Effect of DHA supplementation during pregnancy on maternal depression and neurodevelopment of young children: a randomized controlled trial. A possible preventive effect of low-dose fish oil on early delivery and pre-eclampsia: indications from a 50-year-old controlled trial. High-DHA eggs: Feasibility as a means to enhance circulating DHA in mother and infant Effects of third trimester consumption of eggs high in docosahexaenoic acid on docosahexaenoic acid status and pregnancy Omega-3 Fatty Acid Deficiency in Infants before Birth Identified Using a Randomized Trial of Maternal DHA Supplementation in Pregnancy A randomized controlled trial of the effect of fish oil supplementation in late pregnancy and early lactation on the n−3 fatty acid content in human breast milk Effect of alpha-linolenic acid supplementation during pregnancy on maternal and neonatal polyunsaturated fatty acid status and pregnancy outcome. Similar effects on infants of n-3 and n-6 fatty acids supplementation to pregnant and lactating women. A Randomized Trial of Docosahexaenoic Acid Supplementation During the Third Trimester of Pregnancy Fish oil in various doses or flax oil in pregnancy and timing of spontaneous delivery: a randomised controlled trial. Scotopic electroretinogram in term infants born of mothers supplemented with docosahexaenoic acid during pregnancy. Prevention of Preeclampsia by Linoleic Acid and Calcium Supplementation: A Randomized Controlled Trial Maternal docosahexaenoic acid supplementation and fetal accretion. Supplementation of fish-oil and soy-oil during pregnancy and psychomotor development of infants. Essential fatty acid status in neonates after fish-oil supplementation during late pregnancy. Supplementation with docosahexaenoic acid in the last trimester of pregnancy: maternal-fetal biochemical findings. Effects of a combination of evening primrose oil (gamma linolenic acid) and fish oil (eicosapentaenoic + docahexaenoic acid) versus magnesium, and versus placebo in preventing pre-eclampsia. The effects of 3g eicosapentaenoic acid daily on recurrence of intrauterine growth retardation and pregnancy induced hypertension Randomized controlled trial of maternal omega-3 long-chain PUFA supplementation during pregnancy and early childhood development of attention, working memory, and inhibitory control. Omega-3 Fatty Acid Supplementation to Prevent Recurrent Preterm Birth: A Randomized Controlled Trial Effect of N-3 polyunsaturated fatty acid supplementation in pregnancy: the Nuheal trial. Long-term effects of LCPUFA supplementation on childhood cognitive outcomes. Randomised controlled trial of effect of fish-oil supplementation on pregnancy duration Randomised clinical trials of fish oil supplementation in high risk pregnancies Prenatal DHA status and neurological outcome in children at age 5.5 years are positively associated. Maternal DHA and the development of attention in infancy and toddlerhood.
CONTEXT Uncertainty about the benefits of dietary docosahexaenoic acid ( DHA ) for pregnant women and their children exists , despite international recommendations that pregnant women increase their DHA intakes . OBJECTIVE To determine whether increasing DHA during the last half of pregnancy will result in fewer women with high levels of depressive symptoms and enhance the neurodevelopmental outcome of their children . DESIGN , SETTING , AND PARTICIPANTS A double-blind , multicenter , r and omized controlled trial ( DHA to Optimize Mother Infant Outcome [ DOMInO ] trial ) in 5 Australian maternity hospitals of 2399 women who were less than 21 weeks ' gestation with singleton pregnancies and who were recruited between October 31 , 2005 , and January 11 , 2008 . Follow-up of children ( n = 726 ) was completed December 16 , 2009 . INTERVENTION Docosahexaenoic acid-rich fish oil capsules ( providing 800 mg/d of DHA ) or matched vegetable oil capsules without DHA from study entry to birth . MAIN OUTCOME MEASURES High levels of depressive symptoms in mothers as indicated by a score of more than 12 on the Edinburgh Postnatal Depression Scale at 6 weeks or 6 months postpartum . Cognitive and language development in children as assessed by the Bayley Scales of Infant and Toddler Development , Third Edition , at 18 months . RESULTS Of 2399 women enrolled , 96.7 % completed the trial . The percentage of women with high levels of depressive symptoms during the first 6 months postpartum did not differ between the DHA and control groups ( 9.67 % vs 11.19 % ; adjusted relative risk , 0.85 ; 95 % confidence interval [ CI ] , 0.70 - 1.02 ; P = .09 ) . Mean cognitive composite scores ( adjusted mean difference , 0.01 ; 95 % CI , -1.36 to 1.37 ; P = .99 ) and mean language composite scores ( adjusted mean difference , -1.42 ; 95 % CI , -3.07 to 0.22 ; P = .09 ) of children in the DHA group did not differ from children in the control group . CONCLUSION The use of DHA-rich fish oil capsules compared with vegetable oil capsules during pregnancy did not result in lower levels of postpartum depression in mothers or improved cognitive and language development in their offspring during early childhood . TRIAL REGISTRATION anzctr.org.au Identifier : ACTRN12605000569606 A preventive effect of dietary marine n-3 fatty acids on  early delivery  and toxaemia has recently been hypothesized . In only one published controlled trial fish oil has been given to pregnant women , namely in that conducted during 1938 - 9 in London by the People 's League of Health with a dietary supplement containing vitamins , minerals , and halibut liver oil . Although it was of high quality and its findings are hitherto unexplained , neglect and misinterpretation of the trial seem to occur commonly in review s. Of the 5644 women who were enrolled the 622 withdrawals were independent of treatment . Alternate allocation to treatment was used , producing two groups that were well balanced as to age and parity . The supplement was given from about week 20 . The control group did not receive any supplement . Reductions of 20.4 % ( 95 % confidence interval 9 - 30 % , P = 0.00083 ) and 31.5 % ( 95 % confidence interval 11 - 47 % , P = 0.0047 ) were seen in odds of delivering before 40 weeks of gestation and pre-eclampsia respectively . No significant effects were seen on perinatal mortality , average birth weight , deliveries after 40 weeks , hypertension in the absence of oedema and proteinuria , duration of labour , sepsis or breast-feeding occurrence . Later controlled trials with vitamins or minerals given in the same amounts as in this trial have largely failed to show convincing effects as seen here . A controlled trial assessing the isolated effects of fish oil in pregnancy is warranted Dietary DHA enhances infant  attention and visual development . Because the DHA content of red blood cells and plasma lipids varies approximately threefold in pregnancy , maternal DHA status may influence subsequent infant function . It would be feasible to study the effects of higher maternal  DHA intake on infant development if dietary intake of DHA could be increased by a reliable means . This study was design ed to determine whether women provided with one dozen high-DHA hen eggs ( 135 mg DHA/egg ) would consume the eggs and have higher blood DHA levels than women consuming ordinary eggs  ( 18 mg DHA/egg ) . The study was a r and omized , double-masked comparison of the effect of eggs with different concentrations of DHA on intake and blood lipid DHA content of women and their infants . A third nonr and omized group ate few eggs . In this study , DHA intake reported from eggs was eightfold higher in the high-DHA egg group compared to the ordinary egg group . Including all groups , DHA intake ranged from 0 to 284 mg/d . In this intake range , maternal blood lipid DHA content at enrollment best predicted DHA content at delivery , accounting for 36.5 and 51.7 % of the variance in ordinary and high-DHA egg intake groups , respectively . The high-DHA vs. ordinary egg groups had similar maternal and cord blood lipid DHA , but there was a positive relationship between maternal plasma phospholipid DHA and daily DHA intake from eggs controlled for study duration ( r=0.278 , P=0.048 ) . DHA intake and birth weight were also correlated ( r=0.299 , P=0.041 ) . High-DHA eggs were well accepted and increased DHA intake . Other benefits of DHA intake during pregnancy were also suggested Summary High-DHA eggs appear to be a practical way to increase maternal DHA status . The data suggest that high-DHA eggs could decrease the incidence of preterm and low-birth-weight births , and this could be tested in a study with more statistical power . The neurodevelopment of infants from women fed low- and high-DHA eggs  could also provide helpful information Background DHA is accumulated in the central nervous system ( CNS ) before birth and is involved in early developmental processes , such as neurite outgrowth and gene expression . Objective To determine whether fetal DHA insufficiency occurs and constrains CNS development in term gestation infants . Design A risk reduction model using a r and omized prospect i ve 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 . Results Infants 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 Registration Clinical Trials.gov The aim of this research was to investigate the effect of fish oil supplementation , in the third trimester of pregnancy and early lactation period of healthy pregnant Danish women . Forty-four pregnant women were r and omly allocated to fish oil supplementation ( 1.3 g EPA and 0.9 g DHA per day ) from week 30 of gestation ( FO-group ) or to a control regimen ( olive oil or no oil ; controls ) . The FO-group was r and omly subdivided into women stopping fish oil supplementation at delivery [ FO(pregn ) ] , and women continuing supplementation for an , additional 30 d [ FO(pregn/lact ) ] . Thirty-six women agreed to collect milk sample s at days 4 , 16 , and 30 postpartum . The FA composition of the milk sample s was determined by GLC . At days 4 , 16 , and 30 in lactation , FO(pregn/lact ) women ( n=12 ) had , respectively 2.3 ( P=0.001 ) , 4.1 ( P=0.001 ) , and 3.3 ( P=0.001 ) times higher mean contents of LCPUFA(n−3 ) in their breast milk compared with controls ( n=13 ) , and 1.7 ( P=0.005 ) , 2.8 ( P=0.001 ) , and 2.8 ( P=0.001 ) , times higher LCPUFA(n−3 ) contents , respectively , at these days compared with FO(pregn ) women ( n=11 ) . The latter group did not differ significantly from controls with regard to LCPUFA(n−3 ) content in the breast milk . Similar results were obtained when analyzing separately for effects on the milk content of DHA . Dietary supplementation with 2.7 g LCPUFA(n−3 ) per day from week 30 of gestation and onward more than tripled the LCPUFA(n−3 ) content in early breast milk ; supplementation limited to pregnancy only was much less effective BACKGROUND Maternal essential fatty acid status declines during pregnancy , and as a result , neonatal concentrations of docosahexaenoic acid ( DHA , 22:6n-3 ) and arachidonic acid ( AA , 20:4n-6 ) may not be optimal . OBJECTIVE Our objective was to improve maternal and neonatal fatty acid status by supplementing pregnant women with a combination of alpha-linolenic acid ( ALA , 18:3n-3 ) and linoleic acid ( LA , 18:2n-6 ) , the ultimate dietary precursors of DHA and AA , respectively . DESIGN From week 14 of gestation until delivery , pregnant women consumed daily 25 g margarine supplying either 2.8 g ALA + 9.0 g LA ( n = 29 ) or 10.9 g LA ( n = 29 ) . Venous blood was collected for plasma phospholipid fatty acid analyses at weeks 14 , 26 , and 36 of pregnancy , at delivery , and at 32 wk postpartum . Umbilical cord blood and vascular tissue sample s were collected to study neonatal fatty acid status also . Pregnancy outcome variables were assessed . RESULTS ALA+LA supplementation did not prevent decreases in maternal DHA and AA concentrations during pregnancy and , compared with LA supplementation , did not increase maternal and neonatal DHA concentrations but significantly increased eicosapentaenoic acid ( 20:5n-3 ) and docosapentaenoic acid ( 22:5n-3 ) concentrations . In addition , ALA+LA supplementation  lowered neonatal AA status . No significant differences in pregnancy outcome variables were found . CONCLUSIONS Maternal ALA+LA supplementation did not promote neonatal DHA+AA status . The lower concentrations of Osbond acid ( 22:5n-6 ) in maternal plasma phospholipids and umbilical arterial wall phospholipids with ALA+LA supplementation than with LA supplementation suggest only that functional DHA status improves with ALA+LA supplementation OBJECTIVE There have been indications that high intake of n-3 long-chain polyunsaturated fatty acids ( PUFAs ) during pregnancy may increase birth weight and gestational length . In addition , n-3 long-chain PUFAs may be important for the neurobiological development of the infants . High levels of docosahexaenoic acid ( DHA , 22:6 n-3 ) are found in the gray matter of the cerebral cortex and in the retina , and it seems as if the availability of long-chain PUFAs may be limiting cerebral development . The fetus and the newborn are dependent on a high supply from their mothers , either via the placenta or via breast milk . We supplemented pregnant and lactating women with n-3 or n-6 long-chain PUFAs to evaluate the effect on birth weight , gestational length , and infant development . DESIGN We performed a double-blind , r and omized study recruiting 590 pregnant , healthy , nulli- or primiparous women ( 19 - 35 years old ) in weeks 17 to 19 of pregnancy . The women were provided 10 mL of either cod liver oil or corn oil daily until 3 months after delivery . MAIN OUTCOME MEASURES Primary outcomes were gestational length and birth weight . Electroencephalography ( EEG ) was done on the second day of life and at 3 months of age . Novelty preference ( Fagan test ) was used as an indicator of cognitive function at 6 and 9 months of age . The fatty acid pattern in umbilical plasma phospholipids and in breast milk was measured , and dietary assessment s were performed , both on the mothers during pregnancy and on the infants at 3 months of age . The growth of the infants was followed up to 1 year of age . RESULTS Three hundred forty-one mothers took part in the study until delivery . There were no significant differences in maternal body mass index before pregnancy and at birth , or parity between the 2 groups . Smoking habits and parental education were also similar in the 2 groups . The mean age of the mothers receiving cod liver oil was , by chance , 1 year higher than the age of the mothers receiving corn oil ( 28.6 [ 3.4 ] vs 27.6 [ 3.2 ] years ) . The maternal dietary intake in the 2 groups receiving cod liver oil or corn oil was similar , except for the supplementation . There were no differences in gestational length or birth weight between the cod liver oil group and the corn oil group ( 279.6 [ 9.2 ] vs 279.2 [ 9.3 ] days ; 3609 [ 493 ] vs 3618 [ 527 ] g , respectively ) . Birth length , head circumference , and placental weight were also similar in the 2 groups . The concentrations of the n-3 fatty acids eicosapentaenoic acid ( 20:5 n-3 ) , docosapentaenoic acid ( 22:5 n-3 ) , and DHA in umbilical plasma phospholipids were higher in the cod liver oil group compared with the corn oil group ( 10.8 [ 7.6 ] vs 2.5 [ 1.8 ] microg/mL , 5.0 [ 2.6 ] vs 2.9 [ 1.3 ] microg/mL , 55.8 [ 20.6 ] vs 45.3 [ 12.8 ] microg/mL , respectively ) . Neonates with high concentration of DHA in umbilical plasma phospholipids ( upper quartile ) had longer gestational length than neonates with low concentration ( lower quartile ; 282.5 [ 8.5 ] vs 275.4 [ 9.3 ] days ) . No differences in EEG scores or Fagan scores were found , but neonates with mature EEG ( N = 70 ) had a higher concentration of DHA in umbilical plasma phospholipids than neonates with immature EEG ( N = 51 ) on the second day of life . Dietary information from 251 infants at 3 months of age was collected and 85 % of these infants were exclusively breastfed , in addition to 12 % who were partly breastfed . The breast milk of mothers supplemented with cod liver oil contained more n-3 long-chain PUFAs and less n-6 long-chain PUFAs than breast milk of mothers supplemented with corn oil . There were no significant differences in infant growth during the first year of life between the 2 groups . CONCLUSIONS This study shows neither harmful nor beneficial effects of maternal supplementation of long-chain n-3 PUFAs regarding pregnancy outcome , cognitive development , or growth , as compared with supplementation with n-6 fatty acids . However , it confirms that DHA concentration may be related to gestational length and cerebral maturation of the newborn OBJECTIVE To hypothesize that higher intake of docosahexaenoic acid , an n-3 long chain polyunsaturated fatty acid , would increase duration of gestation and birth weight in US women . METHODS This was a r and omized , double-blind , controlled , clinical trial . Subjects were enrolled in an ambulatory clinic where they received prenatal care . This was a population -based sample . Most subjects received government assistance for  medical care and most were black ( 73 % ) . Subjects were enrolled between the 24th and 28th week of pregnancy and consumed docosahexaenoic acid ( 33 or 133 mg ) from eggs until parturition . Gestational age and birth weight were the main study outcomes . Infant length and head circumference , preterm birth , and low birth weight were secondary outcomes . RESULTS Eighty-three percent of subjects completed the study ( 291 of 350 enrolled ) . No subject was discontinued for an adverse event . After controlling for important predefined risk factors and confounding variables , gestation increased by 6.0 ± 2.3 days ( P = .009 ) in the higher docosahexaenoic acid group . Birth weight , length , and head circumference increased , but did not reach statistical significance ( P = .06–.18 ) , although the increases could be clinical ly important indications of enhanced intrauterine growth . No safety concerns were raised by the study . CONCLUSION Duration of gestation increased significantly when docosahexaenoic acid intake was increased during the last trimester of pregnancy . The increase in gestation was similar to that reported for interventions with much larger amounts of n-3 long chain polyunsaturated fatty OBJECTIVES To test the earlier suggested hypothesis that intake of long-chain n-3 fatty acids from fish oil may delay the timing of spontaneous delivery and to test if alpha-linolenic acid , provided as flax oil capsules , shows the same effect . DESIGN R and omised controlled trial including women reporting low dietary fish intake . The women were allocated in the proportions of 1:1:1:1:1:1:2 into six treatment groups and a control group , respectively , from week 17 - 27 of gestation . The treatment groups received fish oil , in various doses , or flax oil , and the control group did not receive any treatment . SETTING The Danish National Birth Cohort . SAMPLE A total of 3098 women allocated into six treatment groups and one control group . METHODS The six intervention groups were offered fish oil capsules in doses of 0.1 , 0.3 , 0.7 , 1.4 and 2.8 g of eicosapentaenoic acid and docosahexaenoic acid per day or 2.2 g of alpha-linolenic acid ( ALA ) per day from week 17 - 27 of gestation until delivery . MAIN OUTCOME MEASURES Timing of spontaneous delivery . RESULTS No differences in timing of spontaneous delivery was detected in the fish oil groups or the flax oil group , compared with the control group . The difference in timing of spontaneous delivery in the group receiving the highest fish oil dose compared with the control group was 0.8 days ( 95 % CI : -2.3 to 1.0 ) . Only a minority of the women in the intervention groups took capsules until delivery . CONCLUSION Possible explanations for these findings include no true effect of n-3 fatty acids on spontaneous delivery or a quick-acting effect not detectable in this trial PURPOSE To test the hypothesis that the supplementation of the diets of pregnant women with a fish oil rich in docosahexaenoic acid ( DHA ) enhances retinal development in their healthy term infants , as measured during the early postnatal period by the electroretinogram ( ERG ) . METHODS One hundred pregnant women were r and omized to receive either a fish oil ( n = 50 ) or a placebo oleic acid dietary supplement ( n = 50 ) from 15 weeks of pregnancy until delivery . Total fatty acids in red blood cells ( RBCs ) and plasma were measured in mothers at 15 and 28 weeks of pregnancy and at delivery and in their infants in umbilical cord blood . Infant retinal development was assessed within the first week of life with full-field ERGs that included a scotopic blue intensity series ( n = 41 ) and a bright white flash ( 2.0 log cd-s/m(2 ) ; n = 44 ) . RESULTS Infants born of mothers who received supplements did not differ at birth in weight , gestational age , or any other st and ard variable . Infant DHA status at birth , as measured from umbilical cord blood , did not differ significantly between maternal supplementation groups . ERG implicit times , amplitudes , and parameters of the stimulus-response function did not differ significantly between infants in the maternal supplemented and placebo groups . There was , however , a relationship between infant DHA status and maturity of the retina at birth , regardless of maternal supplementation group . A measure of retinal sensitivity ( log sigma ) correlated significantly ( P < 0.005 ) with DHA status ( as a percentage of total fatty acid ; TFA ) in infant cord blood . Infants in the highest quartile for cord blood DHA had higher retinal sensitivity compared with infants in the lowest quartile . Infants in the highest quartile for plasma DHA , both as a percentage of TFA and concentration , were born at a significantly later gestational age than were infants in the lower quartiles . CONCLUSIONS These findings demonstrate an association between the DHA status of term infants and retinal sensitivity , suggesting an essential role of this long-chain polyunsaturated fatty acid ( LCPUFA ) in the development and function of the retina . However , maternal DHA status was not significantly associated with infant retinal sensitivity and no direct effect of maternal supplementation was observed Objective To determine the effect of low doses of linoleic acid and calcium on prostagl and in ( PG ) levels and the efficacy of this treatment in the prevention of preeclampsia . Methods In a r and omized , double-blind , placebo-controlled study we treated 86 primigravidas with risk factors for preeclampsia ( high biopsychosocial risk [ above 3 points ] , positive roll-over test , and high mean blood pressure [ above 85 mmHg ) ] with daily doses of either 450 mg linoleic acid and 600 mg calcium ( n = 43 ) or 450 mg starch and 600 mg lactose placebo ( n = 43 ) during the third trimester of pregnancy . Results Four women in the experimental group ( 9.3 % ) developed preeclampsia compared with 16 ( 37.2 % ) controls ( relative risk 0.25 , 95 % confidence interval 0.09 , 0.69 , P < .001 ) . The median serum levels of PGE2 after 4 weeks of treatment increased by 106 % in the experimental group ( P = .03 ) and decreased by 33 % in the control group ( P = .02 ) . The median ratio between thromboxane B2 and PGE2 decreased by 40 % in the experimental group ( P = .02 ) and increased by 18 % in the control group ( P = .14 ) . No significant differences were observed in the median ratio between thromboxane B2 and 6-keto PGF1α in either group . No serious maternal or neonatal side effects of treatment occurred in either group . Conclusion The administration of low daily doses of linoleic acid and calcium during the third trimester of pregnancy reduced the incidence of preeclampsia significantly in women at high risk , possibly by correcting the PGE2 levels Docosahexaenoic acid ( DHA ) ( 22 : 6n-3 ) is a polyunsaturated fatty acid that is an essential constituent of membranes , particularly of the nervous system . Infants acquire DHA from their mothers , either prenatally via the placenta or postnatally in milk . The present study aim ed to test the hypothesis that maternal supplementation during the second and third trimesters of pregnancy enriches maternal and /or fetal DHA status . In a r and omised , prospect i ve , double-blind study 100 mothers received either fish-oil capsules containing 400 mg DHA/g ( 200 mg/d ) ( n 50 ) , or placebo containing 810 mg oleic acid/g ( 400 mg/d ) ( n 50 ) from 15 weeks gestation until term . Venous blood sample s were obtained from mothers at 15 , 28 and 40 weeks , and from the umbilical cord at birth .  Total fatty acids in plasma and erythrocytes were analysed by GC-MS . There were no significant differences between maternal groups in baseline DHA , as a proportion of total fatty acids ( g/100 g total fatty acids ) or concentration ( nmol/ml ) , in plasma and erythrocytes . DHA concentrations in plasma at 28 weeks ( P=0.02 ) and erythrocytes at both 28 weeks ( P=0.03 ) and term ( P=0.02 ) were 20 % higher in supplemented mothers than the placebo group . DHA accounted for a higher proportion of total fatty acids in erythrocytes of supplemented mothers at 28 weeks ( P=0.003 ) and term ( P=0.01 ) . There were no significant differences between groups in DHA ( g/100 g total fatty acids or nmol/l ) in cord blood . Maternal DHA status was maximal in mid-trimester and declined to term , at a lower rate in supplemented compared with unsupplemented mothers . Maternal DHA supplementation significantly increases maternal DHA status and limits the last trimester decline in maternal status , aiding preferential transfer of DHA from mother to fetus Supplementation of docosahexaenoic acid ( DHA ) in infancy improves neuro-developmental outcomes , but there is limited information about the impact of supplementing pregnant mothers with DHA on the development of their infants . In a follow-up of a r and omized , double-blind controlled trial with 400 pregnant mothers , the effects of supplementation of fish-oil or soy-oil ( 4 g/day ) during the last trimester of pregnancy on psychomotor development and behaviour of infants at 10 months of age ( n=249 ) were assessed . The quality of psychosocial stimulation at home ( HOME ) and nutritional status of the subjects were also measured . There were no significant differences in the fish-oil group and soy-oil group in any of the developmental ( mean + /-SD mental development index : 102.5 + /- 8.0 vs. 101.5 + /- 7.8 , psychomotor development index : 101.7 + /- 10.0 vs. 100.5 + /- 10.1 ) or behavioural outcomes . It may , therefore , be concluded that supplementation of fish-oil during the last trimester of pregnancy does not have any added benefit over supplementation of soy-oil on the development or behaviour of infants in this population Healthy pregnant women ( n 23 ) were supplemented with fish-oil capsules ( 2.7 g n-3 polyunsaturated fatty acids/d ) from the 30th week of gestation until delivery . Subjects in a control group were either supplemented with olive-oil capsules ( 4 g/d , n 6 ) or received no supplementation ( n 10 ) . Fatty acid compositions of the phospholipids isolated from umbilical plasma and umbilical arterial and venous vessel walls were determined . Fatty acid compositions of maternal venous plasma phospholipids were determined as well . Maternal plasma phospholipids of the fish-oil-supplemented group contained more n-3 fatty acids and less n-6 fatty acids . Moreover , the amounts of the essential fatty acid deficiency markers Mead acid ( 20:3n-9 ) and Osbond acid ( 22:5n-6 ) were significantly lower . The extra amount of n-3 fatty acids consumed by the mothers result ed in higher contents of n-3 fatty acids , and of docosahexaenoic acid ( 22:6n-3 ) in particular , in the phospholipids of umbilical plasma and vessel walls . It is , indeed , possible to interfere with the docosahexaenoic acid status at birth : children born to mothers supplemented with fish oil in the last trimester of pregnancy start with a better docosahexaenoic acid status at birth , which may be beneficial to neonatal neurodevelopment The nutritional significance of long-chain polyunsaturated fatty acids ( LCPS ) during the perinatal period is becoming increasingly important . There are currently very few studies on dietary intervention during gestation . The aim of the study was to analyze the effect of docosahexaenoic acid ( DHA ) supplementation during pregnancy on levels in both the newborn and the mother . A r and omized placebo controlled study was carried out on 20 pregnant women in study group receiving 200 mg/day of docosahexaenoic acid-(DHA ) during the last trimester of pregnancy . Results in both groups ( A supplemented , B non-supplemented ) highlighted a decrease in plasma arachidonic acid ( 5.99 + /- 0.91 vs. 4.51 + /- 0.71 p<0.001 for group A and 5.84 + /- 0.71 vs. 4.80 + /- 0.51 p<0.01 for group B ) in the baseline-final intra-group comparison . The intergroup comparison revealed a significant difference in plasma DHA at delivery : it was found to be higher in the population of supplemented pregnant women ( 3.17 + /- 0.26 vs. 2.77 + /- 0.31 ) . The neonate population displayed no significant differences between the two groups . The results show that LCPS are consumed during the final stages of pregnancy and that oral supplementation with 200 mg/day of DHA is reflected in an increase in the plasma level of this fatty acid in the mother . One could speculate that there would be a corresponding increase in DHA bioavailability for the fetus In a placebo controlled , partially double-blinded , clinical trial , a combination of evening primrose oil and fish oil was compared to Magnesium Oxide , and to a Placebo in preventing  Pre-Eclampsia of Pregnancy .  All were given as nutritional supplements for six months to a group of primiparous and multiparous pregnant women . Some of these women had personal or family histories of hypertension ( 21 % ) . Only those patients who received prenatal care at the Central Maternity Hospital for Lu and a were included in the study . Compared to the Placebo group ( 29 % ) , the group receiving the mixture of evening primrose oil and fish oil containing Gamma-linolenic acid ( GLA ) , Eicosapentaenoic acid ( EPA ) , and Docosahexaenoic acid ( DHA ) had a significantly lower incidence of edema ( 13 % , p = 0.004 ) . The group receiving Magnesium Oxide had statistically significant fewer subjects who developed  hypertension of pregnancy . There were 3 cases of eclampsia , all in the Placebo group Objective To study the effects of addition of 3 g eicosapentaenoic acid daily to the diet , on recurrence rate of intrauterine growth retardation and pregnancy induced hypertension in a high risk population BACKGROUND Docosahexaenoic acid ( DHA ) accumulates in the hippocampus and frontal lobes of the fetal brain during the last trimester of pregnancy . These areas of the brain contribute to attention and working memory and inhibitory control ( WMIC ) . OBJECTIVE We evaluated the effect of maternal omega-3 ( n-3 ) long-chain polyunsaturated fatty acid supplementation in pregnancy on child attention and WMIC . DESIGN A total of 185 term-born children of mothers who were r and omly allocated to consume 800 mg DHA/d ( treatment ) or a placebo ( control )  from ∼20 wk of gestation until birth were assessed with multiple measures of attention and WMIC at a mean ( ± SD ) of 27 ± 2 mo . Primary outcomes were the average time it took to be distracted when playing with a toy ( distractibility ) and the accuracy of remembering a new hiding location while inhibiting a learned response to search in the previous location ( WMIC ) . RESULTS Assessment s were completed by 81 children in the treatment group ( mean ± SD age : 835 ± 50.4 d ) and 77 children in the control group ( 839 ± 65.6 d ) . There was no effect of supplementation on primary outcomes [ distractibility mean difference : -0.2 s ( 95 % CI : -0.7 , 0.4 s ) ; WMIC mean difference : 8.9 mm ( 95 % CI : -10.6 , 28.3 mm ) ] . There was no difference between DHA-supplemented and control groups except that treatment-group children looked away from the toys fewer times than controls when presented with multiple toys competing for attention but less accurately remembered a repeated hiding location . These secondary effects were not consistent with any other outcomes and may have been a result of chance . Cord plasma DHA was not consistently associated with attention and WMIC . CONCLUSION Maternal DHA supplementation during pregnancy does not enhance attention or WMIC in term-born preschoolers . The DHA for Maternal and Infant Outcomes trial was registered at www.anzctr.org.au as ACTRN1260500056906 OBJECTIVE : To assess whether the addition of an omega-3 long-chain polyunsaturated fatty acid supplement would reduce preterm birth in women with at least one prior spontaneous preterm birth receiving 17&agr;-hydroxyprogesterone caproate .  METHODS : We conducted a r and omized , double-masked , placebo-controlled trial in 13 centers . Women with a history of prior spontaneous singleton preterm birth and a current singleton gestation were assigned to either a daily omega-3 supplement ( 1,200 mg eicosapentaenoic acid and 800 mg docosahexaenoic acid ) or matching placebo from 16 - 22 through 36 weeks of gestation . All participants received weekly intramuscular 17&agr;-hydroxyprogesterone caproate ( 250 mg ) . The primary study outcome was delivery before 37 weeks of gestation . A sample size of 800 was necessary to have 80 % power to detect a 30 % reduction in the primary outcome from 30 % , assuming a type I error two-sided of 5 % . RESULTS : A total of 852 women were included , and none was lost to follow up . Delivery before 37 weeks of gestation occurred in 37.8 % ( 164/434 ) of women in the omega-3 group and 41.6 % ( 174/418 ) in the placebo group ( relative risk 0.91 , 95 % confidence interval 0.77 - 1.07 ) . CONCLUSION : Omega-3 long-chain polyunsaturated fatty acid supplementation offered no benefit in reducing preterm birth among women receiving 17&agr;-hydroxyprogesterone caproate who have a history of preterm delivery . CLINICAL TRIAL REGISTRATION : Clinical Trials.gov , www . clinical trials.gov , NCT00135902 . LEVEL OF EVIDENCE : In this placebo controlled , r and omised , double blind trial , pregnant women received from the 20th week of gestation onwards either 500 mg docosahexaenoic acid ( DHA ) , 400 mg 5-methyl-tetra-hydro-folate ( 5-MTHF ) , or placebo , or a combination of 500 mg DHA and 400 mg 5-MTHF . The dietary supplements were well tolerated ; the dropout rates did not differ significantly in the active arms of the study ( 10 % to 19 % ) from that seen in the placebo group ( 13 % ) . DHA supplementation result ed in significant enhancement of the contribution of DHA to maternal , placental and venous cord blood lipids BACKGROUND The effect of long-chain polyunsaturated fatty acid ( LCPUFA ) intake on cognitive development is controversial . Most r and omized trials have assessed cognition at 18 mo , although significant development of cognitive abilities ( early executive function ) emerge later . OBJECTIVE The objective was to evaluate cognition beyond 18 mo and longitudinal cognitive change from 18 mo to 6 y in children who were fed variable amounts of docosahexaenoic acid ( 0.32 % , 0.64 % , and 0.96 % of total fatty acids ) and arachidonic acid ( ARA ; 0.64 % ) compared with children who were not fed LCPUFA as infants . DESIGN Eighty-one children ( 19 placebo , 62 LCPUFA ) who participated in a double-blind , r and omized trial of LCPUFA supplementation as infants were re-enrolled at 18 mo and tested every 6 mo until 6 y on age-appropriate st and ardized and specific cognitive tests . RESULTS LCPUFA supplementation did not influence performance on st and ardized tests of language and performance at 18 mo ; however , significant positive effects were observed from 3 to 5 y on rule-learning and inhibition tasks , the Peabody Picture Vocabulary Test at 5 y , and the Weschler Primary Preschool Scales of Intelligence at 6 y. Effects of LCPUFAs were not found on tasks of spatial memory , simple inhibition , or advanced problem solving . CONCLUSIONS The data from this relatively small trial suggest that , although the effects of LCPUFAs may not always be evident on st and ardized developmental tasks at 18 mo , significant effects may emerge later on more specific or fine-grained tasks . The results imply that studies of nutrition and cognitive development should be powered to continue through early childhood . This parent trial was registered at clinical trials.gov as NCT00266825 The high birthweights and long duration of pregnancy  in the Faroe Isl and s led us to suggest that a high intake of marine-fat-derived n-3 fatty acids might prolong pregnancy by shifting the balance of production of prostagl and ins involved in parturition . We have compared the effects on pregnancy duration , birthweight , and birth length of a fish-oil supplement , a control olive-oil supplement , and no supplementation .  533 healthy Danish women in week 30 of pregnancy were r and omly assigned in a ratio of 2/1/1 to fish oil ( four 1 g Pikasol capsules [ containing 2.7 g n-3 fatty acids ] per day ) , olive oil ( four 1 g capsules per day ) , or no supplement . The three groups differed in mean length of gestation ( p = 0.006 ) , which was highest in the fish-oil group and lowest in the olive-oil group ; the result was similar when the analysis was restricted to women with an estimate of gestation length based on early ultrasound findings ( 443 women ) .  Pregnancies in the fish-oil group were on average 4.0 ( 95 % confidence interval 1.5 - 6.4 ) days longer than those in the olive-oil group ; the difference in birthweight was 107 ( 1 - 214 ) g. The effect of  supplementation  on length of gestation was influenced by intake of fish and of fish oil : the difference between fish-oil and other groups was increased by a low fish intake at baseline . Fish-oil supplementation in the third trimester seems to prolong pregnancy without detrimental effects on the growth of the fetus or on the course of labour Objective To test the postulated preventive effects of dietary n‐3 fatty acids on pre‐term delivery , intrauterine growth retardation , and pregnancy induced hypertension Beneficial effects of perinatal DHA supply on later neurological development have been reported . We assessed the effects of maternal DHA supplementation on the neurological development of their children . Healthy pregnant women from Spain , Germany , and Hungary were r and omly assigned to a dietary supplement consisting of either fish oil ( FO ) ( 500 mg/d DHA + 150 mg/d EPA ) , 400 μg/d 5-methyltetrahydrofolate , both , or placebo from wk 20 of gestation until delivery . Fatty acids in plasma and erythrocyte phospholipids ( PL ) were determined in maternal blood at gestational wk 20 and 30 and in cord and maternal blood at delivery . Neurological development was assessed with the Hempel examination at the age of 4 y and the Touwen examination at 5.5 y. Minor neurological dysfunction , neurological optimality score ( NOS ) , and fluency score did not differ between groups at either age , but the odds of children with the maximal NOS score increased with every unit increment in cord blood DHA level at delivery in plasma PL ( 95 % CI : 1.094 - 2.262 ) , erythrocyte phosphatidylethanolamine ( 95 % CI : 1.091 - 2.417 ) , and erythrocyte phosphatidylcholine ( 95 % CI : 1.003 - 2.643 ) . We conclude that  higher DHA levels in cord blood may be related to a better neurological outcome at 5.5 y of age Infants were followed longitudinally to document the relationship between docosahexaenoic acid ( DHA ) levels and the development of attention . Erythrocyte ( red-blood cell ; RBC ) phospholipid DHA ( percentage of total fatty acids ) was measured from infants and mothers at delivery . Infants were assessed in infant-control habituation at 4 , 6 , and 8 months augmented with psychophysiological measures , and on free-play attention and distractibility paradigms at 12 and 18 months . Infants whose mothers had high DHA at birth showed an accelerated decline in looking over the 1st year and increases in examining during single-object exploration and less distractibility in the 2nd year . These findings are consistent with evidence suggesting a link between DHA and cognitive development in infancy
OBJECTIVE : To evaluate the efficacy of omega-3 in reducing the incidence of preterm birth .