II Consensus of the Brazilian Nutrology Association on DHA recommendations during pregnancy, lactation and childhood

Abstract

Objective: To update of the consensus of the Brazilian Association of Nutrology regarding DHA consumption and supplementation during pregnancy, lactation and childhood. Methods: Scientific articles published until 2022 were reviewed in Pubmed/Medline, SciELO and Lilacs databases. Results: Considering the information obtained, the authors drafted the consensus, which was approved by the Brazilian Association of Nutrology board. Conclusions: The recommendations of the Brazilian Nutrology Association are presented based on scientific evidence.

Maternal supplementation with docosahexaenoic acid does not cause constriction of fetal ductus arteriosus: randomized controlled trial

“…The metabolic prostaglandin cascade, starting with arachidonic acid, plays a fundamental role in ductal patency, and its inhibition may lead to ductal constriction and related consequences, as has been reported after maternal ingestion of non-steroidal anti-inflammatory drugs or polyphenol-rich foods [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] . The present study suggests that neither prostaglandin inhibition nor alteration in ductal flow occurs as a consequence of DHA administration at a clinically recommended dose 12 .…”

“…However, possible adverse effects of DHA on the fetal heart and circulation, as a result of its anti-inflammatory activity [13][14][15][16][17] , are unknown and the safety of its administration during pregnancy has not been established. The present study showed that DHA supplementation at a clinically recommended dose 12 did not influence ductus arteriosus dynamics or inhibit PGE2 metabolism. The change in maternal plasma PGE2 level between baseline and follow-up did not differ significantly between the DHA group and the placebo group, contrary to what would be expected if DHA exerted its anti-inflammatory effect on PGE2 metabolism at the dose utilized.…”

“…Consumption of omega-3, in the form of an oral DHA supplement, is recommended routinely in the third trimester of pregnancy, due to its beneficial effects on fetal development [1][2][3][4][5][6][7][8][9][10][11][12] . However, possible adverse effects of DHA on the fetal heart and circulation, as a result of its anti-inflammatory activity [13][14][15][16][17] , are unknown and the safety of its administration during pregnancy has not been established.…”

“…Many studies have demonstrated benefit to the fetus of docosahexaenoic acid (DHA) supplementation during the second and third trimesters of pregnancy, with regard to fetal neurodevelopment, cognition and vision [1][2][3][4][5][6][7][8][9][10][11][12] . DHA has potent anti-inflammatory properties [13][14][15][16][17] , but, since its effect on the fetal ductus arteriosus is unknown, the safety profile of DHA during pregnancy is yet to be established fully.…”