Effect of dietary intervention to reduce the n-6/n-3 fatty acid ratio on maternal and fetal fatty acid profile and its relation to offspring growth and body composition at 1 year of age Effect of two doses of docosahexaenoic acid (DHA) in the diet of preterm infants on infant fatty acid status: results from the DINO trial. Effects of n-3 polyunsaturated fatty acid supplementation in pregnancy on maternal and fetal erythrocyte fatty acid composition Effect of DHA supplementation during pregnancy on maternal depression and neurodevelopment of young children: a randomized controlled trial. Maternal supplementation with very-long-chain n-3 fatty acids during pregnancy and lactation augments children's IQ at 4 years of age. The effect of supplementation with fish oil during pregnancy on breast milk immunoglobulin A, soluble CD14, cytokine levels and fatty acid composition Fatty acid composition in maternal milk and plasma during supplementation with cod liver oil Prenatal determinants of cord blood total immunoglobulin E levels in Mexican newborns Increased intake of oily fish in pregnancy: effects on neonatal immune responses and on clinical outcomes in infants at 6 mo. Allergic disease in infants up to 2 years of age in relation to plasma omega-3 fatty acids and maternal fish oil supplementation in pregnancy and lactation. The Effects of Fish Oil Supplementation in Pregnancy on Breast Milk Fatty Acid Composition Over the Course of Lactation: A Randomized Controlled Trial The effect of docosahexaenoic acid and folic acid supplementation on placental apoptosis and proliferation. Fish oil intake compared with olive oil intake in late pregnancy and asthma in the offspring: 16 y of registry-based follow-up from a randomized controlled trial. Maternal fish oil supplementation in lactation: Effect on visual acuity and n−3 fatty acid content of infant erythrocytes Fish oil supplementation of lactating mothers affects cytokine production in 2 1/2-year-old children Fish Oil Supplementation During Late Pregnancy Does Not Influence Plasma Lipids or Lipoprotein Levels in Young Adult Offspring A Docosahexaenoic Acid-Functional Food During Pregnancy Benefits Infant Visual Acuity at Four but not Six Months of Age 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 Fish Oil Supplementation During Lactation: Effects on Cognition and Behavior at 7 Years of Age Higher dose of docosahexaenoic acid in the neonatal period improves visual acuity of preterm infants: results of a randomized controlled trial. A randomized trial of supplementation with docosahexaenoic acid-rich tuna oil and its effects on the human milk cytokines interleukin 1 beta, interleukin 6, and tumor necrosis factor alpha. Effects of fish-oil and folate supplementation of pregnant women on maternal and fetal plasma concentrations of docosahexaenoic acid and eicosapentaenoic acid: a European randomized multicenter trial. Diet and blood pressure in 2.5-y-old Danish children. Maternal fish oil supplementation during lactation does not affect blood pressure, pulse wave velocity, or heart rate variability in 2.5-y-old children. Maternal diet during pregnancy in relation to eczema and allergic sensitization in the offspring at 2 y of age. Essential n-3 fatty acids in pregnant women and early visual acuity maturation in term infants. Similar effects on infants of n-3 and n-6 fatty acids supplementation to pregnant and lactating women. Maternal Fish Oil Supplementation in Lactation and Growth during the First 2.5 Years of Life Effects of fish oil supplementation on the fatty acid profile in erythrocyte membrane and plasma phospholipids of pregnant women and their offspring: a randomised controlled trial. Maternal fish oil supplementation in lactation: effect on developmental outcome in breast-fed infants. Pre- and post-term growth in pre-term infants supplemented with higher-dose DHA: a randomised controlled trial. Consumption of fish, butter and margarine during pregnancy and development of allergic sensitizations in the offspring: role of maternal atopy. Effects of fish oil supplementation in the third trimester of pregnancy on prostacyclin and thromboxane production. DHA Supplementation during Pregnancy and Lactation Affects Infants' Cellular but Not Humoral Immune Response Maternal supplementation with docosahexaenoic acid during pregnancy does not affect early visual development in the infant: a randomized controlled trial. Ratio of Omega‐6 to Omega‐3 Fatty Acids and Childhood Asthma Effect of reducing the n-6:n-3 long-chain PUFA ratio during pregnancy and lactation on infant adipose tissue growth within the first year of life: an open-label randomized controlled trial. High-Dose Docosahexaenoic Acid Supplementation of Preterm Infants: Respiratory and Allergy Outcomes Cognitive assessment of children at age 2½ years after maternal fish oil supplementation in pregnancy: a randomised controlled trial Dietary supplementation with polyunsaturated fatty acid during pregnancy modulates DNA methylation at IGF2/H19 imprinted genes and growth of infants. Salmon consumption by pregnant women reduces ex vivo umbilical cord endothelial cell activation. Maternal fish oil supplementation during lactation may adversely affect long-term blood pressure, energy intake, and physical activity of 7-year-old boys. Effect of salmon consumption during pregnancy on maternal and infant faecal microbiota, secretory IgA and calprotectin. Essential fatty acid status in neonates after fish-oil supplementation during late pregnancy. Intake of fish oil during pregnancy and adiposity in 19-y-old offspring: follow-up on a randomized controlled trial. Maternal mood scores in mid-pregnancy are related to aspects of neonatal immune function DHA supplementation and pregnancy outcomes. Th1 and Th2 Chemokines, Vaccine-Induced Immunity, and Allergic Disease in Infants After Maternal ω-3 Fatty Acid Supplementation During Pregnancy and Lactation Omega-3 fatty acid supplementation during pregnancy and respiratory symptoms in children. Effect of n-3 long chain polyunsaturated fatty acid supplementation in pregnancy on infants’ allergies in first year of life: randomised controlled trial Maternal fish oil supplementation in pregnancy modifies neonatal leukotriene production by cord-blood-derived neutrophils. Consumption of a DHA-containing functional food during pregnancy is associated with lower infant ponderal index and cord plasma insulin concentration. Does docosahexaenoic acid (DHA) status in pregnancy have any impact on postnatal growth? Six-year follow-up of a prospective randomized double-blind monocenter study on low-dose DHA supplements Increased consumption of salmon during pregnancy partly prevents the decline of some plasma essential amino acid concentrations in pregnant women. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys Maternal fish oil supplementation in pregnancy reduces interleukin‐13 levels in cord blood of infants at high risk of atopy Enhanced prostaglandin F2α formation in human pregnancy and the effect of increased oily fish intake: results from the Salmon in Pregnancy Study. Carbohydrate intake is the main determinant of growth in infants born <33 weeks' gestation when protein intake is adequate. Effect of N-3 polyunsaturated fatty acid supplementation in pregnancy: the Nuheal trial. Effect of fish oil supplementation in pregnancy on the fatty acid composition of erythrocyte phospholipids and breast milk lipids Developmental programming for allergy: a secondary analysis of the Mothers, Omega-3, and Mental Health Study. [Fish oil supplementation and duration of pregnancy. A randomized controlled trial]. Supplementation with 200 mg/Day Docosahexaenoic Acid from Mid-Pregnancy through Lactation Improves the Docosahexaenoic Acid Status of Mothers with a Habitually Low Fish Intake and of Their Infants Randomised controlled trial of effect of fish-oil supplementation on pregnancy duration Human milk fatty acids from lactating mothers of preterm infants: a study revealing wide intra- and inter-individual variation. Plasma inflammatory and vascular homeostasis biomarkers increase during human pregnancy but are not affected by oily fish intake. Prenatal DHA status and neurological outcome in children at age 5.5 years are positively associated. Effects of prenatal fish-oil and 5-methyltetrahydrofolate supplementation on cognitive development of children at 6.5 y of age. Feeding preterm infants milk with a higher dose of docosahexaenoic acid than that used in current practice does not influence language or behavior in early childhood: a follow-up study of a randomized controlled trial. The Impact of Nutritional Fatty Acids during Pregnancy and Lactation on Early Human Adipose Tissue Development Duration of pregnancy in relation to fish oil supplementation and habitual fish intake: a randomised clinical trial with fish oil Effects of Docosahexaenoic Acid Supplementation During Pregnancy on Gestational Age and Size at Birth: Randomized, Double-Blind, Placebo-Controlled Trial in Mexico Auditory- and visual-evoked potentials in Mexican infants are not affected by maternal supplementation with 400 mg/d docosahexaenoic acid in the second half of pregnancy. n -- 3 fatty acid supplementation during pregnancy in women with allergic disease: effects on blood pressure, and maternal and fetal lipids. Fish Oil Supplementation in Pregnancy Lowers F2-isoprostanes in Neonates at High Risk of Atopy Prenatal Docosahexaenoic Acid Supplementation and Infant Morbidity: Randomized Controlled Trial Effect of omega-3 fatty acid concentrations in plasma on symptoms of asthma at 18 months of age. Fish oil supplementation in pregnancy modifies neonatal allergen-specific immune responses and clinical outcomes in infants at high risk of atopy: a randomized, controlled trial. Maternal DHA and the development of attention in infancy and toddlerhood. Effect of Supplementing Pregnant and Lactating Mothers With n-3 Very-Long-Chain Fatty Acids on Children's IQ and Body Mass Index at 7 Years of Age Effects of fish oil supplementation in late pregnancy on blood pressure: a randomised controlled trial Decreased cord blood IL-4, IL-13, and CCR4 and increased TGF-beta levels after fish oil supplementation of pregnant women. Fish-oil supplementation in pregnancy does not reduce the risk of gestational diabetes or preeclampsia. Fish Oil Supplementation in Pregnancy Modifies Neonatal Progenitors at Birth in Infants at Risk of Atopy Respiratory hospitalisation of infants supplemented with docosahexaenoic acid as preterm neonates. The Salmon in Pregnancy Study: study design, subject characteristics, maternal fish and marine n-3 fatty acid intake, and marine n-3 fatty acid status in maternal and umbilical cord blood. Neurodevelopmental outcomes of preterm infants fed high-dose docosahexaenoic acid: a randomized controlled trial. Seven-Year Follow-up of Children Born to Women in a Randomized Trial of Prenatal DHA Supplementation The effect of maternal fish oil supplementation during the last trimester of pregnancy on blood pressure, heart rate and heart rate variability in the 19-year-old offspring. Salmon consumption during pregnancy alters fatty acid composition and secretory IgA concentration in human breast milk. Docosahexaenoic acid supplementation from mid-pregnancy to parturition influenced breast milk fatty acid concentrations at 1 month postpartum in Mexican women.
Background / Objective : Evidence is accumulating that the long-chain PUFA ( LCPUFA ) are associated with offspring growth and body composition . We investigated the relationship between LCPUFAs in red blood cells ( RBCs ) of pregnant women/breastfeeding mothers and umbilical cord RBCs of their neonates with infant growth and body composition ⩽1 year of age . Subjects/ Methods : In an open-label r and omized , controlled trial , 208 healthy pregnant women received a dietary intervention ( daily supplementation with 1200 mg n-3 LCPUFAs and dietary counseling to reduce arachidonic acid ( AA ) intake ) from the 15th week of gestation until 4 months of lactation or followed their habitual diet . Fatty acids of plasma phospholipids ( PLs ) and RBCs from maternal and cord blood were determined and associated with infant body weight , body mass index ( BMI ) , lean body mass and fat mass assessed by skinfold thickness measurements and ultrasonography . Results : Dietary intervention significantly reduced the n-6/n-3 LCPUFA ratio in maternal and cord-blood plasma PLs and RBCs . Maternal RBCs docosahexaenoic acid ( DHA ) , n-3 LCPUFAs and n-6 LCPUFAs at the 32nd week of gestation were positively related to birth weight . Maternal n-3 LCPUFAs , n-6 LCPUFAs and AA were positively associated with birth length . Maternal RBCs AA and n-6 LCPUFAs were significantly negatively related to BMI and Ponderal Index at 1 year postpartum , but not to fat mass . Conclusion : Maternal DHA , AA , total n-3 LCPUFAs and n-6 LCPUFAs might serve as prenatal growth factors , while n-6 LCPUFAs also seems to regulate postnatal growth . The maternal n-6/n-3 LCPUFA ratio does not appear to have a role in adipose tissue development during early postnatal life Formula supplemented with docosahexaenoic acid ( DHA ) improves retinal function of preterm infants but the optimal dose is unknown . In a r and omized controlled trial we examined the effect of increasing the DHA concentration of human milk and formula on circulating fatty acids of preterm infants . Infants born <33 weeks gestation were fed high-DHA milk ( 1 % total fat as DHA ) or st and ard-DHA milk ( 0.2 - 0.3 % DHA ) until reaching their estimated due date ( EDD ) . Milk arachidonic acid ( AA ) concentration was approximately 0.5 % for both groups . At EDD , erythrocyte membrane phospholipid DHA was elevated in the high-DHA group compared with st and ard-DHA ( mean+/-SD , high-DHA 6.8+/-1.2 , st and ard-DHA 5.2+/-0.7 , p<0.0005 ) but AA was lower ( high-DHA 14.9+/-1.3 , st and ard-DHA 16.0+/-1.2 , p<0.0005 ) . Feeding preterm infants human milk and formula with 1 % DHA raises but does not saturate erythrocyte phospholipids with DHA . Milk exceeding 1 % DHA may be required to increase DHA status to levels seen in term infants Objective : The aim of this study was to assess the effects of fish oil supplementation in pregnancy on  maternal erythrocyte fatty acid composition at different stages of pregnancy and in the post-partum period , and on neonatal  erythrocyte fatty acid composition . Design : A double-blind , r and omised , placebo-controlled study . Setting : Subiaco , Western Australia . Subjects : In all , 98 women booked for delivery at St John of God Hospital , Subiaco , were recruited from private rooms of obstetricians . In total , 83 women and their healthy full-term babies completed the study . Interventions : Women received either 4 g of fish oil ( n=52 ) ( 56 % docosahexaenoic acid ( DHA ) and 28 % eicosapentaenoic acid ( EPA ) or placebo ( olive oil ) ( n=46 ) per day from 20 weeks gestation until delivery . Main outcome measures : Erythrocyte phospholipid fatty acids were measured in maternal peripheral blood at 20 , 30 and 37 weeks of pregnancy and at 6 weeks post partum , and from cord blood collected at birth . Results : Compared to the control group , maternal EPA and DHA were significantly higher in the fish oil group at 30 and 37 weeks gestation , and remained elevated at 6 weeks post partum ( P<0.001 ) . The proportions of n-6 polyunsaturated ( arachidonic acid , 22:3n-6 and 22:4n-6 ) were significantly lower in the fish oil supplemented group at the same time periods ( P<0.001 ) . Similarly , the proportions of EPA and DHA were significantly higher ( P<0.001 ) , and those of n-6 polyunsaturated fatty acids arachidonic acid , 20:3n-6 , 22:3n-6 and 22:4n-6 were significantly lower ( P<0.001 ) , in erythrocytes from neonates in the fish oil group , compared to those in the control group . Conclusions : Fish oil supplementation from 20 weeks of pregnancy until birth is an effective means of enhancing n-3 fatty acid status of both mothers and neonates . Furthermore , the changes in maternal erythrocyte fatty acid composition are retained until at least 6 weeks post partum . It is essential to assess the effects of concomitant decreases in arachidonic acid status before any dietary recommendations can be made . Sponsorship : The study was supported by grants from the NH & MRC and Raine Medical Research Foundation , Australia 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 OBJECTIVES Docosahexaenoic acid ( DHA ; 22:6 n-3 ) and arachidonic acid ( AA ; 20:4 n-6 ) are important for development of the central nervous system in mammals . There is a growth spurt in the human brain during the last trimester of pregnancy and the first postnatal months , with a large increase in the cerebral content of AA and DHA .  The fetus and the newborn infant depend on maternal supply of DHA and AA . Our hypothesis was that maternal intake of DHA during pregnancy and lactation is marginal and that high intake of this fatty acid would benefit the child . We examined the effect of supplementing pregnant and lactating women with very-long-chain n-3 polyunsaturated fatty acids ( PUFAs ; cod liver oil ) on mental development of the children , compared with maternal supplementation with long-chain n-6 PUFAs ( corn oil ) . METHODS The study was r and omized and double-blinded . Pregnant women were recruited in week 18 of pregnancy to take 10 mL of cod liver oil or corn oil until 3 months after delivery . The cod liver oil contained 1183 mg/10 mL DHA , 803 mg/10 mL eicosapentaenoic acid ( 20:5 n-3 ) , and a total of 2494 mg/10 mL summation operator n-3 PUFAs . The corn oil contained 4747 mg/10 mL linoleic acid ( 18:2 n-6 ) and 92 mg/10 mL alpha-linolenic acid ( 18:3 n-3 ) . The amount of fat-soluble vitamins was identical in the 2 oils ( 117 micro g/mL vitamin A , 1 micro g/mL vitamin D , and 1.4 mg/mL dl-alpha-tocopherol ) . A total of 590 pregnant women were recruited to the study , and 341 mothers took part in the study until giving birth . All infants of these women were scheduled for assessment of cognitive function at 6 and 9 months of age , and 262 complied with the request . As part of the protocol , 135 subjects from this population were invited for intelligence testing  with the Kaufman Assessment Battery for Children ( K-ABC ) at 4 years of age . Of the 135 invited children , 90 came for assessment . Six children did not complete the examination . The K-ABC is a measure of intelligence and achievement design ed for children aged 2.5 years through 12.5 years . This multisubtest battery comprises 4 scales : Sequential Processing , Simultaneous Processing , Achievement ( not used in the present study ) , and Nonverbal Abilities . The Sequential Processing and Simultaneous Processing scales are hypothesized to reflect the child 's style of problem solving and information processing . Scores from these 2 scales are combined to form a Mental Processing Composite , which serves as the measure of intelligence in the K-ABC . RESULTS We received dietary information from 76 infants ( 41 in the cod liver oil group and 35 in the corn oil group ) , documenting that all of them were breastfed at 3 months of age . Children who were born to mothers who had taken cod liver oil ( n = 48 ) during pregnancy and lactation scored higher on the Mental Processing Composite of the K-ABC at 4 years of age as compared with children whose mothers had taken  corn oil  ( n = 36 ; 106.4 [ 7.4 ] vs 102.3 [ 11.3 ] ) . The Mental Processing Composite score correlated significantly with head circumference at birth ( r = 0.23 ) , but no relation was found with birth weight or gestational length . The children 's mental processing scores at 4 years of age correlated significantly with maternal intake of DHA and eicosapentaenoic acid during pregnancy . In a multiple regression model , maternal intake of DHA during pregnancy was the only variable of statistical significance for the children 's mental processing scores at 4 years of age . CONCLUSION Maternal intake of very-long-chain n-3 PUFAs during pregnancy and lactation may be favorable for later mental development of children Background Breast milk contains many immunomodulatory factors ( soluble CD14 ( sCD14 ) , IgA and cytokines ) with the potential to influence infant immune development Objective : We investigated how cod liver oil influences the amount of essential fatty acids in mothers ’ breast milk . Design and Intervention : Lactating mothers ( n=22 ) were r and omized into four groups 3–8 weeks after parturition . They were supplemented for 14 days with 0 , 2.5 , 5 and 10 ml cod liver oil ( 7.7 g eicosapentaenoic acid ( EPA , 20:5n-3 ) , 10.2 g docosahexaenoic acid ( DHA , 22:6n-3 ) and 22.9 g n-3 fatty acids in total per 100 ml ) . Results : In maternal plasma phospholipids there was an increase in the content of EPA and DHA in the group supplemented with 10 ml cod liver oil daily ( P≤0.05 ) . DHA concentrations in breast milk pre-supplementation ranged from 0.15 to 1.56 wt% and increased in all supplemented groups ( P≤0.05 ) . The concentration of EPA in breast milk increased in the groups supplemented with 5 or 10 ml cod liver oil ( P≤0.05 ) , whereas the concentration of arachidonic acid ( AA , 20:4n-6 ) did not change in any of the supplemented groups . Total intake of DHA adjusted to body mass index ( BMI ) , correlated to DHA concentrations in plasma ( r=0.49 , P=0.02 ) and breast milk ( r=0.45 , P=0.04 ) . The concentration of tocopherol did not change during the supplementation period , neither in plasma nor in breast milk . Conclusion : Dietary intake of DHA is reflected in the concentration of DHA in breast milk , without affecting the concentration of AA or tocopherol . Sponsorship : Supported by Peter Möller avd . av Orkla Asthma and allergic diseases have increased worldwide ; however , etilogic factors for this increase are still poor . Prenatal consumptions of fatty acids are hypothesized , although few clinical trials in developing countries have been performed . This study was design ed to identify predictors of immunoglobulin E ( IgE ) levels in cord blood of Mexican newborns .  Total IgE was measured in umbilical cord blood from 613 infants whose mothers participated in a double-blind r and omized controlled trial of  400 mg of docosahexaenoic acid or placebo  from 18 to 22 weeks gestation through delivery . During pregnancy , information on sociodemographic characteristics , environmental exposures , and perceived maternal stress were obtained ; a maternal blood sample was also collected to determine atopy via specific IgE levels . Logistic regression models were used to identify the main prenatal predictors of detectable total IgE levels in cord blood . IgE was detectable in cord blood from 344 ( 53.7 % ) infants ; the main predictors in multivariate analyses were maternal atopy ( odds ratio [ OR ] = 1.69 ; 95 % CI , 1.19 - 2.42 ; p < 0.05 ) and pesticide use in the home ( OR = 1.49 ; 95 % CI , 1.04 - 2.14 ; p < 0.05 ) . When stratified by maternal atopy , season of birth was a significant predictor in the atopic group only ( OR = 2.48 ; 95 % CI , 1.00 - 6.16 ; p < 0.05 ) , and pesticide use was a significant predictor for infants born to nonatopic mothers ( OR = 1.64 ; 95 % CI , 1.07 - 2.51 ; p < 0.05 ) . No differences were seen in the proportion of infants with detectable IgE by treatment group . Prenatal supplementation with omega-3 polyunsaturated fatty acid did not alter the detectable cord blood IgE levels . Maternal atopy and pesticide use during pregnancy are strong predictors of cord blood IgE levels in newborns . Clinical trial NCT00646360 , www . clinical trials.gov BACKGROUND Long-chain n-3 PUFAs found in oily fish may have a role in lowering the risk of allergic disease . OBJECTIVE The objective was to assess whether an increased intake of oily fish in pregnancy modifies neonatal immune responses and early markers of atopy . DESIGN Women ( n = 123 ) were r and omly assigned to continue their habitual diet , which was low in oily fish , or to consume 2 portions of salmon per week ( providing 3.45 g EPA plus DHA ) from 20 wk gestation until delivery . In umbilical cord blood sample s ( n = 101 ) , we measured n-3 fatty acids , IgE concentrations , and immunologic responses . Infants were clinical ly evaluated at age 6 mo ( n = 86 ) . RESULTS Cord blood mononuclear cell ( C BMC ) production of interleukin (IL)-2 , IL-4 , IL-5 , IL-10 , and tumor necrosis factor-α in response to phytohemagglutinin ( PHA ) and of IL-2 in response to Dermatophagoides pteronyssinus allergen 1 ( Derp1 ) was lower in the salmon group ( all P ≤ 0.03 ) . In the subgroup of C BMC s in which an allergic phenotype was confirmed in the mother or father , IL-10 production in response to Toll-like receptor 2 , 3 , and 4 agonists , ovalbumin , salmon parvalbumin , or Derp1 and prostagl and in E(2 ) production in response to lipopolysaccharide or PHA was lower in the salmon group ( all P ≤ 0.045 ) . Total IgE at birth and total IgE , incidence and severity of atopic dermatitis , and skin-prick-test positivity at 6 mo of age were not different between the 2 groups . CONCLUSION Oily fish intervention in pregnancy modifies neonatal immune responses but may not affect markers of infant atopy assessed at 6 mo of age . This trial is registered at clinical trials.gov as NCT00801502 We have previously reported a protective effect of maternal omega-3 long-chain polyunsaturated fatty acids ( ω-3 LCPUFA ) supplementation in pregnancy and lactation on IgE-associated eczema and food allergy in the infant during the first year of life . Here we investigate whether the effects of the LCPUFA supplementation on IgE-associated diseases last up to 2 yr of age and assess the relationship between plasma proportions of ω-3 PUFAs and the frequency and severity of infant allergic disease . 145 pregnant women , at risk of having an allergic infant , were r and omized to daily supplementation with 1.6 g eicosapentaenoic acid ( EPA ) and 1.1 g docosahexaenoic acid ( DHA ) or placebo starting in the 25th gestational week and continuing through 3.5 months of breastfeeding . Clinical examinations , skin prick tests and analysis of maternal and infant plasma phospholipid fatty acids and infant specific IgE were performed . No difference in the prevalence of allergic symptoms was found between the intervention groups . The cumulative incidence of IgE-associated disease was lower in the ω-3-supplemented group ( 6/54 , 13 % ) compared with the placebo group ( 19/62 , 30 % , p=0.01 ) . Higher maternal and infant proportions of DHA and EPA were associated with lower prevalence of IgE associated disease ( p=0.01 - 0.05 ) in a dose-dependent manner . Higher maternal and infant proportions of DHA and EPA were found if the infants presented none , when compared with multiple allergic symptoms , ( p<0.05 ) regardless of sensitization . In summary , the ω-3 supplementation offered no obvious preventive effect on the prevalence of clinical symptoms of allergic disease , but the decrease in cumulative incidence of IgE-associated disease seen during the first year still remained until 2 yr of age . Furthermore , high proportions of DHA and EPA in maternal and infant plasma phospholipids were associated with less IgE-associated disease and a reduced severity of the allergic phenotype This study evaluated the longitudinal effect of fish oil in pregnancy on breast milk fatty acid composition and infant outcomes . In a r and omized , controlled trial , 98 women received 2.2 g docosahexaenoic acid ( DHA ) and 1.1 g eicosapentaenoic acid ( EPA ) or olive oil from 20 wk of gestation until delivery .  Fatty acid composition in breast milk ( at 3 d , 6 wk , and 6 mo ) and infant erythrocyte membranes ( at 1 y ) were determined by gas liquid chromatography . Breast milk fatty acids were examined in relationship to growth and development . Compared with control group , breast milk from women who received fish oil had proportionally higher DHA and EPA levels at 3 d and 6 wk after delivery , but this difference was no longer apparent by 6 mo . Infant DHA status at 1 y of age was directly related to DHA levels at 3 d , 6 wk , and 6 mo postpartum ( but not to antenatal supplementation ) . Both EPA and DHA in breast milk were positively correlated with Griffith 's developmental scores including h and and eye coordination . Thus , supplementation in pregnancy was associated with increased n-3 long-chain polyunsaturated fatty acids ( LCPUFAs ) in breast milk , particularly in early lactation , and this was positively associated with infant DHA status at 1 The hypothesis was tested that the additional dietary uptake of n-3 fatty acids , in particular of DHA and 5-methyltetrahydrofolate ( 5-MTHF ) , during the second half of pregnancy would influence proliferation and apoptosis in the full-term human placenta . The diets of pregnant women from Spain ( n 55 ) were supplemented with modified fish oil and /or 5-MTHF or placebo , and assigned in a r and om , double-blind manner to one of the four groups . Immunohistochemistry and immunoblotting were used to detect placental proliferation and apoptosis with monoclonal antibodies for key proteins that reflected the extent of both processes : proliferation cell nuclear antigen ( PCNA ) , p53 , cytokeratin 18 neoepitope . The PCNA level in the fish oil/5-MTHF-treated group was higher by 66 % ( P < 0.05 ) than that of the placebo group , whereas the levels of p53 and cytokeratin 18 neoepitope were unaffected by treatment . PCNA expression was altered only in the trophoblast compartment ( placebo 11.1 ( se 0.5 ) % v. combination 21.5 ( se 1.2 ) % ; P < 0.05 ) , whereas the proportion of nuclei stained in endothelial and other stromal cells was similar in the placebo and combined treatment groups . No correlation was found between fish oil or 5-MTHF supplementation and the levels of the proteins . The present data suggest that supplementation with fish oil and /or 5-MTHF had no effect on the parameters reflecting placental proliferation and apoptosis . A defined combination of DHA and 5-MTHF may , however , affect placental proliferation BACKGROUND Evidence suggests that asthma is rooted in the intrauterine environment and that intake of marine n-3 polyunsaturated fatty acids ( n-3 PUFAs ) in pregnancy may have immunomodulatory effects on the child . OBJECTIVE Our aim was to examine whether increasing maternal intake of n-3 PUFAs in pregnancy may affect offspring risk of asthma . DESIGN In 1990 , a population -based sample of 533 women with normal pregnancies were r and omly assigned 2:1:1 to receive four 1-g gelatin capsules/d with fish oil providing 2.7 g n-3 PUFAs ( n = 266 ) ; four 1-g , similar-looking capsules/d with olive oil ( n = 136 ) ; or no oil capsules ( n = 131 ) . Women were recruited and r and omly assigned around gestation week 30 and asked to take capsules until delivery . Among 531 live-born children , 528 were identified in registries and 523 were still alive by August 2006 .  Diagnoses from the International Coding of Diseases version 10 were extracted from a m and atory registry that recorded diagnoses reported from hospital contacts . RESULTS During the 16 y that passed since childbirth , 19 children from the fish oil  and  olive oil groups had received an asthma-related diagnosis ; 10 had received the diagnosis allergic asthma . The hazard rate of asthma was reduced by 63 % ( 95 % CI : 8 % , 85 % ; P = 0.03 ) , whereas the hazard rate of allergic asthma was reduced by 87 % ( 95 % CI : 40 % , 97 % ; P = 0.01 ) in the fish oil compared with the olive oil group . CONCLUSION Under the assumption that intake of olive oil in the dose provided here was inert , our results support that increasing n-3 PUFAs in late pregnancy may carry an important prophylactic potential in relation to offspring asthma Studies on formula-fed infants indicate a beneficial effect of dietary DHA on visual acuity . Cross-sectional studies have shown an association between breast-milk DHA levels and visual acuity in breast-fed infants . The objective in this study was to evaluate the biochemical and functional effects of fish oil ( FO ) supplements in lactating mothers . In this double-blinded r and omized trial , Danish mothers with habitual fish intake below the 50th percentile of the Danish National Birth Cohort were r and omized to microencapsulated FO [ 1.3 g/d long-chain n−3 FA ( n−3 LCPUFA ) ] or olive oil ( OO ) . The intervention started within a week after delivery and lasted 4 mon . Mothers with habitual high fish intake and their infants were included as a reference group . Ninety-seven infants completed the trial ( 44 OO-group , 53 FO-group ) and 47 reference infants were followed up . The primary outcome measures were : DHA content of milk sample s ( 0 , 2 , and 4 mon postnatal ) and of infant red blood cell ( RBC ) membranes ( 4 mon postnatal ) , and infant visual acuity ( measured by swept visual evoked potential at 2 and 4 mon of age ) . FO supplementation gave rise to a threefold increase in the DHA content of the 4-mon milk sample s ( P<0.001 ) . DHA in infant RBC reflected milk contents ( r=0.564 , P<0.001 ) and was increased by almost 50 % ( P<0.001 ) . Infant visual acuity was not significantly different in the r and omized groups but was positively associated at 4 mon with infant RBC-DHA ( P=0.004 , multiple regression ) . We concluded that maternal FO supplementation during lactation did not enhance visual acuity of the infants who completed the intervention . However , the results showed that infants with higher RBC levels of n−3 LCPUFA had a better visual acuity at 4 mon of age , suggesting that n−3 LCPUFA may influence visual maturation Abstract n−3 PUFA influence immune functioning and may affect the cytokine phenotype during development . To examine whether maternal fish oil supplementation during lactation could modify later  immune responses in children , 122 lactating Danish mothers with a fish intake below the population median were r and omized to groups supplemented for the first 4 mon of lactation with 4.5 g/d of fish oil ( equivalent to 1.5 g/d of n−3 long-chain PUFA ) or olive oil .  Fifty-three mothers with a fish intake in the highest quartile of the population were also included . The FA composition of erythrocyte membranes was measured at 4 mon and at 2 1/2 yr . Plasma immunoglobulin E ( IgE ) levels and cytokine production in lipopolysaccharide-stimulated whole-blood cultures were determined at 2 1/2 yr . Erythrocyte n−3 PUFA at 4 mon were higher in infants from the fish oil group compared with the olive oil group ( P<0.001 ) but were no longer different at 2 1/2 yr . The median production of lipopolysaccharide-induced interferon γ(IFN-γ ) in the fish oil group was fourfold higher than that in the olive oil group ( P=0.034 ) , whereas interleukin-10 ( IL-10 ) production was similar . The IFN-γ/IL-10 ratio was twofold higher in the fish oil group ( P=0.019 ) and was positively correlated with 20∶5n−3/20∶4n−6 in erythrocytes at 4 mon ( P=0.050 ) . The percentages of atopic children and plasma IgE were not different in the two groups , but the study was not design ed to look at atopy . Cytokine responses and erythrocyte FA composition in children of mothers with a high fish intake were intermediate in comparison with those in the r and omized groups . Fish oil supplementation during lactation result ed in increased in vitro IFN-γ production in the children 2 yr after the supplementation was given , which may reflect a faster maturation of the immune system Nutritional influences on cardiovascular disease operate throughout life . Studies in both experimental animals and humans have suggested that changes in the peri- and early post-natal nutrition can affect the development of the various components of the metabolic syndrome in adult life . This has lead to the hypothesis that n-3 fatty acid supplementation in pregnancy may have a beneficial effect on lipid profile in the offspring . The aim of the present study was to investigate the effect of supplementation with n-3 fatty acids during the third trimester of pregnancy on lipids and lipoproteins in the 19-year-old offspring . The study was based on the follow-up of a r and omized controlled trial from 1990 where 533 pregnant women were r and omized to fish oil ( n = 266 ) , olive oil ( n = 136 ) or no oil ( n = 131 ) . In 2009 , the offspring were invited to a physical examination including blood sampling . A total of 243 of the offspring participated .  Lipid values did not differ between the fish oil and olive oil groups . The relative adjusted difference ( 95 % confidence intervals ) in lipid concentrations was −3 % ( −11 ; 7 ) for LDL cholesterol , 3 % ( −3 ; 10 ) for HDL cholesterol , −1 % ( −6 ; 5 ) for total cholesterol,−4 % ( −16 ; 10 ) for TAG concentrations , 2%(−2 ; 7 ) for apolipoprotein A1 , −1 % ( −9 ; 7 ) for apolipoprotein B and 3 % ( −7 ; 15 ) in relative abundance of small dense LDL . In conclusion , there was no effect of fish oil supplementation during the third trimester of pregnancy on offspring plasma lipids and lipoproteins in adolescence Within the visual system , docosahexaenoic acid ( DHA , 22:6n−3 ) is an important structural component for retinal photoreceptors and cortical gray matter . There is a marked decrease in neural DHA accumulation in the face of DHA deficiency . DHA is accumulated at an accelerated rate during pregnancy , especially in the third trimester . However , pregnant women in the US and Canada have dietary DHA intakes that are significantly below the optimal level . The main objective of this study was to determine whether a DHA-functional food during pregnancy would benefit infant visual acuity at four and six months of age measured behaviorally using the acuity card procedure ( ACP ) . In a r and omized , longitudinal , double-blinded , and placebo-controlled trial , 30 pregnant women received either the DHA-functional food ( n = 16 ) or the placebo ( n = 14 ) . There were significant main effects for visual acuity at four months of age ( P = 0.018 ) . The mean acuity scores were 3.8 ± 1.1 cycles/degree in the DHA group versus 3.2 ± 0.7 cycles/degree in the placebo group . At six months there were no group differences . Based on our results , we conclude that DHA supplemented during pregnancy plays a role in the maturation of the visual system 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 Early accumulation of n-3 long-chain PUFA ( LCPUFA ) in the brain may contribute to differences in later cognitive abilities . In this study , our objective was to examine whether fish oil ( FO ) supplementation during lactation affects processing speed , working memory , inhibitory control , and socioemotional development at 7 years . Danish mothers ( n = 122 ) were r and omized to FO [ 1.5 g/d n-3 LCPUFA ] or olive oil ( OO ) supplementation during the first 4 months of lactation . The trial also included a high-fish intake ( HFI ) reference group ( n = 53 ) . Ninety-eight children were followed-up with an assessment of processing speed , an age-appropriate Stroop task , and the Strength and Difficulties Question naire  at 7 year . A group effect of the intervention ( FO vs. OO ) was found in prosocial behavior scores ; this negative effect was carried by the boys . Exploratory analyses including all participants revealed the speed of processing scores were predicted by maternal n-3 LCPUFA intake during the intervention period ( negative relation ) and maternal education ( positive relation ) . Stroop scores indicative of working memory and inhibitory control were predicted by infant erythrocyte DHA status at 4 months of age ( negative relation ) . Early fish oil supplementation may have a negative effect on later cognitive abilities . Speed of processing and inhibitory control/working memory are differentially affected , with speed of processing showing effects of fish oil intake as a whole , whereas inhibitory control/working memory was related more specifically to DHA status BACKGROUND Preterm infants have improved visual outcomes when fed a formula containing 0.2 - 0.4 % docosahexaenoic acid ( DHA ) compared with infants fed no DHA , but the optimal DHA dose is unknown . OBJECTIVE We assessed visual responses of preterm infants fed human milk ( HM ) and formula with a DHA concentration estimated to match the intrauterine accretion rate ( high-DHA group ) compared with infants fed HM and formula containing DHA at current concentrations . DESIGN A double-blind r and omized controlled trial studied preterm infants born at <33 wk gestation and fed HM or formula containing 1 % DHA ( high-DHA group ) or approximately 0.3 % DHA ( current practice ; control group ) until reaching their estimated due date ( EDD ) . Both groups received the same concentration of arachidonic acid . Sweep visual evoked potential ( VEP ) acuity and latency were assessed at 2 and 4 mo corrected age ( CA ) . Weight , length , and head circumference were assessed at EDD and at 2 and 4 mo CA . RESULTS At 2 mo CA , acuity of the high-DHA group did not differ from the control group [ high-DHA group ( x + /- SD ) : 5.6 + /- 2.4 cycles per degree ( cpd ) , n = 54 ; control group : 5.6 + /- 2.4 cpd , n = 61 ; P = 0.96 ] . By 4 mo CA , the high-DHA group exhibited an acuity that was 1.4 cpd higher than the control group ( high-DHA : 9.6 + /- 3.7 cpd , n = 44 ; control : 8.2 + /- 1.8 cpd ; n = 51 ; P = 0.025 ) . VEP latencies and anthropometric measurements were not different between the high-DHA and control groups . CONCLUSION The DHA requirement of preterm infants may be higher than currently provided by preterm formula or HM of Australian women BACKGROUND Increased consumption of n-3 long-chain polyunsaturated fatty acids ( PUFAs ) has been recommended during pregnancy and lactation . The production of proinflammatory cytokines by human peripheral blood mononuclear cells ( P BMC s ) can be modified by dietary n-3 PUFAs . OBJECTIVE We sought to determine whether dietary supplementation of lactating women with docosahexaenoic acid ( DHA ) can modulate the concentration of cytokines in the aqueous phase of human milk and the production of cytokines by human milk cells ( HMCs ) and P BMC s. DESIGN In this double-blind , prospect i ve , r and omized trial , mothers of healthy full-term infants were asked to consume daily a nutritional supplement of 2000 mg oil containing either placebo ( n = 40 ) , 300 mg DHA + 70 mg eicosapentaenoic acid ( EPA ; n = 40 ) , or 600 mg DHA + 140 mg EPA ( n = 40 ) . The fatty acid composition of plasma , P BMC s , milk , and HMCs from lactating mothers at 4 wk postpartum was measured by gas chromatography . The concentration of interleukin 6 and tumor necrosis factor alpha in milk and the production of interleukin 1beta , tumor necrosis factor alpha , and interleukin 6 by P BMC s and HMCs after stimulation with lipopolysaccharide was measured by enzyme-linked immunosorbent assay . RESULTS At 4 wk postpartum , 82 mothers were still breast-feeding their infants .  DHA increases in maternal plasma , P BMC s , milk , and HMCs were proportional to dietary DHA . There was no relation between tissue DHA status and cytokine concentrations . CONCLUSIONS Consumption of < or = 600 mg DHA and 140 mg EPA/d for 4 wk increased n-3 PUFA concentrations in relevant tissues but did not cause perturbations in cytokine concentrations in human milk BACKGROUND Pregnant women usually meet their increased energy needs but do not always meet their increased micronutrient requirements . The supply of both folic acid and docosahexaenoic acid ( DHA ) has been related to positive pregnancy and infant outcomes . OBJECTIVE We aim ed to assess whether fish-oil ( FO ) supplementation with or without folate from gestation week 22 to birth improves maternal and fetal n-3 long-chain polyunsaturated fatty acid ( n-3 LC-PUFA ) status . DESIGN We conducted a multicenter ( Germany , Hungary , and Spain ) , r and omized , double-blind , 2 x 2 factorial , placebo-controlled trial . From gestation week 22 until delivery , 311 pregnant women received daily a preparation with FO [ 0.5 g DHA and 0.15 g eicosapentaenoic acid ( EPA ) ] , 400 microg methyltetrahydrofolic acid ( MTHF ) , FO with MTHF , or placebo . Outcome measures included maternal and cord plasma DHA and EPA contents at gestation weeks 20 and 30 and at delivery , indicators of pregnancy outcome , and fetal development . RESULTS FO significantly ( P<0.001 ) increased maternal DHA and EPA ( % by wt ) , as shown by 3-factor repeated- measures ANOVA ( ie , MTHF , FO , and time ) with adjustment for maternal baseline DHA and EPA . In addition , FO significantly ( P<0.001 ) increased cord blood DHA ( % by wt ; 2-factor ANOVA ) . MTHF was significantly ( P=0.046 ) associated with increased maternal DHA ( % by wt ) . There was no FO x MTHF interaction for the time course of DHA or EPA ( P=0.927 and 0.893 ) . Pregnancy outcomes and fetal development did not differ significantly among the intervention groups . CONCLUSIONS FO supplementation from gestation week 22 until delivery improves fetal n-3 LC-PUFA status and attenuates depletion of maternal stores . MTHF may further enhance maternal n-3 LC-PUFA proportions BACKGROUND Blood pressure tracks from childhood into adulthood , and early diet may have long-term effects on hypertension . OBJECTIVE The study 's aim was to investigate whether intakes of n-3 long-chain polyunsaturated fatty acids ( n-3 LC-PUFAs ) during lactation and current intakes of macronutrients affect blood pressure in 2.5-y-old Danish children . DESIGN Mothers ( n = 122 ) with low fish intakes were r and omly assigned to receive supplementation with 4.5 g fish oil or olive oil/d during the first 4 mo of lactation . The trial also included 53 mothers with high fish intakes . One hundred five of these women 's children attended a 2.5-y follow-up examination at which anthropometric data and blood pressure were obtained . Mothers then kept a 7-d dietary record of food consumed by their children . A full set of data from 73 children was analyzed for effects of fish oil supplementation and cross-sectional correlations with current diet . RESULTS We found no significant effect of the mothers ' fish oil intakes during the first 4 mo of lactation on the blood pressure of the children 2.5 y later . Greater protein intakes measured as a percentage of energy were associated cross-sectionally with significantly lower diastolic and systolic blood pressures in the children at age 2.5 y after control for outdoor temperature , age , sex , weight , and height ( P = 0.028 and 0.035 , respectively ) . Greater protein intakes measured as g/d were also associated with significantly lower systolic blood pressures ( P = 0.008 ) . A 1-SD increase in protein intake corresponded with a decrease of approximately 3 mm Hg in systolic blood pressure . CONCLUSION The blood pressure of young Danish children was not significantly affected by intakes of n-3 LC-PUFAs via breast milk , but greater protein intakes at 2.5 y were associated with lower blood pressure Maternal ( n-3 ) PUFA deficiency is associated with higher  blood pressure ( BP ) later in life in rat offspring , and early intake of ( n-3 ) PUFA in formula-fed infants was shown to modify later BP . BP , heart rate ( HR ) , and heart rate variability ( HRV ) are affected by dietary ( n-3 ) PUFA in adults . In this study , we investigated whether fish oil ( FO ) supplementation of lactating mothers could modify BP , pulse wave velocity ( PWV ) , and HRV in their children after 2 y. Mothers with low fish intake were r and omly assigned to FO or olive oil ( OO ) supplementation for the first 4 mo after delivery . A reference group of mothers with a high habitual fish intake ( HFI ) was also followed . At the follow-up study at 2.5 y of age , BP and PWV were measured , and electrocardiograms were recorded for 0.5 h. FO supplementation significantly increased RBC levels of long-chain ( n-3 ) PUFA of the 4 mo-old children , but at 2.5 y , the FO and OO groups did not differ . BP , PWV , HR , and HRV also did not differ among the groups . However , for all 3 groups , the children 's intake of ( n-3 ) PUFA at 2.5 y was negatively correlated with mean arterial pressure after adjustment for outdoor temperature ( r = -0.245 , P = 0.04 ) . In conclusion , maternal FO supplementation had no overall effect on BP , PWV , or HRV of the children , indicating that ( n-3 ) PUFA intake of Danish mothers may be sufficient in this sense . However , children 's dietary intake of ( n-3 ) PUFA might have a beneficial effect on BP in childhood BACKGROUND Maternal diet during pregnancy might be one of the factors that influences fetal immune responses associated with childhood allergy . OBJECTIVE We analyzed the association between maternal diet during the last 4 wk of pregnancy and allergic sensitization and eczema in the offspring at 2 y of age . DESIGN Data from 2641 children at 2 y of age were analyzed within a German prospect i ve birth cohort study ( LISA ) . Maternal diet during the last 4 wk of pregnancy was assessed with a semiquantitative food-frequency question naire , which was administered shortly after childbirth . RESULTS High maternal intake of margarine [ adjusted odds ratio ( aOR ) : 1 . 49 ; 95 % CI : 1.08 , 2.04 ] and vegetable oils ( aOR : 1.48 ; 95 % CI : 1.14 , 1.91 ) during the last 4 wk of pregnancy was positively associated and high maternal fish intake ( aOR : 0.75 ; 95 % CI : 0.57 , 0.98 ) was inversely associated with eczema during the first 2 y in the offspring . High celery ( aOR : 1.85 ; 95 % CI : 1.18 , 2.89 ) and citrus fruit ( aOR : 1.73 ; 95 % CI : 1.18 , 2.53 ) intakes increased the risk of sensitization against food allergens . In turn , sensitization against inhalant allergens was positively related to a high maternal intake of deep-frying vegetable fat ( aOR : 1.61 ; 95 % CI : 1.02 , 2.54 ) , raw sweet pepper ( aOR : 2.16 ; 95 % CI : 1.20 , 3.90 ) , and citrus fruit ( aOR : 1.72 ; 95 % CI : 1.02 , 2.92 ) . CONCLUSIONS We suggest that the intake of allergenic foods and foods rich in n-6 polyunsaturated fatty acids during pregnancy may increase and foods rich in n-3 polyunsaturated fatty acids may decrease the risk of allergic diseases in the offspring BACKGROUND Docosahexaenoic acid ( DHA ) is important to neural development . Whether DHA intakes are low enough in some pregnant women to impair infant development is uncertain . OBJECTIVE We sought to determine whether DHA deficiency occurs in pregnant women and contributes to poor infant development . DESIGN Biochemical cutoffs , dietary intakes , or developmental scores indicative of DHA deficiency are not defined . Infant development has a distribution in which an individual 's potential development is unknown . This was a r and omized intervention to establish a distribution of developmental scores for infants of women with DHA intakes considered to be above requirements against which to compare the development of infants of mothers consuming their usual diet .  DHA ( 400 mg/d ; n = 67 ) or a placebo ( n = 68 ) was consumed by the women from 16 wk gestation until delivery . We determined maternal red blood cell ethanolamine phosphoglyceride fatty acids , dietary intakes at 16 and 36 wk gestation , and infant visual acuity at 60 d of age . RESULTS We described an approach to identify DHA deficiency when biochemical and functional markers of deficiency are unknown . In multivariate analyses , infant visual acuity was related to sex ( beta = 0.660 , SE = 0.93 , and odds ratio = 1.93 ) and maternal DHA intervention ( beta = 1.215 , SE = 1.64 , and odds ratio = 3.37 ) . More infant girls in the placebo than in the DHA intervention group had a visual acuity below average ( P = 0.048 ) . Maternal red blood cell ethanolamine phosphoglyceride docosatetraenoic acid was inversely related to visual acuity in boys ( rho = -0.37 , P < 0.05 ) and girls ( rho = -0.48 , P < 0.01 ) . CONCLUSIONS These studies suggest that some pregnant women in our study population were DHA-deficient 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 Fish oil addition to infant formulas has raised concern on whether increased intake of n-3 long-chain polyunsaturated fatty acid ( n-3LCPUFA ) affects infant growth .  The objective of this study was to determine whether maternal fish oil supplementation during 0–4 mo of lactation influences growth in infancy and early childhood . In a r and omized , blinded intervention trial , lactating Danish mothers with a fish intake below the population median were r and omized to 4.5 g/d fish oil or olive oil . A reference group of 53 mothers with a fish intake in the highest quartile of the population and their infants were included in the study .  Head circumference , weight , length , skinfold thickness , and waist circumference of children were measured at 2 , 4 , and 9 mo and at 2.5 y. One hundred children completed the intervention trial , and 72 were followed up at 2.5 y together with 29 from the reference group .  Growth in weight , length , and head circumference did not differ between the r and omized groups up to 9 mo , but at 2.5 y , body composition differed significantly . Children in the fish oil group had larger waist circumference body mass index ( BMI ; 0.6 kg/m2 ; p = 0.022 ) , and head circumference compared with those in the olive oil group . Adjusted for sex , ponderal index at birth and current energy intake , BMI at 2.5 y was associated with docosahexaenoic acid in maternal erythrocytes after the intervention . In conclusion , the n-3LCPUFA intake of lactating mothers may be important for growth of young children . The long-term effect on weight and BMI remains to be investigated We aim ed to investigate the effects of fish oil ( FO ) supplementation to pregnant women on the maternal and fetal fatty acid profile in plasma and erythrocyte phospholipids ( PL ) and to identify the best compartment for the assessment of fatty acid status . A multi-centre , double-blind , controlled trial was conducted . Healthy pregnant women from three European centres were r and omly assigned to receive from week 20 of gestation until delivery a daily dietary supplement with either FO ( 500 mg DHA+150 mg EPA ) , 400 μg 5-methyltetrahydrofolate , both or placebo .  Fatty acids in plasma and erythrocyte PL were determined in maternal blood ( week 20 , week 30 of pregnancy and delivery ) and in cord blood ( delivery ) . FO supplementation  increased DHA levels in maternal and cord plasma and erythrocyte PL . Higher percentage changes were observed in erythrocyte PL than in plasma PL . There were significant correlations between plasma and erythrocyte fatty acid levels in maternal and cord blood . Significant correlations between maternal and cord fatty acid levels at delivery in plasma and erythrocytes were also observed ; however , correlation coefficients were higher for erythrocyte phophatidylethanolamine . FO supplementation  increases maternal and fetal DHA status . Both plasma and erythrocytes appear to be suitable to evaluate the fatty acid status of mothers but erythrocytes seem to be a more reliable marker in neonates Docosahexaenoic acid ( DHA ) accumulates in the brain during the 1st and 2nd years of life . The objective of this study was to see if an increased content of DHA in breast-milk via maternal fish oil (FO)-supplementation affects mental development in term infants . one hundred twenty-two Danish mothers with a habitual fish intake below the population median were r and omized to  4.5 g.d(-1 ) of FO or olive oil ( OO ) for the first four months of lactation .  Fifty-three mothers with habitual fish intake in the highest quartile were included as reference group . The effect of the result ing increase in infant DHA-intake and RBC-DHA level was assessed on problem solving ability at nine months and language at one and two years of age . Infants in the three groups performed equally well on the problem test and no association was observed between problem solving and erythrocyte-DHA at four months . Passive vocabulary at one year was lower in the children of the FO- compared with the OO-group ( P < 0.05 ) , but no differences were found at two years of age . Word comprehension at one year was inversely associated with erythrocyte-DHA at four months . The trial indicate a small effect of DHA levels in breast-milk on early language development of breast-fed infants The effect of the dietary n-3 long-chain PUFA , DHA ( 22 : 6n-3 ) , on the growth of pre-term infants is controversial . We tested the effect of higher-dose DHA ( approximately 1 % dietary fatty acids ) on the growth of pre-term infants to 18 months corrected age compared with st and ard feeding practice ( 0·2 - 0·3 % DHA ) in a r and omised controlled trial . Infants born < 33 weeks gestation ( n 657 ) were r and omly allocated to receive breast milk and /or formula with higher DHA or st and ard DHA according to a concealed schedule stratified for sex and birth-weight ( < 1250 and ≥ 1250 g ) . The dietary arachidonic acid content of both diets was constant at approximately 0·4 % total fatty acids . The intervention was from day 2 to 5 of life until the infant 's expected date of delivery ( EDD ) . Growth was assessed at EDD , and at 4 , 12 and 18 months corrected age . There was no effect of higher DHA on weight or head circumference at any age , but infants fed higher DHA were 0·7 cm ( 95 % CI 0·1 , 1·4 cm ; P = 0·02 ) longer at 18 months corrected age . There was an interaction effect between treatment and birth weight strata for weight ( P = 0·01 ) and length ( P = 0·04 ) . Higher DHA result ed in increased length in infants born weighing ≥ 1250 g at 4 months corrected age and in both weight and length at 12 and 18 months corrected age . Our data show that DHA up to 1 % total dietary fatty acids does not adversely affect growth It has been suggested that changes in dietary habits , particularly increased consumption of omega-6 polyunsaturated fatty acids ( PUFA ) and decreased consumption of omega-3 PUFAs may explain the increase in atopic disease seen in recent years . Furthermore , it seems possible that it is mainly prenatal or very early life environmental factors that influence the development of allergic diseases . It has also been suggested that intrauterine risk factors may act differently if mother themselves suffer from allergic disease . The aim of this study was to investigate whether the consumption of fish , butter and margarine during pregnancy might influence the development of allergic sensitizations in the offspring . The study population was divided into the offspring of allergic and non-allergic mothers . This was a retrospective cohort study enrolling 295 offspring of allergic mothers and 693 of non-allergic mothers . Information regarding maternal intake of fish , butter and margarine during pregnancy as well as other prenatal and perinatal confounding factors were retrospectively assessed by parental report via a st and ardized question naire . Atopy was determined by skin-prick tests ( SPT ) to eight prevalent inhalant allergens and two foods . In the allergic mothers ' group there is no clear correlation between maternal intakes of fish , butter and margarine  and sensitizations to food or inhalants . In the non-allergic mothers ' group there was no correlation between butter and margarine  intake and food or inhalant sensitizations . On the contrary , a protective effect of fish intake on SPT positivity was observed . In particular , frequent maternal intake ( ' 2 - 3 times/wk or more ' ) of fish reduced the risk of food sensitizations by over a third ( aOR 0.23 ; 95 % CI : 0.08 - 0.69 ) . A similar trend , even if not significant , was found for inhalants . Finally , even in the whole study population , i.e. allergic group plus non-allergic group , there was a similar trend between increased consumption of fish and decreased prevalence of SPT positivity for foods . This study shows that frequent intake of fish during pregnancy may contrast the development of SPT sensitizations for foods in the offspring of mothers without atopic disease . Therefore , larger prospect i ve studies are needed , enrolling mothers with and without allergic disease , to confirm these results OBJECTIVE Disturbance in thromboxane and prostacyclin bio synthesis has been observed in preeclampsia . We studied whether fish oil supplementation in late pregnancy interferes with maternal and fetal production of thromboxane A2 and prostacyclin I2 . STUDY DESIGN Forty-seven women in the thirtieth week of pregnancy were r and omly assigned in a ratio of 2:1:1 to receive fish oil ( 2.7 gm of n-3 fatty acid per day [ Pikasol ] , or either olive oil or no oil supplementation as controls .  Metabolites of thromboxane A2 and A3 and of prostacyclin I2 and I3 were quantified by mass spectrometry methods in serum and urine , respectively . Maternal serum and urine were sample d at baseline , in the thirty-third and thirty-seventh weeks of pregnancy . Fetal serum was sample d at delivery . RESULTS At the thirty-seventh week the mean concentrations of the eicosapentaenoic-derived metabolites , thromboxane B3 and prostacyclin I3 , was twofold to threefold higher ( p < 0.001 ) in the group receiving fish oil compared with combined control groups . There were no significant effects of fish oil on the prostacyclin I2 metabolite , although there was a trend toward a reduction in thromboxane B2 in this group . In umbilical cord blood the mean concentration of thromboxane B2 was lowest in the group receiving fish oil ( p = 0.03 ) . CONCLUSIONS Fish oil was metabolized to the eicosapentaenoic acid-derived eicosanoids thromboxane A3 and prostacyclin I3 in pregnant women . Correspondingly , analog products of arachidonic acid tended to be depressed . It remains to be established whether these biochemical effects will prove beneficial in the prevention or treatment of preeclampsia and intrauterine growth retardation Background . It is currently recommended that diet of pregnant mothers contain 200–300 mg DHA/day . Aim . To determine whether DHA supplementation during pregnancy and lactation affects infants ' immune response . Methods . 60 women in ≥3rd pregnancy studied ; 30 r and omly assigned to receive DHA 400 mg/day from 12th week gestation until 4 months postpartum . From breast-fed infants , blood obtained for anti-HBs antibodies , immunoglobulins , lymphocyte subset phenotyping , and intracellular cytokine production . Results . CD4 + lymphocytes did not differ between groups , but CD4CD45RA/CD4 ( naïve cells ) significantly higher in infants in DHA+ group . Proportion of CD4 and CD8 cells producing IFNγ significantly lower in DHA+ group , with no differences in proportion of IL4-producing cells . Immunoglobulins and anti-HBs levels did not differ between groups . Conclusions . In infants of mothers  receiving DHA supplementation , a higher percentage of CD4 naïve cells and decreased CD4 and CD8 IFNγ production is compatible with attenuation of a proinflammatory response BACKGROUND The docosahexaenoic acid ( DHA ) intake of pregnant women is lower than estimates of the DHA accretion by the fetus , and recommendations were made to increase the DHA intake of pregnant women . OBJECTIVE The objective of this study was to determine whether the supplementation of pregnant women with DHA improved the visual acuity of infants at 4 mo . DESIGN We conducted a blinded assessment of a subset of healthy , full-term infants born to women enrolled in a double-blind , r and omized controlled trial called the DHA for Maternal and Infant Outcomes ( DOMInO ) trial . Women were r and omly assigned to consume DHA-rich fish-oil capsules ( ≈800 mg DHA/d in the treatment group ) or vegetable oil capsules ( control group ) from midpregnancy to delivery . The primary outcome was the sweep visual evoked potential ( VEP ) acuity at 4 mo . The VEP latency at 4 mo was a secondary outcome . RESULTS Mean ( ±SD ) VEP acuity did not differ between treatment and control groups [ treatment group : 8.37 ± 2.11 cycles per degree ( cpd ) , n = 89 ; control group : 8.55 ± 1.86 cpd , n = 93 ; P = 0.55 ] . VEP latencies also did not differ between groups . Irrespective of the group , maternal smoking in pregnancy was independently associated with poorer VEP acuity in the infant . CONCLUSIONS DHA supplementation in women with singleton pregnancies does not enhance infant visual acuity in infants at 4 mo of age . Visual acuity in infancy is adversely associated with maternal smoking in pregnancy . This trial was registered at www.anzctr.org.au as ACTRN12606000327583 . The DOMInO trial was registered at www.anzctr.org.au as ACTRN12605000569606 Asthma is a leading cause of morbidity for children and is a major public health problem in Australia . Ecological and temporal data suggest that dietary factors may have a role in recent increases in the prevalence of asthma . Aim : The aim of conducting this study was to investigate whether  childhood asthma was associated with the ratio of omega 6 ( n‐6 ) to omega 3 ( n‐3 ) fatty acids in the diet ( n‐6:n‐3 ) . Method : The Western Australian Pregnancy Cohort Study is a prospect i ve birth cohort of 2602 children . Using a nested case‐control cross‐sectional study design within this cohort , a group of children were identified as cases with current asthma at 6 or at 8 years of age or as controls with no asthma at 6 or at 8 years .  Dietary details including n‐6 and n‐3 fatty acid intake data were collected by parent response to a question naire when the children were 8 years old . Logistical regression was used to compare quartiles of n‐6:n‐3 intake in cases and controls . Adjustment was made for covariates : gender , gestational age , breastfeeding , older siblings , maternal smoking during pregnancy , maternal age , maternal asthma , child 's current age in months , body mass index , total energy intake , and antioxidant intake  ( vitamins A , C , E , and zinc ) . Results : A response rate of 83 % was achieved by providing complete data from 335 children [ 49 % cases with current asthma ( n = 166 ) , 51 % controls ( n = 169 ) ] . Following adjustment for covariates the association between the ratio of n‐6:n‐3 fatty acids and risk for current asthma was statistically significant ( p = 0.022 ) . Conclusion : We found evidence for a modulatory effect of the dietary n‐6:n‐3 fatty acid ratio on the presence of asthma in children . Our results provide evidence that promotion of a diet with increased n‐3 fatty acids and reduced n‐6 fatty acids to protect children against symptoms of asthma is warranted BACKGROUND The composition of long-chain PUFAs ( LCPUFAs ) in the maternal diet may affect obesity risk in the mother 's offspring . OBJECTIVE We hypothesized that a reduction in the n-6 (omega-6):n-3 ( omega-3 ) LCPUFA ratio in the diet of pregnant women and breastfeeding mothers may prevent expansive adipose tissue growth in their infants during the first year of life . DESIGN In a r and omized controlled trial , 208 healthy pregnant women were r and omly assigned to an intervention ( 1200 mg n-3 LCPUFAs as a supplement per day and a concomitant reduction in arachidonic acid intake ) or a control diet from the 15th wk of pregnancy to 4 mo of lactation . The primary outcome was infant fat mass estimated by skinfold thickness ( SFT ) measurements at 4 body sites at 3 - 5 d , 6 wk , and 4 and 12 mo postpartum . Secondary endpoints included sonographic assessment of abdominal subcutaneous and preperitoneal fat , fat distribution , and child growth . RESULTS Infants did not differ in the sum of their 4 SFTs at ≤1 y of life [ intervention : 24.1 ± 4.4 mm ( n = 85 ) ; control : 24.1 ± 4.1 mm ( n = 80 ) ; mean difference : -0.0 mm ( 95 % CI : -1.3 , 1.3 mm ) ] or in growth . Likewise , longitudinal ultrasonography showed no significant differences in abdominal fat mass or fat distribution . CONCLUSIONS We showed no evidence that supplementation with n-3 fatty acids and instructions to reduce arachidonic acid intake during pregnancy and lactation relevantly affects fat mass in offspring during the first year of life . Prospect i ve long-term studies are needed to explore the efficacy of this dietary approach for primary prevention . This trial was registered at clinical trials.gov as NCT00362089 BACKGROUND : Docosahexaenoic acid ( DHA ) has been associated with downregulation of inflammatory responses . OBJECTIVE : To report the effect of DHA supplementation on  long-term atopic and respiratory outcomes in preterm infants . METHODS : This study is a multicenter , r and omized controlled trial comparing the outcomes for preterm infants <33 weeks ' gestation who consumed expressed breast milk from mothers taking either tuna oil ( high-DHA diet ) or soy oil ( st and ard-DHA ) capsules .  Data collected included incidence of bronchopulmonary dysplasia ( BPD ) and parental reporting of atopic conditions over the first 18 months of life . RESULTS : Six hundred fifty-seven infants were enrolled ( 322 to high-DHA diet , 335 to st and ard ) , and 93.5 % completed the 18-month follow-up . There was a reduction in BPD in boys ( relative risk [ RR ] : 0.67 [ 95 % confidence interval ( CI ) : 0.47–0.96 ] ; P = .03 ) and in all infants with a birth weight of < 1250 g ( RR : 0.75 [ 95 % CI : 0.57–0.98 ] ; P = .04 ) . There was no effect on duration of respiratory support , admission length , or home oxygen requirement . There was a reduction in reported hay fever in all infants in the high-DHA group at either 12 or 18 months ( RR : 0.41 [ 95 % CI : 0.18–0.91 ] ; P = .03 ) and at either 12 or 18 months in boys ( RR : 0.15 [ 0.03–0.64 ] ; P = .01 ) . There was no effect on asthma , eczema , or food allergy . CONCLUSIONS : DHA supplementation for infants of <33 weeks ' gestation reduced the incidence of BPD in boys and in all infants with a birth weight of < 1250 g and reduced the incidence of reported hay fever in boys at either 12 or 18 months Objective : To assess the effects of antenatal omega 3 long-chain polyunsaturated fatty acid ( n-3 LC PUFA ) on cognitive development in a cohort of children whose mothers received high-dose fish oil in pregnancy . Design : A double-blind r and omised placebo-controlled trial . Setting : Perth , Western Australia , Australia . Patients : 98 pregnant women received the supplementation from 20 weeks ’ gestation until delivery . Their infants ( n = 72 ) were assessed at age 2½ years . Interventions : Fish oil ( 2.2 g docosahexaenoic acid ( DHA ) and 1.1 g eicosapentaenoic acid (EPA)/day ) or olive oil from 20 weeks ’ gestation until delivery . Outcome measures : Effects on infant growth and developmental quotients ( Griffiths Mental Development Scales ) , receptive language ( Peabody Picture Vocabulary Test ) and behaviour ( Child Behaviour Checklist ) . Results : Children in  the fish oil-supplemented group ( n = 33 ) attained a significantly higher score for eye and h and coordination ( mean ( ( SD ) score 114 ( 10.2 ) ) than those in the placebo group ( n = 39 , mean score 108 ( SD 11.3 ) ; p = 0.021 , adjusted p = 0.008 ) . Eye and h and coordination scores correlated with n-3 PUFA levels in cord blood erythrocytes ( EPA : r = 0.320 , p = 0.007 ; DHA : r = 0.308 , p = 0.009 ) and inversely correlated with n-6 PUFA ( arachidonic acid 20:4n-6 : r = −0.331 , p = 0.005 ) . Growth measurements in the two groups were similar at age 2½ years . Conclusion : Maternal fish oil supplementation during pregnancy is safe for the fetus and infant , and may have potentially beneficial effects on the child ’s eye and h and coordination . Further studies are needed to determine the significance of this finding Epigenetic regulation of imprinted genes is regarded as a highly plausible explanation for linking dietary exposures in early life with the onset of diseases during childhood and adulthood . We sought to test whether prenatal dietary supplementation with docosahexaenoic acid ( DHA ) during pregnancy may modulate epigenetic states at birth . This study was based on a r and omized intervention trial conducted in Mexican pregnant women supplemented daily with 400 mg of DHA or a placebo from gestation week 18 - 22 to parturition . We applied quantitative profiling of DNA methylation states at IGF2 promoter 3 ( IGF2 P3 ) , IGF2 differentially methylated region ( DMR ) , and H19 DMR in cord blood mononuclear cells of the DHA-supplemented group ( n = 131 ) and the control group ( n = 130 ) . In stratified analyses , DNA methylation levels in IGF2 P3 were significantly higher in the DHA group than the control group in preterm infants ( P = 0.04 ) . We also observed a positive association between DNA methylation levels and maternal body mass index ; IGF2 DMR methylation was higher in the DHA group than the control group in infants of overweight mothers ( P = 0.03 ) . In addition , at H19 DMR , methylation levels were significantly lower in the DHA group than the control group in infants of normal weight mothers ( P = 0.01 ) . Finally , methylation levels at IGF2/H19 imprinted regions were associated with maternal BMI . These findings suggest that epigenetic mechanisms may be modulated by DHA , with potential impacts on child growth and development BACKGROUND In vitro exposure of endothelial cells ( ECs ) to n-3 ( omega-3 ) long-chain PUFAs ( LCPUFAs ) reduces cell adhesion molecule ( CAM ) expression . However , to our knowledge , no previous human studies have examined the influence of an altered diet on CAM expression . OBJECTIVE We assessed whether salmon ( rich in n-3 LCPUFAs ) consumption twice a week during pregnancy affected offspring umbilical vein EC CAM expression . DESIGN Women were r and omly assigned to maintain their habitual diets or to consume 2 portions of salmon per week during pregnancy months 4 - 9 . ECs were isolated from umbilical cord veins collected at birth and cultured . The cell surface expression of intercellular adhesion molecule 1 ( ICAM-1 ) and vascular cell adhesion molecule 1 ( VCAM-1 ) was assessed by flow cytometry after the culture of ECs in the presence and absence of bacterial LPS for 24 h. Cytokine and growth factor concentrations in culture supernatant fluid were measured by using a multiplex assay . RESULTS LPS increased the expression of VCAM-1 and the production of several cytokines and growth factors . The level of ICAM-1 expression per cell [ ie , the median fluorescence intensity ( MFI ) ] was increased by LPS stimulation in the control group ( 16.9 ± 2.4 compared with 135.3 ± 20.2 ; P < 0.001 ) and to a lesser extent in the salmon group ( 14.1 ± 3.8 compared with 65.8 ± 22.4 ; P = 0.037 ) . The ICAM-1 MFI in the salmon group after LPS stimulation was lower than in the control group ( P = 0.006 ) . CONCLUSION Increased dietary salmon intake in pregnancy dampens offspring EC activation , which implicates a role for n-3 LCPUFAs in the suppression of inflammatory processes in humans . This trial was registered at clinical trials.gov as NCT00801502 Early nutrition may program obesity and cardiovascular risk later in life , and one of the potential agents is ( n-3 ) long-chain PUFA ( LCPUFA ) . In this study , our objective was to examine whether fish oil ( FO ) supplementation during lactation affects  blood pressure and body composition of children . Danish mothers ( n = 122 ) were r and omized to FO [ 1.5 g/d ( n-3 ) LCPUFA ] or olive oil ( OO ) supplementations during the first 4 mo of lactation . The trial also included a high-fish intake reference group ( n = 53 ) . Ninety-eight children were followed-up with blood pressure and anthropometry measurements at 7 y. Diet and physical activity level ( PAL ) were assessed by 4-d weighed dietary records and ActiReg . The PAL value was 4 % lower ( P = 0.048 ) and energy intake ( EI ) of the boys was 1.1 + /- 0.4 MJ/d higher ( P = 0.014 ) in the FO group than in the OO group . Starch intake was 15 + /- 6 g/d higher ( P = 0.012 ) in the FO group , but there were no other differences in diet . Body composition did not differ between the r and omized groups with or without adjustment for starch intake , EI , and PAL . FO boys had 6 mm Hg higher diastolic and mean arterial blood pressure than OO boys ( P < 0.01 ) , but girls did not differ . Within the r and omized groups , blood pressure was not correlated with maternal RBC ( n-3 ) LCPUFA after the intervention , but PAL values were ( r = -0.277 ; P = 0.038 ) . We previously found higher BMI at 2.5 y in the FO group , but the difference did not persist . The differences in blood pressure , EI , and PAL , particularly among boys , suggest that early ( n-3 ) LCPUFA intake may have adverse effects , which should be investigated in future studies The gut microbiota plays an important role in the development of the immune and gastrointestinal systems of infants . In the present study , we investigated whether increased salmon consumption during pregnancy , maternal weight gain during pregnancy or mode of infant feeding alter the markers of gut immune defence and inflammation .  Women ( n 123 ) who rarely ate oily fish  were r and omly assigned to continue consuming their habitual diet or to consume two 150 g portions of farmed salmon per week from 20 weeks of pregnancy to delivery . Faecal sample s were collected from the mothers ( n 75 ) at 38 weeks of gestation and from their infants ( n 38 ) on days 7 , 14 , 28 and 84 post-partum . Fluorescence in situ hybridisation was used to determine faecal microbiota composition and ELISA to measure faecal secretory IgA ( sIgA ) and calprotectin concentrations . There was no effect of salmon consumption on maternal faecal microbiota or on maternal or infant faecal sIgA and calprotectin concentrations . The degree of weight gain influenced maternal faecal microbiota , and the mode of infant feeding influenced infant faecal microbiota . Faecal sample s collected from infants in the salmon group tended to have lower bacterial counts of the Atopobium cluster compared with those collected from infants in the control group ( P=0·097 ) . This difference was significant in the formula-fed infants ( P < 0·05 ) , but not in the exclusively breast-fed infants . In conclusion , the impact of oily fish consumption during pregnancy on maternal and infant gut microbiota composition is limited , but significant differences are associated with  maternal weight gain during pregnancy and mode of infant feeding 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 BACKGROUND It is well established that obesity tends to track from early childhood into adult life . Studies in experimental animals have suggested that changes in the peri- and early postnatal intake of n-3 ( omega-3 ) polyunsaturated acids can affect the development of obesity in adult life . OBJECTIVE The aim of the current study was to investigate the effect of daily supplementation with 2.7 g long-chain n-3 fatty acids during the third trimester of pregnancy on adiposity in 19-y-old offspring . DESIGN The study was based on follow-up of a r and omized controlled trial from 1990 , in which 533 pregnant women were r and omly assigned to receive fish oil , olive oil , or no oil . At ≈19 y of age , the offspring of subjects from the r and omized controlled trial were invited to undergo a physical examination , including anthropometric measurements and fasting blood sampling . The blood sample was analyzed for insulin , glucose , glycated hemoglobin , leptin , adiponectin , insulin-like growth factor I , and high-sensitivity C-reactive protein . Multiple linear regression modeling , adjusted for sex , smoking , and parental overweight , was used to estimate the effect of fish oil relative to that of olive oil  on BMI ( in kg/m(2 ) ) , waist circumference , and biochemical measures . RESULTS A total of 243 of the offspring were followed up . We found no difference between the fish-oil and olive oil groups in BMI ( 0.13 ; -0.92 , 1.17 ) or waist circumference ( 0.7 cm ; -2.1 , 3.4 cm ) . Overall , results of the biochemical analyses supported the finding of no difference between the groups . CONCLUSION We detected no effect of fish-oil supplementation during pregnancy on offspring adiposity in adolescence BACKGROUND Although there are recognised associations between psychological and immune function , the effects of maternal depressive symptoms on fetal immune development have not been investigated . METHODS This study examined the relationship between maternal depression scores as assessed by the Beck Depression Inventory ( BDI ) in the second trimester and measure of neonatal immune function measured in cord blood . This study was conducted in a cohort of women ( n=83 ) who had received either fish oil containing 3.7 g/day n-3 polyunsaturated fatty acid ( n-3PUFA ) or a placebo from 20 weeks gestation as part of a r and omised controlled trial . RESULTS At 20 weeks gestation , prior to the intervention , 22 % of women in the study manifested mild to moderate depressive symptoms ( BDI > or = 10 ) . Neonates of these women had higher lymphoproliferative responses to a range of stimuli ( including egg ovalbumin and cat allergen ) compared with neonates of women with normal BDI scores ( < 10 ) . These neonates also showed higher spontaneous cytokine production including ( IL-6 and IL-10 ) and higher stimulated cytokine responses to both bacterial antigens and allergens . These patterns were evident after allowing for maternal age and education , parity , gestation , infant gender , delivery method and neonatal n-3/n-6 PUFA status . CONCLUSION This exploratory study supports the notion that maternal mood in pregnancy may have the potential to influence fetal immune development . Further studies are needed to determine the significance of this BACKGROUND Observational studies associate higher intakes of n-3 ( omega-3 ) long-chain polyunsaturated fatty acids ( LCPUFAs ) during pregnancy with higher gestation duration and birth size .  The results of r and omized supplementation trials using various n-3 LCPUFA sources and amounts are mixed . OBJECTIVE We tested the hypothesis that 600 mg/d of the n-3 LCPUFA docosahexaenoic acid ( DHA ) can increase  maternal and newborn DHA status , gestation duration , birth weight , and length . Safety was assessed . DESIGN This phase III , double-blind , r and omized controlled trial was conducted between January 2006 and October 2011 . Women ( n = 350 ) consumed capsules ( placebo , DHA ) from < 20 wk of gestation to birth . Blood ( enrollment , birth , and cord ) was analyzed for red blood cell ( RBC ) phospholipid DHA . The statistical analysis was intent-to-treat . RESULTS Most of the capsules were consumed ( 76 % placebo ; 78 % DHA ) ; the mean DHA intake for the treated group was 469 mg/d . In comparison with placebo , DHA supplementation result ed in higher maternal and cord RBC-phospholipid-DHA ( 2.6 % ; P < 0.001 ) , longer gestation duration ( 2.9 d ; P = 0.041 ) , and greater birth weight ( 172 g ; P = 0.004 ) , length ( 0.7 cm ; P = 0.022 ) , and head circumference ( 0.5 cm ; P = 0.012 ) . In addition , the DHA group had fewer infants born at < 34 wk of gestation ( P = 0.025 ) and shorter hospital stays for infants born preterm ( 40.8 compared with 8.9 d ; P = 0.026 ) than did the placebo group . No safety concerns were identified . CONCLUSIONS A supplement of 600 mg DHA/d in the last half of gestation result ed in overall greater gestation duration and infant size . A reduction in early preterm and very-low birth weight could be important clinical and public health outcomes of DHA supplementation . This trial was registered at clinical trials.gov as NCT00266825 We investigated whether the previously reported preventive effect of maternal ω-3 fatty acid supplementation on  IgE-associated allergic disease in infancy may be mediated by facilitating a balanced circulating Th2/Th1 chemokine profile in the infant . Vaccine-induced immune responses at 2 y of age were also evaluated . Pregnant women , at risk of having an allergic infant , were r and omized to daily supplementation with 1.6 g eicosapentaenoic acid and 1.1 g docosahexaenoic acid or placebo from the 25th gestational week through 3.5 mo of breastfeeding . Infant plasma was analyzed for chemokines ( cord blood , 3 , 12 , 24 mo ) and anti-tetanus and anti-diphtheria IgG ( 24 mo ) . High Th2-associated CC-chemokine lig and 17 ( CCL17 ) levels were associated with infant allergic disease ( p < 0.05 ) . In infants without , but not with , maternal history of allergy , the ω-3 supplementation was related to lower CCL17/CXC-chemokine lig and 11 ( CXCL11 ) ( Th2/Th1 ) ratios ( p < 0.05 ) . Furthermore , in nonallergic , but not in allergic infants , ω-3 supplementation was linked with higher Th1-associated CXCL11 levels ( p < 0.05 ) , as well as increased IgG titers to diphtheria ( p = 0.01 ) and tetanus ( p = 0.05 ) toxins . Thus , the prospect of balancing the infant immune system toward a less Th2-dominated response , by maternal ω-3 fatty acid supplementation , seems to be influenced by allergic status BACKGROUND Prenatal consumption of omega-3 fatty acids can act as an adjuvant in the development of the immune system and affect the inflammatory response of neonates . METHODS We conducted a double-blind , r and omized , placebo-controlled trial in Cuernavaca , Mexico . We r and omly assigned 1,094 pregnant women ( 18 - 35 years of age ) to receive 400 mg/d of algal docosahexaenoic acid ( DHA ) or placebo from 18 to 22 weeks of gestation through delivery . Birth outcomes and respiratory symptoms information until 18 months were available for 869 mother-child pairs . Question naires were administered , and maternal blood sample s were obtained at baseline . Maternal atopy was based on specific IgE levels . During follow-up , information on infants ' respiratory symptoms was collected through question naires administered at 1 , 3 , 6 , 9 , 12 , and 18 months of age . Negative binomial regression models were used to evaluate the effect of supplementation on respiratory symptoms in infants . RESULTS Among infants of atopic mothers , a statistically significant protective effect of DHA treatment was observed on phlegm with nasal discharge or nasal congestion ( 0.78 ; 95 % CI , 0.60 - 1.02 ) and fever with phlegm and nasal discharge or nasal congestion ( 0.53 ; 95 % CI , 0.29 - 0.99 ) , adjusting for potential confounders . CONCLUSIONS Our results support the hypothesis that DHA supplementation during pregnancy may decrease the incidence of respiratory symptoms  in children with a history of maternal atopy . TRIAL REGISTRY Clinical Trials.gov ; No. : NCT00646360 ; URL : www . clinical trials.gov Objective To determine whether dietary n-3 long chain polyunsaturated fatty acid ( LCPUFA ) supplementation of pregnant women with a fetus at high risk of allergic disease reduces immunoglobulin E associated eczema or food allergy at 1 year of age . Design Follow-up of infants at high hereditary risk of allergic disease in the Docosahexaenoic Acid to Optimise Mother Infant Outcome ( DOMInO ) r and omised controlled trial . Setting Adelaide , South Australia . Participants 706 infants at high hereditary risk of developing allergic disease whose mothers were participating in the DOMInO trial . Interventions The intervention group ( n=368 ) was r and omly allocated to receive fish oil capsules ( providing 900 mg of n-3 LCPUFA daily ) from 21 weeks ’ gestation until birth ; the control group ( n=338 ) received matched vegetable oil capsules without n-3 LCPUFA . Main outcome measure Immunoglobulin E associated allergic disease ( eczema or food allergy with sensitisation ) at 1 year of age . Results No differences were seen in the overall percentage of infants with immunoglobulin E associated allergic disease between the n-3 LCPUFA and control groups ( 32/368 ( 9 % ) v 43/338 ( 13 % ) ; unadjusted relative risk 0.68 , 95 % confidence interval 0.43 to 1.05 , P=0.08 ; adjusted relative risk 0.70 , 0.45 to 1.09 , P=0.12 ) , although the percentage of infants diagnosed as having atopic eczema ( that is , eczema with associated sensitisation ) was lower in the n-3 LCPUFA group ( 26/368 ( 7 % ) v 39/338 ( 12 % ) ; unadjusted relative risk 0.61 , 0.38 to 0.98 , P=0.04 ; adjusted relative risk 0.64 , 0.40 to 1.02 , P=0.06 ) . Fewer infants were sensitised to egg in the n-3 LCPUFA group ( 34/368 ( 9 % ) v 52/338 ( 15 % ) ; unadjusted relative risk 0.61 , 0.40 to 0.91 , P=0.02 ; adjusted relative risk 0.62 , 0.41 to 0.93 , P=0.02 ) , but no difference between groups in immunoglobulin E associated food allergy was seen . Conclusion n-3 LCPUFA supplementation in pregnancy did not reduce the overall incidence of immunoglobulin E associated allergies in the first year of life , although atopic eczema and egg sensitisation were lower . Longer term follow-up is needed to determine if supplementation has an effect on respiratory allergic diseases and aeroallergen sensitisation in childhood . Trial registration Australian New Zeal and Clinical Trials Registry ACTRN12610000735055 ( DOMInO trial : ACTRN12605000569606 ) Fish oil supplementation has been shown to reduce neutrophil production of inflammatory LTB4 ( leukotriene B4 ) in adults . The present study is the first to examine the effects on  neonatal neutrophil function following supplementation in pregnancy . Pregnant women with allergic disease ( n=98 ) were r and omized to receive either fish oil [ 3.7 g of n-3 long-chain PUFAs ( polyunsaturated fatty acids)/day ] or a placebo supplement for the final 20 weeks of pregnancy . Leukotriene production by neonatal neutrophils was measured after stimulation with the calcium ionophore A23187 . This was examined in relation to supplementation , cell membrane fatty acid levels and mononuclear cytokine production . Neutrophil LTB4 production was significantly reduced in neonates whose mothers had received fish oil in pregnancy . This was most evident for isomer 2 of LTB4 ( P=0.031 ) , although this was also observed for total LTB4 ( P=0.051 ) and isomer 1 ( P=0.088 ) . There was also a trend for lower production of other PUFA metabolites , namely 5-HETE ( 5-hydroxyeicosatetraenoic acid ; P=0.054 ) in the fish oil group . Accordingly , LTB4 levels were inversely related to membrane n-3 PUFA levels . Less inflammatory products ( LTB5 ) were only produced at very low levels , although there was a trend for higher levels of this metabolite in the fish oil group . Consistent with this , LTB5 levels were positively correlated with n-3 PUFA membrane levels , particularly EPA ( eicosapentanoic acid ) and negatively correlated with n-6 PUFAs . Neonates with lower neutrophil LTB4 production also had lower production of pro-inflammatory IL (interleukin)-6 responses ( r=0.35 , P=0.005 ) and regulatory IL-10 responses ( r=0.37 , P=0.003 ) by LPS (lipopolysaccharide)-stimulated neonatal mononuclear cells . In conclusion , maternal dietary changes can modify  neonatal neutrophil function . This has implication s for the early immune programming , which can be influenced by the inflammatory milieu of local tissues during initial antigen encounter . It also provides evidence of another pathway through which long-chain PUFAs status can influence early immune development DHA ( 22 : 6n-3 ) in pregnancy has previously been shown to benefit infant brain and retinal development . Fatty acid consumption during pregnancy may also have an impact on infant adipose tissue development . The objective of the present study was to assess the prenatal impact of a DHA-containing functional food ( DHA-FF ) on  infant intra-uterine growth . This was a longitudinal , r and omised , double-blinded , placebo-controlled trial . Pregnant women were assigned to consume a DHA-FF or placebo bar from 24 weeks ' gestation until delivery . Blood sample s were collected from mothers at baseline and delivery and from the umbilical cord at delivery . Plasma and erythrocyte fatty acids were analysed by GLC and plasma insulin concentrations were analysed using a commercially available ELISA kit . Infant birth weight and length were obtained at delivery and ponderal index ( weight (g)/length (cm)3 × 100 ) was calculated . A total of forty-seven mothers completed the study . Infants of mothers consuming the DHA-FF during the last half of pregnancy had lower ponderal indices ( β = 0.198 , P < 0.05 ) and umbilical cord blood insulin concentrations ( β = 0.743 , P < 0.05 ) than infants of mothers consuming the placebo . Thus , DHA consumption during pregnancy may be advantageous with respect to infant body composition at birth and insulin sensitivity Abstract Fetuses and breastfed children depend on the maternal docosahexaenoic acid ( DHA ) supply , which might have long-lasting consequences . We studied the growth of 6-year-old children whose mothers received supplemental DHA from midpregnancy to 3 months after delivery . One hundred and forty-four pregnant women had been r and omized to receive one of three vitamin-mineral supplements  , one supplying an additional 200 mg/day DHA . Of the original sample , 120 children were measured at age 6 years with st and ardized methods . As one objective of the follow-up was to investigate the DHA influence on normal growth , the DHA group was compared with the pooled controls after exclusion of five premature infants . The weight , length , body mass index ( BMI ) , head circumference , and skin-fold thickness at 6 years were similar in the 41 children of the DHA group and the 74 controls . Longitudinally , the BMI z-scores of the DHA group increased up at a later age than that of the controls . We found a highly significant negative correlation between height at 6 years and the increase in red blood cell DHA concentration of mothers from 22 to 37 weeks of pregnancy . We conclude that DHA supplements during midpregnancy corrected a low maternal DHA status ( which correlated with children ’s height ) and was favorable in regard to the BMI development up to 6 years BACKGROUND & AIMS Oily fish is a good source of n-3 long-chain polyunsaturated fatty acids . Since these fatty acids may change efficiency of amino acid ( AA ) absorption , we determined whether increased salmon consumption influences plasma AA concentrations in pregnant women and their newborns . METHODS Pregnant women were r and omly allocated to remain on their habitual diet  ( n = 61 ; control group ) or to consume two 150 g farmed salmon portions per week from 20 weeks pregnancy until birth  ( n = 62 ; salmon group ) . Plasma AA concentrations were determined in women at w20 , w34 and w38 of pregnancy and in umbilical cord at delivery . RESULTS Concentrations of arginine , valine , leucine and lysine were affected by both time of pregnancy and salmon intake ( p < 0.05 ) , with a smaller gestation-associated decrease in the salmon group . Total essential AA concentrations were similar in both groups at w20 , but at w38 were higher in salmon group ( p < 0.05 ) . Cord plasma AA concentrations , higher than in maternal plasma ( p < 0.01 ) , were similar in the two groups ( p > 0.05 ) . CONCLUSIONS Two portions/wk of oily fish increased plasma essential AA concentrations during pregnancy and could contribute to a maternal health benefit . Two portions/wk of salmon did not affect plasma AA concentrations in the newborn . CLINICAL TRIALS IDENTIFIER NCT00801502 BACKGROUND Data for trends in prevalence of asthma , allergic rhinoconjunctivitis , and eczema over time are scarce . We repeated the International Study of Asthma and Allergies in Childhood ( ISAAC ) at least 5 years after Phase One , to examine changes in the prevalence of symptoms of these disorders . METHODS For the ISAAC Phase Three study , between 2002 and 2003 , we did a  cross-sectional question naire survey of 193,404 children aged 6 - 7 years from 66 centres in 37 countries , and 304,679 children aged 13 - 14 years from 106 centres in 56 countries , chosen from a r and om sample of schools in a defined geographical area . FINDINGS Phase Three was completed a mean of 7 years after Phase One . Most centres showed a change in prevalence of 1 or more SE for at least one disorder , with increases being twice as common as decreases , and increases being more common in the 6 - 7 year age-group than in the 13 - 14 year age-group , and at most levels of mean prevalence . An exception was asthma symptoms in the older age-group , in which decreases were more common at high prevalence . For both age-groups , more centres showed increases in all three disorders more often than showing decreases , but most centres had mixed changes . INTERPRETATION The rise in prevalence of symptoms in many centres is concerning , but the absence of increases in prevalence of asthma symptoms for centres with existing high prevalence in the older age-group is reassuring . The divergent trends in prevalence of symptoms of allergic diseases form the basis for further research into the causes of such disorders Background and objectives The epidemiological association between higher dietary n‐3 polyunsaturated fatty acids ( PUFA ) and lower prevalence of asthma , has led to interest in the role of early dietary modification in allergic disease prevention . In this study we examined the effects of maternal n‐3 (PUFA)‐rich fish oil supplementation on cord blood ( CB ) IgE and cytokine levels in neonates at risk of developing allergic disease Oily fish intake during pregnancy may reduce the risk of allergic diseases in infancy possibly by shifts in the fatty acid balance and subsequent altered prostagl and in ( PG ) formation . This intervention is the first study to evaluate if increased oily fish intake affects in vivo PGF(2α ) formation during pregnancy . British pregnant women were r and omised to two portions of farmed salmon weekly ( n=47 ) , or maintenance of their normal diet low in fish ( n=41 ) , from pregnancy week 20 until parturition . The concentrations of eicosapentaenoic and docosahexaenoic acids in plasma phosphatidylcholine ( PC ) were higher and the concentration of arachidonic acid in plasma PC was lower in the salmon group than the control group at weeks 34 and 38 of pregnancy . PGF(2α ) formation was evaluated by urinary measurement of 15-keto-dihydro-PGF(2α ) , a major PGF(2α ) metabolite , at 20 , 34 and 38 weeks . In both the salmon and control groups urinary 15-keto-dihydro-PGF(2α ) concentrations increased significantly during pregnancy , which may be of physiological importance . Oily fish intervention  altered fatty acid concentrations but did not affect urinary 15-keto-dihydro-PGF(2α ) concentrations in pregnant women OBJECTIVE We investigated the relative contribution of macronutrients to postnatal growth in preterm infants born <33 wk of gestation . METHODS An audit of daily parenteral and enteral intakes of protein , carbohydrate , fat , energy , and growth ( daily weight , weekly length , and head circumference ) from birth to discharge home in 138 infants at <33 wk of gestation admitted to an Australian tertiary hospital was done . A mixed-model analysis of variance with r and om effects ( slope and intercept ) for subject and controlling for time , sex , gestational age , and total energy was used to determine the relative contribution of macronutrients to growth . RESULTS A higher energy intake ( kilocalories per day ) had a positive influence on growth . With total energy held constant , the contribution of carbohydrate to total energy had a positive relation to weight , length , and head circumference gains ; protein had no relation and fat was negatively associated . For every 1 % increase in energy from carbohydrate , there was a 2.3-g/d increase in weight ( 95 % confidence interval 1.6 - 3.0 , P < 0.0001 ) , a 0.013-cm/d increase in length ( 95 % confidence interval 0.003 - 0.022 , P = 0.007 ) , and a 0.015-cm/d increase in head circumference ( 95 % confidence interval 0.009 - 0.022 , P < 0.0001 ) . CONCLUSION A re-examination of the macronutrient balance in the diet of preterm infants is required in relation to optimizing growth 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 To investigate the effect of n-3 polyunsaturated fatty acid ( PUFA ) supplementation on the fatty acid composition of erythrocyte phospholipids and breast milk lipids , pregnant Brazilian women in the 30th week of gestation were r and omized to supplement their usual diet with 2 g/day of fish oil ( FO group ) or primrose oil ( PO group , control ) capsules for 15 days . Erythrocyte phospholipids from FO group had proportionally higher docosahexaenoicacid and eicosapentaenoic acid levels and furthermore , the ratio of n-6/n-3 PUFA was significantly lower in the breast milk lipids compared with the control group . Assessment of plasma anti-oxLDL autoantibodies and thiobarbituric acid-reactive substance concentration demonstrated that both groups had the same levels and they were unaltered by supplementations OBJECTIVE Fetal dysregulation of T helper cell pathways may predispose to allergy , as high cord blood T helper 2/T helper 1 ratios have been shown to precede development of allergic diseases . We aim ed to determine whether prenatal eicosapentaenoic acid and docosahexaenoic acid supplementation reduces T helper 2 to T helper 1-associated chemokine ratios . We also explored the effect of mode of delivery on T helper 2/T helper 1 ratios . STUDY DESIGN We conducted a secondary analysis of a r and omized placebo controlled trial initially performed to assess the effects of docosahexaenoic acid or eicosapentaenoic acid supplementation on pregnancy-related depressive symptoms among 126 participants . Cord plasma specimens from 98 newborns were assayed for chemokines associated with T helper 2 ( thymus and activation-regulated chemokine [ CCL17 ] , macrophage-derived chemokine [ CCL22 ] , eotaxin [ CCL 11 ] ) and T helper 1 ( interferon-inducible protein-10 [ CXCL 10 ] ) by enzyme-linked immunosorbent assay and Multiplex immunoassays . Ratios of log-transformed chemokines macrophage-derived chemokine/interferon-inducible protein-10 and thymus and activation-regulated chemokine/interferon-inducible protein-10 were compared between groups by analyses of variance . Multiple linear regression was performed to examine associations between treatments and chemokine ratios , adjusting for covariates . RESULTS After adjusting for gestational age at delivery , birthweight , and mode of delivery , both omega-3 supplementation groups were associated with lower macrophage-derived chemokine/interferon-inducible protein-10 ratios than placebo ( eicosapentaenoic acid : coefficient -1.8 ; 95 % confidence interval [ CI ] , -3.6 to -0.05 ; P = .04 ; docosahexaenoic acid : -2.0 ; 95 % CI , -3.9 to -0.07 ; P = .04 ) . Similar associations were found for thymus and activation-regulated chemokine/interferon-inducible protein-10 ( eicosapentaenoic acid : -1.5 ; 95 % CI , -3.0 to 0.06 ; P = .06 ; docosahexaenoic acid -2.2 ; 95 % CI , -3.8 to -0.52 ; P = .01 ) . Cesarean delivery was associated with higher macrophage-derived chemokine/interferon-inducible protein-10 ( 1.6 ; 95 % CI , 0.01 - 3.3 ; P = .049 ) and thymus and activation-regulated chemokine/interferon-inducible protein-10 ( 1.5 ; 95 % CI , 0.1 - 2.9 ; P = .042 ) ratios than vaginal delivery . CONCLUSION Prenatal supplementation with eicosapentaenoic acid and docosahexaenoic acid result ed in decreased cord blood T helper 2/T helper 1 chemokine ratios . Cesarean delivery was associated with a pronounced T helper 2 deviation at birth It was hypothesised from previous observational studies in the Faroes and Denmark that dietary marine n-3 fatty acids would prolong the duration of pregnancy and thereby increase the birth weight , by influencing the production of prostagl and ins involved in the process of parturition . Five hundred and thirty-three healthy Danish women were r and omly assigned in the 30th week of pregnancy to fish oil ( 2.7 g n-3 fatty acids ( 4 1-g capsules Pikasol oil ) per day ) , olive oil ( 4 1-g capsules per day ) or no oil supplementation . The three groups differed in mean gestational age at birth ( ANOVA , p = 0.006 ) , with the fish oil group ranking highest and the olive oil group lowest . Babies born to women allocated fish oil had on average 4.0 ( 95 % confidence interval 1.5;6.4 ) days higher gestational age and 107 ( 95 % confidence interval 1;214 ) g higher weight at birth than babies born to women allocated olive oil ; the difference in gestational age depended on the level of fish intake at enrollment , with a low fish intake enhancing the difference . Fish oil supplementation in the third trimester seems to prolong gestation while allowing continued growth of the foetus ; this effect seems to explain the difference between the Faroes and Denmark in pregnancy duration Background / Aims : The supply of docosahexaenoic acid ( DHA , 22:6ω–3 ) , important for fetal/infant neurodevelopment , depends on the maternal fatty acid ( FA ) status , which may be marginal in central Europe . Therefore , we investigated the effect of a daily vitamin/mineral supplement with and without 200 mg DHA from mid-pregnancy through lactation on the DHA concentrations in maternal and infant red blood cell phospholipids ( RBC% ) , and in breast milk FA ( % ) . Methods : At 21 weeks ’ gestation , 144 women were enrolled into a r and omised , double-blind clinical trial receiving daily : ( 1 ) a basic vitamin-mineral supplement ( Vit/Min group ) , ( 2 ) Vit/Min plus 4.5 g fructo-oligosaccharide ( FOS group ) , or ( 3 ) Vit/Min plus 4.5 g FOS plus 200 mg fish oil-derived DHA ( DHA-FOS group ) . FAs were determined by capillary gas-liquid chromatography . Results : While maternal RBC-DHA% at enrolment was not different , at 37 weeks gestation , and 3 months after delivery RBC-DHA% were significantly higher in the DHA-FOS group . The breast milk DHA% was twice as high in the DHA-FOS group ( 0.50 % ) than in the two others ( 0.25 % ) ( p < 0.001 ) , and the ratio ARA/DHA in the DHA-FOS group was 1.0 ± 0.43 , in the others 2.1 ± 0.43 ( p < 0.001 ) . The RBC-DHA% of the infants in the DHA-FOS group was also significantly higher , and correlated significantly with maternal RBC-DHA% before and 3 months after delivery . Conclusions : In central Europe , a dose of 200 mg/day DHA from mid-pregnancy through lactation seems appropriate to improve the DHA status of mothers and infants 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 Docosahexaenoic acid ( DHA ) and arachidonic acid ( AA ) are important nutrients in the preterm diet and fixed ratios have been proposed for formula . We evaluated the intra- and inter-individual variation in milk fatty acids from mothers of preterm infants involved in a r and omised trial of tuna oil or placebo supplementation .  Milk sample s were collected every 2 weeks while infants were hospitalised and fatty acids analysed by capillary gas chromatography . DHA was higher in milk of supplemented mothers than control ( % total fatty acids , mean+/-SD , treatment 0.9+/-0.4 , control 0.3+/-0.1 , p<0.0005 ) and ranged between 0.3 - 2.5 % and 0.1 - 1.1 % , respectively . AA did not differ between groups and ranged between 0.2 - 0.9 % and 0.3 - 0.9 % , respectively . Control mothers milk had wider AA : DHA ratio than treatment mothers ( 0.4 - 3.2 versus 0.2 - 2.1 ) . Due to the wide variation in milk AA and DHA , statements recommending infant formula based on a fixed AA : DHA ratio should be re-examined The Salmon in Pregnancy Study investigated whether the increased consumption of ( n-3 ) long-chain PUFA ( LC-PUFA ) from farmed Atlantic salmon  affects immune function during pregnancy and atopic disease in neonates compared with a habitual diet low in oily fish . In this context , because the ingestion of ( n-3 ) LC-PUFA may lower the concentrations of inflammatory biomarkers , we investigated whether the consumption of oily fish affects the levels of inflammatory cytokines and vascular adhesion factors during pregnancy . Pregnant women ( n = 123 ) were r and omly assigned to continue their habitual diet ( control group , n = 61 ) , which was low in oily fish , or to consume two 150-g salmon portions/wk ( salmon group , n = 62 ; providing 3.45 g EPA plus DHA ) from 20 wk of gestation until delivery . Plasma inflammatory cytokines and vascular adhesion factors were measured in maternal plasma sample s. Inflammatory biomarkers , including IL-8 , hepatocyte growth factor , and monocyte chemotactic protein , increased over the course of pregnancy ( P < 0.001 ) , whereas plasma matrix metalloproteinase 9 , IL-6 , TNFα , and nerve growth factor concentrations were not affected . Vascular homeostasis biomarkers soluble E-selectin , soluble vascular adhesion molecule-1 , soluble intercellular adhesion molecule (sICAM)-1 , and total plasminogen activator inhibitor-1 increased as pregnancy progressed ( P < 0.001 ) . The plasma sICAM-1 concentration was greater in the control group than in the salmon group at wk 20 ( baseline ) and 38 ( P = 0.007 ) but there was no group x time interaction , and when baseline concentration was used as a covariate , the groups did not differ ( P = 0.69 ) . The remaining biomarkers analyzed were similar in both groups . Therefore , although some inflammatory and vascular homeostasis biomarkers change during pregnancy , they are not affected by the increased intake of farmed salmon 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 BACKGROUND The influence of prenatal long-chain polyunsaturated fatty acids ( LC-PUFAs ) and folate on neurologic development remains controversial . OBJECTIVE The objective was to assess the long-term effects of n-3 ( omega-3 ) LC-PUFA supplementation , 5-methyltetrahydrofolate ( 5-MTHF ) supplementation , or both in pregnant women on cognitive development of offspring at 6.5 y of age . DESIGN This was a follow-up study of the NUHEAL ( Nutraceuticals for a Healthier Life ) cohort . Healthy pregnant women in 3 European centers were r and omly assigned to 4 intervention groups . From the 20th week of pregnancy until delivery , they received a daily supplement of 500 mg docosahexaenoic acid ( DHA ) + 150 mg eicosapentaenoic acid [ fish oil ( FO ) ] , 400 μg 5-MTHF , or both or a placebo .  Infants received formula containing 0.5 % DHA and 0.4 % arachidonic acid ( AA ) if they were born to mothers receiving FO supplements or were virtually free of DHA and AA until the age of 6 mo if they belonged to the groups that were not supplemented with FO . Fatty acids and folate concentrations were determined in maternal blood at weeks 20 and 30 of pregnancy , at delivery , and in cord blood . Cognitive function was assessed at 6.5 y of age with the Kaufman Assessment Battery for Children ( K-ABC ) . RESULTS We observed no significant differences in K-ABC scores between intervention groups . Higher DHA in maternal erythrocytes at delivery was associated with a Mental Processing Composite Score higher than the 50th percentile in the offspring . CONCLUSION We observed no significant effect of supplementation on the cognitive function of children , but maternal DHA status may be related to later cognitive function in children . This trial was registered at clinical trials.gov as NCT01180933 BACKGROUND The visual and mental development of preterm infants improved after feeding them milk enriched with docosahexaenoic acid ( DHA ) in amounts matching the fetal accretion rate . OBJECTIVE The objective was to evaluate whether feeding preterm infants milk with a higher DHA content than that used in current practice influences language or behavior in early childhood . DESIGN This was a follow-up study in a subgroup of infants enrolled in the DINO ( Docosahexaenoic acid for the Improvement in Neurodevelopmental Outcome ) trial . In a double-blind r and omized controlled trial , infants born at <33 wk of gestation were fed milk containing 1 % of total fatty acids as DHA ( higher-DHA group ) or approximately 0.3 % DHA ( control group ) until reaching full-term equivalent age . The longer-term effects of the intervention on language , behavior , and temperament were measured by using the MacArthur Communicative Development Inventory ( MCDI ) at 26-mo corrected age , the Strengths and Difficulties Question naire ( SDQ ) , and the Short Temperament Scale for Children ( STSC ) between 3- and 5-y corrected age . RESULTS Mean ( + /-SD ) MCDI scores did not differ significantly ( adjusted P = 0.8 ) between the higher-DHA group ( 308 + /- 179 , n = 60 ) and the control group ( 316 + /- 192 , n = 67 ) per the Vocabulary Production subscale . Composite scores on the SDQ and STSC did not differ between the higher-DHA group and the control group [ SDQ Total Difficulties : higher-DHA group ( 10.3 + /- 6.0 , n = 61 ) , control group ( 9.5 + /- 5.5 , n = 64 ) , adjusted P = 0.5 ; STSC score : higher-DHA group ( 3.1 + /- 0.7 , n = 61 ) , control group ( 3.0 + /- 0.7 , n = 64 ) , adjusted P = 0.3 ] . CONCLUSIONS Feeding preterm infants milk containing 3 times the st and ard amount of DHA did not result in any clinical ly meaningful change to language development or behavior when assessed in early childhood . Whether longer-term effects of dietary DHA supplementation can be detected remains to be assessed . This trial was registered with the Australia and New Zeal and Clinical Trial Registry at www.anzctr.org.au as 12606000327583 Recent observational studies suggest that mean birth weight and body fat growth in the first year of life have increased continuously over the last decades . Both elevated birth weight and early fat mass are potential risk factors for childhood obesity . Experimental and limited clinical data suggest that the dietary ratio of n–6 to n–3 fatty acids ( FAs ) during pregnancy is critical for early adipose tissue growth . The aim of this r and omized controlled study is to examine the effect of the supplementation with n–3 long-chain polyunsaturated FAs and reduction in the n–6/n–3 ratio in the diet of pregnant women/breast-feeding mothers on adipose tissue growth in their newborns using various methods for the assessment of body fat mass . Measurement of skinfold thickness in the newborn is the primary outcome parameter . Two hundred and four pregnant women will be recruited before the 15th week of gestation and r and omly assigned to either active intervention or an isocaloric control diet . This upcoming study will explore the potential of this dietary approach to limit early adipose tissue growth and may contribute to the development of a new strategy for the primary prevention of childhood obesity Objective : To examine the effect of fish oil supplementation on duration of pregnancy , conditional on the woman 's habitual fish intake . Design : Multicentre 1:1 r and omised clinical trial of effect of fish oil in a high-risk population of pregnant women in whom habitual fish intake was assessed at r and omisation . Setting : Nineteen university delivery wards in seven European countries . Subjects : Pregnant women with preterm delivery , intrauterine growth retardation ( IUGR ) , or pregnancy-induced hypertension ( PIH ) in a previous pregnancy ( group 1 , n=495 ) ; with twin pregnancies ( group 2 , n=367 ) ; or with suspicion of IUGR or threatening preeclampsia in the current pregnancy ( group 3 , n=106 ) . Women were stratified into low , middle , or high fish consumers . Methods : The intervention group received fish oil capsules providing 2.7 g long-chain n-3 fatty acids per day ( n-3 poly unsaturated fatty acids ( PUFA ) ) from around week 20 ( groups 1 and 2 ) or 6.3 g n-3 PUFA from week 33 ( group 3 ) . The control regimen was capsules with olive oil . Effect on timing of spontaneous delivery was examined by Cox regression , assuming elective delivery ( occurring in 40 % ) as a censoring event . Analyses of effect of fish oil were intention to treat , and all analyses were adjusted for maternal smoking , age , and parity . Results : In group 1 , fish oil reduced the hazard rate of spontaneous delivery ( HR ) by 44 % ( 95 % confidence interval 14–64 % ) and 39 % ( 16–56 % ) in low and middle fish consumers , respectively , with no detectable effect ( −56 to 33 % ) in high fish consumers . In groups 2 and 3 , no significant effect of fish oil was detected in any of the sub-strata defined by baseline fish consumption . Conclusions : In pregnant women with previous pregnancy complications , fish oil supplementation delayed onset of delivery in low and middle , but not in high , fish consumers . Sponsorship : March of Dimes Birth Defects Foundation , Concerted Action ( ERB-BMH1-CT92 - 1906 ) and PECO ( ERB-CIPD-CT94 - 0235 ) programmes of the European Commission , and the Danish National Research Foundation . Lube Ltd donated the oil capsules Background The need for omega-3 fatty acids , especially docosahexaenoic acid ( DHA ) , during pregnancy has received much attention , but evidence of effects on birth outcomes is limited . Objective To evaluate whether prenatal DHA supplementation  increases gestational age and birth size . Methods We conducted a double-blind , r and omized , placebo-controlled trial in Cuernavaca , Mexico . We r and omly assigned 1,094 pregnant women ( 18 to 35 years of age ; median DHA dietary intake , 55 mg/day ) to 400 mg/day of algal DHA or placebo from 18 to 22 weeks of gestation through delivery . Birth outcomes ( 968 live births and 5 stillbirths ) were ascertained from hospital records within 24 hours of delivery . Results Intention-to-treat analysis showed no differences between the control and DHA group ( all p > .05 ) in mean gestational age ( 39.1 + 1.7 and 39.0 ± 1.9 weeks , respectively ) , weight ( 3.20 + 0.47 and 3.21 ± 0.45 kg , respectively ) , length ( 50.3 ± 2.7 and 50.3 ± 2.3 cm , respectively ) and head circumference ( 34.3 ± 1.8 and 34.3 ± 1.5 cm , respectively ) at birth . Offspring of supplemented primigravidae ( n = 370 ) were heavier ( difference , 99.4 g ; 95 % CI , 5.5 to 193.4 ) and had larger head circumferences ( difference , 0.5 cm ; 95 % CI , 0.1 to 0.9 ) than controls ; the differences in multigravidae ( n = 603 ) were −53.3 g ( 95 % CI , −126.8 to 20.2 ) and −0.2 cm ( 95 % CI , −0.4 to 0.1 ) , respectively ( p < .05 for heterogeneity ) . Conclusions Prenatal DHA supplementation of primigravid women may result in increased birth size in a population where dietary DHA intakes are very low . Benefits of the intervention on infant health and neurodevelopment are under study The evidence relating prenatal supplementation with DHA to offspring neurological development is limited . We investigated the effect of prenatal DHA supplementation on infant brainstem auditory-evoked responses and visual- evoked potentials in a double-blind , r and omized controlled trial in Cuernavaca , Mexico . Pregnant women were supplemented daily with 400 mg DHA or placebo from gestation wk 18 - 22 through delivery . DHA and placebo groups did not differ in maternal characteristics at r and omization or infant characteristics at birth . Brainstem auditory-evoked responses were measured at 1 and 3 mo in 749 and 664 infants , respectively , and visual-evoked potentials were measured at 3 and 6 mo in 679 and 817 infants , respectively . Left-right brainstem auditory-evoked potentials were moderately correlated ( range , 0.26 - 0.43 ; all P < 0.001 ) and left-right visual-evoked potentials were strongly correlated ( range , 0.79 - 0.94 ; all P < 0.001 ) within any assessment . Correlations across visits were modest to moderate ( range , 0.09 - 0.38 ; all P < 0.01 ) . The offspring of  DHA-supplemented women did not differ from those of control women with respect to any outcome measure ( all comparisons P > 0.10 ) . We conclude that DHA supplementation during pregnancy did not influence brainstem auditory-evoked responses at 1 and 3 mo or visual-evoked potentials at 3 and 6 mo n--3 Fatty acids derived from fish oil reduce plasma triacylglycerols ( triglycerides ) and increase HDL-C ( high-density lipoprotein cholesterol ) ; however , the effect of n--3 fatty acid supplementation during pregnancy , a hyperlipidaemic state , remains unknown . We took the opportunity to investigate maternal lipid levels and blood pressure during and after pregnancy , and fetal lipid levels at birth , in a study that aim ed primarily to examine the effect of fish oil supplementation during pregnancy on immune function in infants born to women with allergic disease . Eighty-three pregnant women who had allergic disease , but were otherwise healthy , completed the study . They were r and omly allocated to receive fish oil or olive oil capsules , taken as 4 g/day , from 20 weeks of pregnancy until delivery . Compared with olive oil , fish oil supplementation did not alter triacylglycerols , total cholesterol , LDL-C ( low-density lipoprotein cholesterol ) or HDL-C during or after pregnancy . There was also no effect of fish oil on cord blood triacylglycerols , total cholesterol , LDL-C or HDL-C.  Fish oil supplementation during pregnancy did not alter maternal blood pressure during or after pregnancy . The effects of fish oil on lipids and blood pressure in non-pregnant individuals appear to be lost when it is administered during pregnancy The anti-inflammatory properties of n-3 polyunsaturated fatty acids ( n-3 PUFA ) have suggested a potential role of these nutrients in dietary modification for prevention of allergic disease in early life . As oxidative stress is known to modify antigen presenting cell ( APC ) signalling and result ing immune responses , we examined the effects of maternal n-3 PUFA supplementation in pregnancy on markers of oxidative stress and APC function in neonates at high risk of allergy . Eighty-three pregnant atopic women were r and omised to receive 4 g daily of either fish oil ( n=40 ) or olive oil ( n=43 ) capsules in a controlled trial from 20 weeks gestation until delivery . Plasma ( cord blood ) and urinary F2-isoprostanes were measured as markers of lipid peroxidation . Cord erythrocyte fatty acids and markers of APC function ( HLA-DR expression and cytokine responses ) were measured and related to levels of plasma F2-isoprostanes . Maternal fish oil supplementation lowered plasma ( p<0.0001 ) and urinary ( p=0.06 ) F2-isoprostanes . HLA-DR expression on APC was not different between the groups . In multiple regression analysis , 28.8 % of the variance in plasma F2-isoprostanes was explained by positive relationships with erythrocyte arachidonic acid ( AA ) and monocyte HLA-DR expression and a negative relationship with erythrocyte eicosapentaenoic acid ( EPA ) . This study shows that maternal supplementation with fish oil can attenuate neonatal lipid peroxidation . Clinical follow-up of these infants will help to determine if there are sustained effects on postnatal oxidative stress and expression of allergic disease OBJECTIVE : Long-chain polyunsaturated fatty acids such as docosahexaenoic acid ( DHA ) influence immune function and inflammation ; however , the influence of maternal DHA supplementation on infant morbidity is unknown . We investigated the effects of prenatal DHA supplementation on  infant morbidity . METHODS : In a double-blind r and omized controlled trial conducted in Mexico , pregnant women received daily supplementation with 400 mg of DHA or placebo from 18 to 22 weeks ' gestation through parturition . In infants aged 1 , 3 , and 6 months , caregivers reported the occurrence of common illness symptoms in the preceding 15 days . RESULTS : Data were available at 1 , 3 , and 6 months for 849 , 834 , and 834 infants , respectively . The occurrence of specific illness symptoms did not differ between groups ; however , the occurrence of a combined measure of cold symptoms was lower in the DHA group at 1 month ( OR : 0.76 ; 95 % CI : 0.58–1.00 ) . At 1 month , the DHA group experienced 26 % , 15 % , and 30 % shorter duration of cough , phlegm , and wheezing , respectively , but 22 % longer duration of rash ( all P ≤ .01 ) . At 3 months , infants in the DHA group spent 14 % less time ill ( P < .0001 ) . At 6 months , infants in the DHA group experienced 20 % , 13 % , 54 % , 23 % , and 25 % shorter duration of fever , nasal secretion , difficulty breathing , rash , and “ other illness , ” respectively , but 74 % longer duration of vomiting ( all P < .05 ) . CONCLUSIONS : DHA supplementation during pregnancy decreased the occurrence of colds in children at 1 month and influenced illness symptom duration at 1 , 3 , and 6 months The objective of this study was to assess the relation between observed levels of omega-3 fatty acids in plasma and symptoms of asthma and atopy in children at 18 months of age . A total of 616 women at risk of having a child who would develop asthma because of a family history were recruited from the antenatal clinics of six hospitals in Sydney , Australia . Families were r and omized to either active omega-3 supplemented or control group . The active group received a daily tuna fish oil supplement and omega-3-rich margarines and cooking oils and the control group received a placebo supplement with polyunsaturated margarines and cooking oils . When the children were 18 months of age an assessment of symptoms was carried out by a research nurse blinded to treatment group allocation . Atopy was measured by skin prick tests , blood was collected to determine serum immunoglobulin E ( IgE ) , and plasma fatty acid concentrations . A total of 376 children ( 61.0 % of total recruited ) completed an assessment at 18 months and had blood taken to determine plasma fatty acid concentrations . Omega-3 fatty acid levels were expressed in quintiles of exposure ' as treated ' without reference to treatment group allocation . Wheeze ever , doctor visits for wheeze , bronchodilator use and nocturnal coughing were significantly reduced in children in the higher exposure quintiles . Serum IgE was reduced in the highest quintile but not significantly so . There was no difference in diagnosed asthma or atopy between the exposure quintiles . Although wheeze at this age may not be a good indicator of asthma in later childhood , it is encouraging that some symptoms have been reduced in children with high omega-3 fatty acid concentrations in plasma BACKGROUND There is growing interest in the potential role of anti-inflammatory n-3 polyunsaturated fatty acids ( n-3 PUFAs ) in the prevention of allergic disease . OBJECTIVE We sought to determine whether maternal dietary supplementation with n-3 PUFAs during pregnancy could modify immune responses in infants . METHODS In a r and omized , controlled trial 98 atopic , pregnant women received fish oil ( 3.7 g n-3 PUFAs per day ) or placebo from 20 weeks ' gestation until delivery . Neonatal PUFA levels and immunologic response to allergens were measured at birth . RESULTS Eighty-three women completed the study .  Fish oil supplementation ( n = 40 ) achieved significantly higher proportions of n-3 PUFAs in neonatal erythrocyte membranes ( mean + /- SD , 17.75 % + /- 1.85 % as a percentage of total fatty acids ) compared with the control group ( n = 43 , 13.69 % + /- 1.22 % , P < .001 ) . All neonatal cytokine ( IL-5 , IL-13 , IL-10 , and IFN-gamma ) responses ( to all allergens ) tended to be lower in the fish oil group ( statistically significant only for IL-10 in response to cat ) . Although this study was not design ed to examine clinical effects , we noted that infants in the fish oil group were 3 times less likely to have a positive skin prick test to egg at 1 year of age ( odds ratio , 0.34 ; 95 % confidence interval , 0.11 to 1.02 ; P = .055 ) . Although there was no difference in the frequency of atopic dermatitis at 1 year of age , infants in the fish oil group also had significantly less severe disease ( odds ratio , 0.09 ; 95 % confidence interval , 0.01 to 0.94 ; P = .045 ) . CONCLUSIONS These data suggest a potential reduction in subsequent infant allergy after maternal PUFA supplementation . More detailed follow-up studies are required in larger cohorts to establish the robustness of these findings and to ascertain their significance in relation to longer-term modification of allergic disease in children 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 OBJECTIVES . Arachidonic acid ( 20:4n-6 ) and docosahexaenoic acid ( 22:6n-3 ) are essential for brain growth and cognitive development . We have reported that supplementing pregnant and lactating women with n-3 very-long-chain polyunsaturated fatty acids promotes higher IQ scores at 4 years of age as compared with maternal supplementation with n-6 polyunsaturated fatty acids . In our present study , the children were examined at 7 years of age with the same cognitive tests as at 4 years of age . We also examined the relation between plasma fatty acid pattern and BMI in children , because an association between arachidonic acid and adipose tissue size has been suggested . METHODS . The study was r and omized and double-blinded . The mothers took 10 mL of cod liver oil or corn oil from week 18 of pregnancy until 3 months after delivery . Their children were tested with the Kaufman Assessment Battery for Children at 7 years of age , and their height and weight were measured . RESULTS . We did not find any significant differences in scores on the Kaufman Assessment Battery for Children test at 7 years of age between children whose mothers had taken cod liver oil ( n = 82 ) or corn oil ( n = 61 ) . We observed , however , that maternal plasma phospholipid concentrations of α-linolenic acid ( 18:3n-3 ) and docosahexaenoic acid during pregnancy were correlated to sequential processing at 7 years of age . We observed no correlation between fatty acid status at birth or during the first 3 months of life and BMI at 7 years of age . CONCLUSION . This study suggests that maternal concentration of n-3 very-long-chain polyunsaturated fatty acids during pregnancy might be of importance for later cognitive function , such as sequential processing , although we observed no significant effect of n-3 fatty acid intervention on global IQs . Neonatal fatty acid status had no influence on BMI at 7 years of age Objective To study the effect of fish oil supplementation on  blood pressure  during the third trimester of pregnancy BACKGROUND Altered intakes of n-3 and n-6 polyunsaturated fatty acids were suggested to modulate allergic disease , but intervention trials yielded inconclusive results . Because allergies are primed in early infancy and in utero , the fetus might be more accessible to nutritional intervention strategies . OBJECTIVE We sought to investigate how supplementation of pregnant women with a fish oil ( FO ) preparation  modulates allergy-related immune parameters in mothers and offspring . METHODS We performed a multicenter , r and omized , double-blind , placebo-controlled trial . Three hundred eleven pregnant women received daily either FO with 0.5 g of docosahexaenoic acid and 0.15 g of eicosapentaenoic acid , 400 mug of methyl-tetra-hydrofolic acid , both , or placebo from the 22nd gestational week . T(H)1/T(H)2-related molecules were quantified in 197 maternal and 195 cord blood sample s by using real-time RT-PCR . Data are given as geometric means [ 95 % CIs ] . RESULTS FO supplementation was associated with increased TGF-beta mRNA in maternal ( 0.85 [ 0.8 - 0.89 ] ; placebo : 0.68 [ 0.64 - 0.72 ] ) and cord blood ( 0.85 [ 0.81 - 0.9 ] ; placebo : 0.75 [ 0.71 - 0.79 ] ) . IL-1 ( 0.69 [ 0.66 - 0.73 ] ; placebo : 0.83 [ 0.79 - 0.88 ] ) and IFN-gamma ( 0.54 [ 0.51 - 0.57 ] ; placebo : 0.65 [ 0.61 - 0.69 ] ) were decreased in mothers only ( P < .001 ) . Cord blood mRNA levels of IL-4 ( 0.54 [ 0.52 - 0.57 ] ; placebo : 0.64 [ 0.61 - 0.68 ] ) , IL-13 ( 0.61 [ 0.58 - 0.65 ] ; placebo : 0.85 [ 0.80 - 0.89 ] ) , CCR4 ( 0.70 [ 0.67 - 0.73 ] ; placebo : 0.88 [ 0.84 - 0.92 ] ; all P < .001 ) , and natural killer ( P < .001 ) and CCR3+CD8 + T cells ( P < .04 ) were decreased in the FO group . CONCLUSION Supplementation with FO during pregnancy is associated with decreased mRNA levels of T(H)2-related molecules in the fetus and decreased maternal inflammatory cytokines . We speculate that both effects are mediated by TGF-beta BACKGROUND There is uncertainty regarding the efficacy of increasing n-3 long-chain PUFA ( LCPUFA ) intake during pregnancy in reducing the risk of  gestational diabetes mellitus ( GDM ) and preeclampsia .  OBJECTIVES The objective was to determine whether n-3 LCPUFA supplementation in pregnancy reduces the incidence of GDM or preeclampsia . A secondary objective was to assess the effect of n-3 LCPUFA supplementation on perinatal complications . DESIGN This was a double-blind , multicenter r and omized control trial-the DHA to Optimize Mother Infant Outcome ( DOMInO ) trial . Pregnant women ( n = 2399 ) of < 21 wk gestation were r and omly assigned to receive DHA-enriched fish oil ( 800 mg/d ) or vegetable oil capsules without DHA from trial entry to birth . The presence of GDM or preeclampsia was assessed through a blinded audit of medical records . Birth outcomes and prenatal complications were also assessed . RESULTS The overall incidences of GDM and preeclampsia were 8 % and 5 % , respectively , based on clinical diagnosis . The RR of GDM was 0.97 ( 95 % CI : 0.74 , 1.27 ) and of preeclampsia was 0.87 ( 95 % CI : 0.60 , 1.25 ) , and they did not differ significantly between the groups . Birth weight , length , and head circumference z scores also did not differ between the groups . There were 12 perinatal deaths and 5 neonatal convulsions in the control group compared with 3 perinatal deaths and no neonatal convulsions in the DHA group ( P = 0.03 in both cases ) . CONCLUSION DHA supplementation of 800 mg/d in the second half of pregnancy does not reduce the risk of GDM or preeclampsia . Whether supplementation reduces the risk of perinatal death and neonatal convulsions requires further investigation . The DOMInO trial was registered with the Australian New Zeal and Clinical Trials Registry as TRN12605000569606 Dietary n-3 polyunsaturated fatty acids ( PUFA ) may represent a mode of allergy prevention . Cord blood ( CB ) CD34 + hemopoietic progenitors are altered in infants at risk of atopy . We therefore studied the effects of dietary n-3 PUFA supplementation during pregnancy on numbers and function of progenitors in neonates at high risk of atopy . In a double-blind study , atopic , pregnant women were r and omized to receive fish oil capsules or placebo from 20 wk gestation until delivery . At birth , CB CD34 + cells were isolated and analyzed by flow cytometry for expression of cytokine ( IL-5Rα , IL-3Rα , granulocyte/macrophage colony-stimulating factor Rα ) or chemokine ( CXCR4 and CCR3 ) receptors . CB cells were also cultured in methylcellulose assays for eosinophil/basophil colony-forming cells . At age 1 y , infants were clinical ly assessed for atopic symptoms and skin tests . Percentages of CB CD34 + cell numbers were higher after n-3 PUFA than placebo .  Co-expression of cytokine or chemokine receptors on CD34 cells was not altered by n-3 PUFA supplementation . However , there were significantly more IL-5-responsive CB eosinophil/basophil colony forming units ( Eo/B-CFU ) in the fish oil , compared with the control , group . Overall , there was a positive association between CD34 + cells and IL-5-responsive Eo/B-CFU in CB and 1 y clinical outcomes , including atopic dermatitis and wheeze . Dietary n-3 PUFA supplementation during pregnancy in atopic mothers alters infant cord blood hemopoietic progenitor phenotype . This may have an impact on development of atopic disease AIM To determine the effect of neonatal docosahexaenoic acid ( DHA ) supplementation in preterm infants on later respiratory-related hospitalisations . METHODS We enrolled 657 infants in a multicentre , r and omised , controlled trial design ed to study the long-term efficacy of higher dose dietary DHA in infants born <33 weeks ' gestation . Treatment was with high DHA ( ∼1 % ) compared with st and ard DHA ( ∼0.3 % ) in breast milk or formula , given from the first week of life to term equivalent . Parent-reported hospital admissions to 18 months corrected age were recorded . The proportion of children hospitalised for lower respiratory tract ( LRT ) conditions and the mean number of hospitalisations per infant were determined . RESULTS Twenty-three per cent ( 154/657 ) of infants were hospitalised for LRT conditions . Seventy-three per cent ( 173/238 ) of admissions were for bronchiolitis . There was no significant effect of higher DHA on the proportion of infants admitted for LRT conditions ( high DHA 22 % vs. st and ard DHA 25 % , adjusted relative risk 0.92 , 95 % confidence interval ( CI ) 0.68 - 1.24 , P = 0.57 ) or in the mean number of admissions per infant ( high DHA 0.34 , st and ard DHA 0.38 , adjusted ratio of means 0.91 , 95 % CI 0.63 - 1.32 , P = 0.62 ) . The sexes responded differently to treatment ( interaction P = 0.046 ) , with reduced admissions in boys given high DHA , but this was not statistically significant ( high DHA 19 % , st and ard DHA 28 % , adjusted relative risk 0.69 , 95 % CI 0.46 - 1.04 , P = 0.08 ) . CONCLUSIONS Hospitalisation for LRT problems in the first 18 months for preterm infants was not reduced by neonatal supplementation with 1 % DHA BACKGROUND Oily fish provides marine n-3 ( omega-3 ) fatty acids that are considered to be important in the growth , development , and health of the fetus and newborn infant . OBJECTIVES The objectives were to increase salmon consumption among pregnant women and to determine the effect on maternal and umbilical cord plasma marine n-3 fatty acid content . DESIGN Women ( n = 123 ) with low habitual consumption of oily fish  were r and omly assigned to continue their habitual diet or were provided with 2 portions of farmed salmon/wk to include in their diet from week 20 of pregnancy until delivery . RESULTS Median weekly consumption frequency of study salmon in the salmon group was 1.94 portions , and total fish consumption frequency was 2.11 portions/wk in the salmon group and 0.47 portions/wk in the control group ( P < 0.001 ) . Intakes of eicosapentaenoic acid ( EPA ) and docosahexaenoic acid ( DHA ) from the diet , from seafood , and from oily fish were higher in the salmon group ( all P < 0.001 ) . Percentages of EPA and DHA in plasma phosphatidylcholine decreased during pregnancy in the control group ( P for trend = 0.029 and 0.008 , respectively ) , whereas they increased in the salmon group ( P for trend for both < 0.001 ) . EPA and DHA percentages were higher in maternal plasma phosphatidylcholine at weeks 34 and 38 of pregnancy and in umbilical cord plasma phosphatidylcholine in the salmon group ( P < 0.001 for all ) . CONCLUSION If pregnant women , who do not regularly eat oily fish , eat 2 portions of salmon/wk , they will increase their intake of EPA and DHA , achieving the recommended minimum intake ; and they will increase their and their fetus ' status of EPA and DHA . This trial was registered at clinical trials.gov as NCT00801502 CONTEXT Uncertainty exists about the benefit of dietary docosahexaenoic acid ( DHA ) on the  neurodevelopment of preterm infants . OBJECTIVE To determine the effect of meeting the estimated DHA requirement of preterm infants on neurodevelopment at 18 months ' corrected age . DESIGN , SETTING , AND PARTICIPANTS R and omized , double-blind controlled trial enrolling infants born at less than 33 weeks ' gestation from April 2001 to October 2005 at 5 Australian tertiary hospitals , with follow-up to 18 months . INTERVENTION High-DHA ( approximately 1 % total fatty acids ) enteral feeds compared with st and ard DHA ( approximately 0.3 % total fatty acids ) from day 2 to 4 of life until term corrected age . MAIN OUTCOME MEASURES Bayley Mental Development Index ( MDI ) at 18 months ' corrected age . A priori subgroup analyses were conducted based on r and omization strata ( sex and birth weight < 1250 g vs > or = 1250 g ) . RESULTS Of the 657 infants enrolled , 93.5 % completed the 18-month follow-up . Bayley MDI scores did not differ between the high- and st and ard-DHA groups ( mean difference , 1.9 ; 95 % confidence interval [ CI ] , -1.0 to 4.7 ) . The MDI among girls fed the high-DHA diet was higher than girls fed st and ard DHA in unadjusted and adjusted analyses ( unadjusted mean difference , 4.7 ; 95 % CI , 0.5 - 8.8 ; adjusted mean difference , 4.5 ; 95 % CI , 0.5 - 8.5 ) . The MDI among boys did not differ between groups . For infants born weighing less than 1250 g , the MDI in the high-DHA group was higher than with st and ard DHA in the unadjusted comparison ( mean difference , 4.7 ; 95 % CI , 0.2 - 9.2 ) but did not reach statistical significance following adjustment for gestational age , sex , maternal education , and birth order ( mean difference , 3.8 ; 95 % CI , -0.5 to 8.0 ) . The MDI among infants born weighing at least 1250 g did not differ between groups . CONCLUSION A DHA dose of approximately 1 % total fatty acids in early life did not increase MDI scores of preterm infants overall born earlier than 33 weeks but did improve the MDI scores of girls . TRIAL REGISTRATION anzctr.org.au Identifier : ACTRN12606000327583 The sale of prenatal supplements with docosahexaenoic acid ( DHA ) continues to increase , despite little evidence of benefit to offspring neurodevelopment.1 We r and omized pregnant women to receive 800 mg of DHA daily or a placebo during the last half of pregnancy and found no group differences in cognitive , language , and motor development at 18 months of age , although secondary analyses revealed less cognitive delay but lower language scores in the DHA group.2 At 4 years of age there was no benefit of DHA supplementation in general intelligence , language , and executive functioning , and a possible negative effect on parent-rated behavior and executive functioning.3 This follow-up was design ed to evaluate the effect of prenatal DHA on intelligence quotient ( IQ ) at 7 years , the earliest age at which adult performance can be indicated Studies in experimental animals and human subjects have suggested that intake of n-3 fatty acids in early life can affect cardiovascular risk factors in adult life . Therefore , the aim of the present study was to investigate the effect of fish oil ( FO ) supplementation during the third trimester of pregnancy on blood pressure ( BP ) , heart rate ( HR ) and HR variability ( HRV ) in the 19-year-old offspring . The study was based on follow-up of a r and omised , controlled trial from 1990 , in which 533 pregnant women were r and omised to FO , olive oil ( OO ) or no oil ( NO ) during the last trimester of pregnancy . The offspring was invited to a physical examination including BP , HR and HRV measurements . A subgroup consisting of the offspring of mothers with a low baseline fish intake also had 24 h HRV determined . The OO group was used as reference and multiple linear regression modelling was used to compare the FO and OO groups . A total of 180 of the offspring from the FO and OO groups agreed to participate in the study ( 45 % ) . The adjusted difference between the FO and OO groups was 2 ( 95 % CI -1 , 4 ) mmHg in systolic and 1 ( 95 % CI 0 , 3 ) mmHg in diastolic BP . The difference in HR was 1 ( 95 % CI -2 , 4 ) . Also , HRV indices did not differ significantly between groups . Hence , FO supplementation during late pregnancy was not associated with offspring BP , HR and HRV during adolescence Fish oil supplementation during pregnancy alters breast milk composition , but there is little information about the impact of oily fish consumption . We determined whether increased salmon consumption during pregnancy alters breast milk fatty acid composition and immune factors . Women ( n = 123 ) who rarely ate oily fish  were r and omly assigned to consume their habitual diet or to consume 2 portions of farmed salmon per week from 20 wk of pregnancy until delivery . The salmon provided 3.45 g long-chain ( LC ) ( n-3 ) PUFA/wk . Breast milk fatty acid composition and immune factors [ soluble CD14 , transforming growth factor-β (TGFβ)1 , TGFβ2 , and secretory IgA ] were analyzed at 1 , 5 , 14 , and 28 d postpartum ( PP ) . Breast milk from the salmon group had higher proportions of EPA ( 80 % ) , docosapentaenoic acid ( 30 % ) , and DHA ( 90 % ) on d 5 PP compared with controls ( P < 0.01 ) . The LC ( n-6 ) PUFA : LC ( n-3 ) PUFA ratio was lower for the salmon group on all days of PP sampling ( P ≤ 0.004 ) , although individual ( n-6 ) PUFA proportions , including arachidonic acid , did not differ . All breast milk immune factors decreased between d 1 and 28 PP ( P < 0.001 ) . Breast milk secretory IgA ( sIgA ) was lower in the salmon group ( d 1 - 28 PP ; P = 0.006 ) . Salmon consumption during pregnancy , at the current recommended intakes , increases the LC ( n-3 ) PUFA concentration of breast milk in early lactation , thus improving the supply of these important fatty acids to the breast-fed neonate . The consequence of the lower breast milk concentration of sIgA in the salmon group is not clear ( n-3 ) PUFA , including DHA , are essential for neural development and accumulate extensively in the fetal and infant brain . ( n-3 ) PUFA concentrations in breast milk , which are largely dependent on maternal diet and tissue stores , are correlated with infant PUFA status . We investigated the effect of prenatal DHA supplementation on PUFA concentrations in breast milk at 1 mo postpartum . In a double-blind , r and omized , controlled trial conducted in Mexico , pregnant women were supplemented daily with 400 mg DHA or placebo from 18 - 22 wk gestation to parturition . Fatty acid concentrations in breast milk obtained from 174 women at 1 mo postpartum were determined using GLC and were expressed as % by weight of total detected fatty acids . Breast milk DHA concentrations in the DHA and placebo groups were ( mean ± SD ) 0.20 ± 0.06 and 0.17 ± 0.07 ( P < 0.01 ) , respectively , and those of α-linolenic acid ( ALA ) were 1.38 ± 0.47 and 1.24 ± 0.46 ( P = 0.01 ) , respectively . Concentrations of EPA and arachidonic acid did not differ between groups ( P > 0.05 ) . Maternal plasma DHA concentrations at 1 mo postpartum correlated positively with breast milk DHA at 1 mo postpartum in both the placebo and DHA groups ( r = 0.4 ; P < 0.01 for both treatment groups ) . Prenatal DHA supplementation from 18 - 22 wk gestation to parturition increased concentrations of DHA and ALA in breast milk at 1 mo postpartum , providing a mechanism through which breast-fed infants could benefit
BACKGROUND Allergies have become more prevalent globally over the last 20 years .
Dietary consumption of n-3 ( or omega 3 ) long chain polyunsaturated fatty acids ( LCPUFA ) has declined over the same period of time .
This , together with the known role of n-3 LCPUFA in inhibiting inflammation , has result ed in speculation that n-3 LCPUFA may prevent allergy development .
Dietary n-3 fatty acids supplements may change the developing immune system of the newborn before allergic responses are established , particularly for those with a genetic predisposition to the production of the immunoglobulin E ( IgE ) antibody .
Individuals with IgE-mediated allergies have both the signs and symptoms of the allergic disease and a positive skin prick test ( SPT ) to the allergen .
OBJECTIVES To assess the effect of n-3 LCPUFA supplementation in pregnant and /or breastfeeding women on allergy outcomes ( food allergy , atopic dermatitis ( eczema ) , allergic rhinitis ( hay fever ) and asthma/wheeze ) in their children .