Omega-3 Fatty Acid Deficiency in Infants before Birth Identified Using a Randomized Trial of Maternal DHA Supplementation in Pregnancy

Abstract

BackgroundDHA is accumulated in the central nervous system (CNS) before birth and is involved in early developmental processes, such as neurite outgrowth and gene expression.ObjectiveTo determine whether fetal DHA insufficiency occurs and constrains CNS development in term gestation infants.DesignA risk reduction model using a randomized prospective study of term gestation single birth healthy infants born to women (n = 270) given a placebo or 400 mg/day DHA from 16 wk gestation to delivery. Fetal DHA deficiency sufficient to constrain CNS development was assessed based on increased risk that infants in the placebo group would not achieve neurodevelopment scores in the top quartile of all infants in the study.ResultsInfants in the placebo group were at increased risk of lower language development assessed as words understood (OR 3.22, CL 1.49–6.94, P = 0.002) and produced (OR 2.61, CL 1.22–5.58, P = 0.01) at 14 mo, and words understood (OR 2.77, CL 1.23–6.28, P = 0.03) and sentences produced (OR 2.60, CL 1.15–5.89, P = 0.02) at 18 mo using the McArthur Communicative Developmental Inventory; receptive (OR 2.23, CL 1.08–4.60, P = 0.02) and expressive language (OR 1.89, CL 0.94–3.83, P = 0.05) at 18 mo using the Bayley Scales of Infant Development III; and visual acuity (OR 2.69, CL 1.10–6.54, P = 0.03) at 2 mo.Trial RegistrationClinicalTrials.gov NCT00620672

Omega-3 Long Chain Polyunsaturated Fatty Acids to Prevent Preterm Birth

“…[4][5][6][7][8][9][10][11][12][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] No similar systematic reviews were found during the search process. Twenty RCTs were excluded for various reasons.…”

Breastmilk from obese mothers has pro-inflammatory properties and decreased neuroprotective factors

“…39 DHA insufficiency in pregnancy has been associated with higher risk of delayed language development in one study, although other studies have had mixed findings. 40 Lutein preferentially accumulates in the neural retina and brain, which undergo rapid maturation and development in the first 6 to 12 months of life. Lower levels of lutein in Ob BM may be due to accumulation of carotenoids in adipose tissues, which may impede transport into BM.…”

Impact of maternal dietary lipids on human health

“…However, no PUFA maternal dietary intakes were assessed before DHA supplementation, women who consumed non-adequate intakes of n-3 PUFA not being distinguished from women consuming adequate intakes. In other series of observational and clinical studies conducted in Canada (Innis and Elias, 2003;Innis and Friesen, 2008;Mulder et al, 2014), daily usual intakes of individual n-6 and n-3 PUFA were quantified in pregnant women and then validated by the measurement of PUFA levels in plasma phospholipids (Innis and Elias, 2003). During the last trimester of pregnancy, 40% were considered as DHA-deficient since they consumed a quantity of DHA lower than the total amount deposited in the fetus during this period (Innis and Friesen, 2008).…”

“…Moreover, the DHA deficiency was amplified in some pregnant women because their ALA dietary intake was low and associated with a high LA/ALA ratio unfavorable for the DHA synthesis. Clinical data showed an increased risk of lower visual acuity in 2-months-old infants and of lower language development in 18-months-old infants whose mothers consumed these unbalanced diets, in comparison to infants whose mothers have received a DHA supplementation (400 mg/d) until delivery (Innis and Friesen, 2008;Mulder et al, 2014). As regards to the period of lactation, several observational studies have reported positive associations between visual and cognitive development in term gestation breastfed infants and DHA amounts in their red blood cell and in mothers' milk (reviewed by Innis, 2014).…”