3:n-6 ratio are important for brain development. Whether maternal LC-PUFA status during pregnancy affects risk of problem behavior in later childhood is unclear. Methods: Within a population-based cohort, we measured maternal plasma docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), and arachidonic acid (AA) concentrations and n-3:n-6-ratio in mid-pregnancy. Child emotional and behavioral problems at 6 y of age were assessed by parents (child behavior checklist), teachers (teacher report form), and combined parent/teacher report. results: Higher maternal DHA and n-3:n-6 ratio were associated with fewer child emotional problems using parent (odds ratio (OR) DHA = 0.82; 95% confidence interval (CI): 0.70, 0.96; P = 0.02 and OR n-3:n-6 = 0.83; 95% CI: 0.71, 0.96; P = 0.01; n = 5,307) and combined parent/teacher scores (OR DHA = 0.79; 95% CI: 0.66, 0.95; P = 0.01 and OR n-3:n-6 = 0.77; 95% CI: 0.65, 0.92; P < 0.01; n = 2,828). Higher AA was associated with more child behavioral problems using teacher (OR = 1.10; 95% CI: 1.00, 1.20; P = 0.04; n = 3,365) and combined parent/teacher scores (OR = 1.12; 95% CI: 1.02, 1.22; P = 0.02; n = 2,827). Maternal EPA was not associated with child problem behavior. conclusion: Indications of associations of maternal LC-PUFA status with child emotional and behavioral problems were found. Future research is needed to identify LC-PUFAsensitive periods of fetal brain development by including multiple assessments of prenatal LC-PUFA status. t wo families of polyunsaturated fatty acids (PUFAs), the omega 3 (n-3) and 6 (n-6) fatty acids (FAs), are nutrients that play a major role in brain development and functioning. They affect numerous processes, including membrane fluidity, neurotransmission, and gene expression (1). The long-chain PUFAs (LC-PUFAs), eicosapentaenoic acid (EPA; C20:5n-3), docosahexaenoic acid (DHA; C22:6n-3), and arachidonic acid (AA; C20:4n-6) are the main FAs that are metabolically active.In addition, the ratio between n-3 and n-6 FAs is important for optimal brain functioning. During the last century, however, the Western diet has provided a lower n-3 and higher n-6 intake than that in previous generations, diminishing the n-3:n-6 ratio (2).Because of their role in brain function and development, maternal LC-PUFAs during fetal development have been hypothesized to affect child problem behavior. Approximately half of the dry weight of the brain is lipid, of which 35% are PUFA, most of which is LC-PUFA (1). Increase in AA and DHA content of brain tissue starts during the third trimester of pregnancy (3), indicating that the fetal period possibly is a sensitive period. Moreover, the fetus mostly depends on maternal LC-PUFA supply for its development, because fetal LC-PUFA synthesis is limited (4).Research in this field is however scarce, and results are conflicting. Two studies on maternal fish intake, a major source of DHA, during pregnancy and offspring problem beha...

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Section: Discussioncontrasting

confidence: 99%

Section: Covariatesmentioning

confidence: 99%

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confidence: 99%

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Maternal LC-PUFA status during pregnancy and child problem behavior: the Generation R Study

et al. 2014

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“…-2.0 points (95% CI -3.5 to -0.6; p = 0.007; increase in R 2 = 0.27%), and low levels of DHA (22:6n-3) with a reduction of full scale IQ of -1.5 points (95% CI -2.9 to -0.1; p = 0.031; R 2 = 0.15%). Kohlboeck et al [38] reported a longitudinal cohort study with analysis of venous cord blood glycerophospholipid fatty acids at birth and behavior at age 10 years in 416 children in Munich, Germany. A 1% increase in DHA in cord blood serum decreased total behavioral difficulties by (exp)β adj = 0.93 (SE 0.02; p = 0.0001) and hyperactivity or inattentiveness by (exp)β adj = 0.94 (SE 0.03; p = 0.04).…”

Section: Resultsmentioning

confidence: 99%

Current Information and Asian Perspectives on Long-Chain Polyunsaturated Fatty Acids in Pregnancy, Lactation, and Infancy: Systematic Review and Practice Recommendations from an Early Nutrition Academy Workshop

et al. 2014

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The Early Nutrition Academy supported a systematic review of human studies on the roles of pre- and postnatal long-chain polyunsaturated fatty acids (LC-PUFA) published from 2008 to 2013 and an expert workshop that reviewed the information and developed recommendations, considering particularly Asian populations. An increased supply of n-3 LC-PUFA during pregnancy reduces the risk of preterm birth before 34 weeks of gestation. Pregnant women should achieve an additional supply ≥200 mg docosahexaenic acid (DHA)/day, usually achieving a total intake ≥300 mg DHA/day. Higher intakes (600-800 mg DHA/day) may provide greater protection against early preterm birth. Some studies indicate beneficial effects of pre- and postnatal DHA supply on child neurodevelopment and allergy risk. Breast-feeding is the best choice for infants. Breast-feeding women should get ≥200 mg DHA/day to achieve a human milk DHA content of ∼0.3% fatty acids. Infant formula for term infants should contain DHA and arachidonic acid (AA) to provide 100 mg DHA/day and 140 mg AA/day. A supply of 100 mg DHA/day should continue during the second half of infancy. We do not provide quantitative advice on AA levels in follow-on formula fed after the introduction of complimentary feeding due to a lack of sufficient data and considerable variation in the AA amounts provided by complimentary foods. Reasonable intakes for very-low-birth weight infants are 18-60 mg/kg/day DHA and 18-45 mg/kg/day AA, while higher intakes (55-60 mg/kg/day DHA, ∼1% fatty acids; 35-45 mg/kg/day AA, ∼0.6-0.75%) appear preferable. Research on the requirements and effects of LC-PUFA during pregnancy, lactation, and early childhood should continue.

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“…In another observational study, a test of the association between levels of fatty acids in cord blood and maternal report of behavioral and emotional problems in children at 10 years of age revealed significant negative associations; higher levels of fatty acids were associated with lower levels of behavior problems. 57 The results of studies evaluating offspring neurodevelopment have been mixed among the few doubleblind, randomized, controlled studies of DHA supplementation during pregnancy in humans. Helland et al 58 assigned 341 women to receive either 10 mL/day of cod liver oil (1,183 mg DHA) or corn oil beginning at gestational week18 and continuing through postpartum month 3.…”

Section: Evidence For An Association Between Docosahexaenoic Acid Levmentioning

confidence: 99%

Modulation of prenatal stress via docosahexaenoic acid supplementation: implications for child mental health

Keenan

Hipwell

2015

Nutrition Reviews

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Effect of fatty acid status in cord blood serum on children's behavioral difficulties at 10 y of age: results from the LISAplus Study

Cited by 54 publications

References 50 publications

Maternal LC-PUFA status during pregnancy and child problem behavior: the Generation R Study

Maternal LC-PUFA status during pregnancy and child problem behavior: the Generation R Study

Current Information and Asian Perspectives on Long-Chain Polyunsaturated Fatty Acids in Pregnancy, Lactation, and Infancy: Systematic Review and Practice Recommendations from an Early Nutrition Academy Workshop

Modulation of prenatal stress via docosahexaenoic acid supplementation: implications for child mental health

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