Omega-3 Fatty Acid Dietary Supplements Consumed During Pregnancy and Lactation and Child Neurodevelopment: A Systematic Review

Abstract

Background Maternal nutrition during pregnancy and lactation has profound effects on the development and lifelong health of the child. Long-chain PUFAs are particularly important for myelination and the development of vision during the perinatal period. Objectives We conducted a systematic review to examine the relationship between supplementation with omega-3 fatty acids during pregnancy and/or lactation and neurodevelopment in children, to inform the Scientific Report of the 2020 Dietary Guidelines Advisory Committee. Methods We identified articles on omega-3 fatty acid supplementation in pregnant and lactating women that included measures of neurodevelopment in their children (0–18 y) by searching PubMed, CENTRAL, Embase, and CINAHL Plus. After dual screening articles for inclusion, we qualitatively synthesized and graded the strength of evidence using pre-established criteria for assessing risk of bias, consistency, directness, precision, and generalizability. Results We included 33 articles from 15 randomized controlled trials (RCTs) and 1 prospective cohort study. Of the 8 RCTs that delivered omega-3 fatty acid dietary supplements during pregnancy alone (200–2200 mg/d DHA and 0–1100 mg/d EPA for approximately 20 wk), 5 studies reported ≥1 finding that supplementation improved measures of cognitive development in the infant or child by 6%–11% (P < 0.05), but all 8 studies also reported ≥1 nonsignificant (P > 0.05) result. There was inconsistent or insufficient evidence for other outcomes (language, social-emotional, physical, motor, or visual development; academic performance; risks of attention deficit disorder, attention-deficit/hyperactivity disorder, autism spectrum disorder, anxiety, or depression) and for supplementation during lactation or both pregnancy and lactation. Populations with a lower socioeconomic status and adolescents were underrepresented and studies lacked racial and ethnic diversity. Conclusions Limited evidence suggests that omega-3 fatty acid supplementation during pregnancy may result in favorable cognitive development in the child. There was insufficient evidence to evaluate the effects of omega-3 fatty acid supplementation during pregnancy and/or lactation on other developmental outcomes.

Fat Intake and Fat Quality in Pregnant and Lactating Women, Infants, Children, and Adolescents and Related Health Outcomes: A Scoping Review of Systematic Reviews of Prospective Studies

“…High certainty evidence showed a 12% reduction of preterm birth (risk ratio 0.88, 95% confidence interval: 0.81-0.95) and a 35% reduction of early preterm birth (risk ratio 0.65, 95% confidence interval: 0.46-0.92). Moreover, in line with our findings, evidence on maternal omega-3 PUFA supplementation on child cognitive performance/neurodevelopment remained inconclusive [46,47]. Finally, maternal omega-3 PUFA supplementation during pregnancy had no overall beneficial effect on the risk of eczema and asthma/wheeze in offspring [48,49]; however, some specific effects in subgroups were suggested.…”

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

“…Future studies in this field should address such deficiencies. According to Nevins et al [143], limited evidence suggests that omega-3 fatty acid supplementation during pregnancy may result in favorable cognitive development in the child and, according to Carlson et al [111] a 600 mg DHA per day supplement in the last half of pregnancy resulted in longer overall gestations durations and increased baby size. A reduction in preterm infants and very low birth weight may be important clinical and public health outcomes od DHA supplementation.…”

Something Smells Fishy: How Lipid Mediators Impact the Maternal–Fetal Interface and Neonatal Development

“…N-3 and n-6 FAs are incorporated into the phospholipid bilayer and released from the membrane to influence downstream pathways (Figure 1) [6]. N-3 FAs have known important roles during pregnancy, including in eye and brain development [7,8], whereas excess n-6 FAs demonstrate some detrimental effects [9,10]. The essential FAs that must be obtained from the diet are linoleic acid (LA) and alpha-linolenic acid (ALA).…”