Effect of DHA supplementation during pregnancy on maternal depression and neurodevelopment of young children: a randomized controlled trial. The effect of supplementation with fish oil during pregnancy on breast milk immunoglobulin A, soluble CD14, cytokine levels and fatty acid composition Randomized Controlled Trial of DHA Supplementation during Pregnancy: Child Adiposity Outcomes The effect of perinatal fish oil supplementation on neurodevelopment and growth of infants: a randomized controlled trial 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. Similar effects on infants of n-3 and n-6 fatty acids supplementation to pregnant and lactating women. 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. Cognitive assessment of children at age 2½ years after maternal fish oil supplementation in pregnancy: a randomised controlled trial Intake of fish oil during pregnancy and adiposity in 19-y-old offspring: follow-up on a randomized controlled trial. Breast milk fatty acid profile in relation to infant growth and body composition: results from the INFAT study Prenatal Supplementation with Docosahexaenoic Acid Has No Effect on Growth through 60 Months of Age. Maternal insulin resistance, triglycerides and cord blood insulin in relation to post-natal weight trajectories and body composition in the offspring up to 2 years. The effect of fish oil supplementation on maternal and neonatal outcomes: a triple-blind, randomized controlled trial 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 Effect of N-3 polyunsaturated fatty acid supplementation in pregnancy: the Nuheal 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 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. Effects of Docosahexaenoic Acid Supplementation During Pregnancy on Gestational Age and Size at Birth: Randomized, Double-Blind, Placebo-Controlled Trial in Mexico 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. The effect of maternal DHA supplementation on body fat mass in children at 7 years: follow-up of the DOMInO randomized controlled trial. 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 Does maternal docosahexaenoic acid supplementation during pregnancy and lactation lower BMI in late infancy? Maternal plasma polyunsaturated fatty acid status in late pregnancy is associated with offspring body composition in childhood. Importance of adequate sample sizes in fatty acid intervention trials.
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 Background Breast milk contains many immunomodulatory factors ( soluble CD14 ( sCD14 ) , IgA and cytokines ) with the potential to influence infant immune development Investigating safe and effective interventions in pregnancy that lower offspring adiposity is important given the burden of obesity and subsequent metabolic derangements . Our objective was to determine if docosahexaenoic acid ( DHA ) given during pregnancy to obese mothers results in lower offspring adiposity . This study was a long-term follow-up of a r and omized trial of mothers with gestational diabetes or obesity who were r and omized to receive DHA supplementation at 800 mg/day or placebo ( corn/soy oil ) starting at 25–29 weeks gestation .  Anthropometric measures were collected at birth and maternal erythrocyte DHA and arachidonic ( AA ) levels were measured at 26 and 36 weeks gestation . At two- and four-year follow-up time points , offspring adiposity measures along with a diet recall were assessed . A significant increase in erythrocyte DHA levels was observed at 36 weeks gestation in the supplemented group ( p < 0.001 ) . While no significant differences by measures of adiposity were noted at birth , two or four years by r and omization group , duration of breastfeeding ( p < 0.001 ) , and DHA level at 36 weeks ( p = 0.002 ) were associated with body mass index z-score . Our data suggest that DHA supplementation during pregnancy in obese mothers may have long-lasting effects on offspring measures of adiposity Introduction Long-chain polyunsaturated fatty acids , the most abundant fatty acids in the brain , are essential for the growth and development of the brain and the retina . Objective To evaluate the effect of fish oil supplementation on the development ( primary outcome ) and growth of  4- and 6-month-old infants . Methods In this triple-blind r and omized controlled trial , 150 pregnant women aged 18–35 years , who were referred to healthcare centres of Tabriz-Iran , were r and omly allocated into two groups . One group of women consumed fish oil supplementation ( containing 120 mg docosahexaenoic acid and 180 mg eicosapentaenoic acid ) daily , while the other consumed a placebo from the 20th week of pregnancy till 30 days after childbirth in a parallel design by a computer-generated block r and omization scheme . The neurodevelopment of infants was the primary outcome ; it was assessed using the ages and stages question naire ( ASQ ) at 4- and a-6 months of age . The growth of these infants was measured using weight , length and head circumference . The participants , the caregivers , and those assessing the outcomes were blind to the group assignment . Results Only one woman in the placebo group discontinued the intervention because of persistent severe nausea .  All 75 neonates aged 4- and a-6 months in the fish oil supplementation group , along with 73 and 71 neonates aged 4 and 6 months , respectively in the placebo group , were followed and analysed . Although the mean scores of neurodevelopment at the end of 4 and 6 months were higher in the supplemented group than in the placebo group in each ASQ domain , a statistically significant difference was observed only in the communication domain at the 4th month ( adjusted mean difference 2.63 ; 95 % confidence interval 0.36–4.89 ) . There was no significant difference in weight , length , or head circumference between the two groups of infants aged 4 and 6 months ( P ≥ 0.05 ) . Conclusion Based on the results , perinatal fish oil supplementation is beneficial for the communication domain of neurodevelopment of 4-month-old infants . The study results relating to the supplementation effect on other domains are inconclusive . There ought to be further studies with up-to- date lipidomic analysis to find biochemical correlate compared to an intervention and developmental finding 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 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 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 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 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 : There is some evidence that the n-6/n-3 long-chain polyunsaturated fatty acids ( LCPUFAs ) ratio in early nutrition , and thus in breast milk , could influence infant body composition . Methods : In an open-label r and omized controlled trial ( RCT ) , 208 healthy pregnant women were allocated to a dietary intervention ( supplementation with 1,200 mg n-3 LCPUFAs per day and instructions to reduce arachidonic acid ( AA ) intake ) from the 15th wk of gestation until 4 mo of lactation or to follow their habitual diet . Breast milk LCPUFAs at 6 wk and 4 mo postpartum were related to infant body composition assessed by skinfold thickness ( SFT ) measurements and ultrasonography during the first year of life . Results : Dietary intervention significantly reduced breast milk n-6/n-3 LCPUFAs ratio . In the whole sample , early breast milk docosahexaenoic acid ( DHA ) , eicosapentaenoic acid ( EPA ) , and n-3 LCPUFAs at 6 wk postpartum were positively related to the sum of four SFT measurements at age 1 . Breast milk AA and n-6 LCPUFAs at 6 wk postpartum were negatively associated with weight , BMI , and lean body mass ( LBM ) up to 4 mo postpartum . Conclusion : Breast milk n-3 LCPUFAs appear to stimulate fat mass growth over the first year of life , whereas AA seems to be involved in the regulation of overall growth , especially in the early postpartum period BACKGROUND Prenatal supplementation with docosahexaenoic acid ( DHA ) has been shown to increase birth size , but it is unclear whether these differences translate into improved postnatal growth . OBJECTIVE We assessed the effect of prenatal supplementation with DHA on offspring weight , length , and body mass index ( BMI ) through 60 mo of age . METHODS We examined growth patterns ( height , weight , and BMI ) in a cohort of 802 Mexican children whose mothers participated in a r and omized , controlled trial of daily supplementation with 400 mg/d of DHA or a placebo from week 18 - 22 of gestation through delivery , with the use of a longitudinal multilevel model of growth . RESULTS Overall , means ± SDs of height- , weight- , and BMI -for-age z scores relative to WHO growth st and ards at 60 mo were -0.49 ± 0.91 , -1.15 ± 1.07 and 0.13 ± 1.11 , respectively . There were no significant differences by treatment group ( all P > 0.05 ) for height , weight , or BMI at any age through 60 mo . Similarly , DHA did not affect the average growth or the trajectories for these measures through 60 mo . CONCLUSION Prenatal DHA supplementation did not affect height , weight , or BMI through 60 mo of age . This trial was registered at clinical trials.gov as NCT00646360 AIMS The intrauterine metabolic environment might have a programming effect on offspring body composition . We aim ed to explore associations of maternal variables of glucose and lipid metabolism during pregnancy , as well as cord blood insulin , with infant growth and body composition up to 2 years post-partum . METHODS Data of pregnant women and their infants came from a r and omized controlled trial design ed to investigate the impact of nutritional fatty acids on adipose tissue development in the offspring . Of the 208 pregnant women enrolled , 118 infants were examined at 2 years . In the present analysis , maternal fasting plasma insulin , homeostasis model assessment of insulin resistance and serum triglycerides measured during pregnancy , as well as insulin in umbilical cord plasma , were related to infant growth and body composition assessed by skinfold thickness measurements and abdominal ultrasonography up to 2 years of age . RESULTS Maternal homeostasis model assessment of insulin resistance at the 32nd week of gestation was significantly inversely associated with infant lean body mass at birth , whereas the change in serum triglycerides during pregnancy was positively associated with ponderal index at 4 months , but not at later time points . Cord plasma insulin correlated positively with birthweight and neonatal fat mass and was inversely associated with body weight gain up to 2 years after multiple adjustments . Subsequent stratification by gender revealed that this relationship with weight gain was stronger , and significant only in girls . CONCLUSIONS Cord blood insulin is inversely associated with subsequent infant weight gain up to 2 years and this seems to be more pronounced in girls Abstract Objective : To evaluate the effect of fish oil supplementation on pregnancy outcomes in mother and newborn . Methods : This r and omized , triple-blind , placebo-controlled trial was conducted on 150 pregnant women aged 18–35 years from Feburary 2014 to April 2015 in Tabriz , Iran . Participants were assigned to receive either 1000 mg fish oil supplements containing 180 mg eicosapentaenoic acid ( EPA ) and 120 mg docosahexanoic acid or placebo from week 20 of gestation to birth . The primary outcome measure was birth weight . Gestational duration , preterm labor low birth weight ( LBW ) , length , head circumference , and maternal serum docosahexaenoic acid ( DHA ) and EPA level at 35–37 weeks were also examined . The statistical analysis was on an intention-to-treat basis . Results : Demographic characteristics were similar in both groups ( P>0.05 ) . The mean ( SD ) birth weight values in the fish oil and placebo groups were 3256 ( 362 ) g and 3172 ( 447 ) g , respectively ( adjusted mean difference (MD)=84.1 g , 95 % confidence interval [CI]=−24.8 to 193.2 ) . Five ( 7.6 % ) neonates in the placebo versus no case in the fish oil group were born with LBW ( P=0.02 ) . The rate of preterm labor was lower in the fish oil group ( adjusted OR=0.74 , 95 % CI=0.16–3.42 ) . However , there were no statistically significant differences in the maternal outcomes ( P>0.05 ) with the exception of the proportion of maternal serum DHA fatty acid at 35–37 weeks ( P<0.001 ) . Conclusion : Although low dose fish oil supplementation increased birth weight , its effect was not statistically significant . The frequency of LBW was significantly reduced in the intervention group , but the observed reduction needs to be confirmed in future larger investigations using different doses of omega-3 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 In this placebo controlled , r and omised , double blind trial , pregnant women received from the 20th week of gestation onwards either 500 mg docosahexaenoic acid ( DHA ) , 400 mg 5-methyl-tetra-hydro-folate ( 5-MTHF ) , or placebo , or a combination of 500 mg DHA and 400 mg 5-MTHF . The dietary supplements were well tolerated ; the dropout rates did not differ significantly in the active arms of the study ( 10 % to 19 % ) from that seen in the placebo group ( 13 % ) . DHA supplementation result ed in significant enhancement of the contribution of DHA to maternal , placental and venous cord blood lipids Background / 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 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 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 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 BACKGROUND Animal studies have suggested that an increased supply of omega-3 long chain polyunsaturated fatty acids ( LCPUFA ) , in particular docosahexaenoic acid ( DHA ) , during the perinatal period can prevent later excess body fat mass . However , previous human studies have produced inconsistent findings , and few have assessed potential effects beyond 6 years of age . OBJECTIVE To evaluate the effect of supplementing women in the second half of pregnancy with omega-3 LCPUFA , chiefly as DHA , on the percentage body fat  of children at 7 years of age , as assessed by two methods : air displacement plethysmography ( BOD POD ) and bioelectrical impedance spectroscopy ( BIS ) . DESIGN A time-restricted follow up at 7 years of age of children born to mothers enrolled in DOMInO ( DHA to Optimise Maternal Infant Outcome ) r and omized controlled trial , in which women took either high-DHA tuna oil ( 800mg/day DHA ) or placebo capsules from 20 weeks ' gestation to delivery , at Adelaide-based centers . Primary outcomes were the percentage body fat at 7 years of age as assessed by both BOD POD and BIS . Weight , height , waist/hip circumferences and BMI were also recorded . RESULTS A total of 252 DOMInO children ( n=135 males , n=117 females ) completed the follow up study . There were no differences between the DHA and placebo groups in percentage body fat as assessed by either BOD POD [ adjusted mean difference : -0.35 , 95 % CI : -1.46 , 2.16 ; P=0.71 ] or BIS [ adjusted mean difference : 0.64 , 95 % CI : -0.99 , 2.27 ; P=0.44 ] . BMI z-scores were also similar between groups [ adjusted mean difference : 0.18 , 95 % CI : -0.10 , 0.45 ; P=0.21 ] . There were also no differences in height , weight or waist and hip circumference between the DHA and placebo groups at 7 years of age . CONCLUSION DHA supplementation in the second half of pregnancy has no effect on childhood growth or fat mass at 7 years of age , supporting findings from follow ups of the DOMInO children at 3 and 5 years 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 Abstract We compared growth of infants whose mothers either did or did not receive docosahexaenoic acid ( DHA ) supplements during pregnancy and lactation . At 21 weeks ' gestation , 144 women were enrolled into a r and omized , double-blind clinical trial receiving : ( 1 ) a basic supplement consisting of vitamins and minerals ( BS ) , or ( 2 ) BS plus 4.5 g fructooligosaccharide ( BSF ) , or ( 3 ) BSF plus fish oil DHA ( 200 mg ) until the end of the third month of lactation .  Infants ' length , weight and head circumference were measured at birth and at 1 , 3 and 21 months . A total of 51 mothers/infants were lost to follow-up by the third month and 24 at 21 months . The two groups not receiving DHA were combined into a control group . Analysis with mixed models adjusted for confounding factors showed a significant time dependent effect for the DHA group on the development of the body mass index ( BMI ) ( P=0.037 ) , and of weight ( P=0.046 ) , but no effect on the development of length ( P=0.537 ) , or of head circumference ( P=0.267 ) . At 21 months , weight of the  DHA group was lower by −601 g ( 95 % CI −171 ; −1030 g ) and BMI was lower by −0.76 kg/m2 ( 95 % CI −0.07 ; −1.46 ) compared to controls . The results indicate that DHA taken by pregnant and lactating mothers may reduce BMI in late infancy CONTEXT Maternal diet  during pregnancy has been linked to offspring adiposity , but it is unclear whether maternal polyunsaturated fatty acid ( PUFA ) status during pregnancy affects offspring body composition . OBJECTIVE We investigated the associations between maternal plasma n-3 and n-6 PUFA status at 34 wk gestation and offspring body composition . DESIGN AND SETTING A prospect i ve United Kingdom population -based mother-offspring cohort , the Southampton Women 's Survey ( SWS ) , was studied . PARTICIPANTS A total of 12,583 nonpregnant women were recruited into the SWS , among whom 1987 delivered a baby before December 31 , 2003 ; 293 mother-child pairs had complete measurements of maternal plasma PUFA concentrations in late pregnancy and offspring body composition at both ages 4 and 6 yr . MAIN OUTCOMES MEASURED We measured offspring body composition by dual-energy x-ray absorptiometry , yielding fat mass , lean mass , percentage fat mass , and percentage lean mass . Results are presented as β-coefficients for st and ardized variables , therefore reflecting the sd change of the outcome for every 1 sd of the predictor . RESULTS After adjustment for maternal factors and child factors including height and duration of breast-feeding , maternal plasma n-6 PUFA concentration positively predicted offspring fat mass at 4 yr ( β = 0.14 SD/SD ; P = 0.01 ) and 6 yr ( β = 0.11 SD/SD ; P = 0.04 ) , but there was no association with offspring lean mass at either age ( β = 0.005 SD/SD , P = 0.89 ; and β = 0.008 SD/SD , P = 0.81 , respectively ) . Maternal plasma n-3 PUFA concentration was not associated with offspring fat mass at 4 yr ( β = 0.057 SD/SD ; P = 0.34 ) or 6 yr ( β = 0.069 SD/SD ; P = 0.21 ) . Maternal plasma n-3 PUFA  status was positively associated with offspring lean mass on univariate analysis ( 4 yr , β = 0.11 , P = 0.06 ; 6 yr , β = 0.14 ; P = 0.02 ) ; however , this was confounded by a positive association with offspring height . CONCLUSIONS This observational study suggests that maternal n-6 PUFA status during pregnancy might influence  offspring adiposity in childhood R and omised controlled trials are the ideal way to assess the effects of interventions . Small trials are useful for generating pilot data to determine sample s sizes for larger trials , but can produce unreliable or biased results if they are considered in their own right . We investigate the impact of small sample sizes due to either inadequate recruitment targets or high attrition rates on the results of fatty acid intervention trials . Data from our large trial of DHA supplementation during pregnancy with minimal attrition are used for illustration . Our findings demonstrate that recruiting fewer participants or neglecting to follow up difficult participants can lead to substantially different results and alter conclusions about the effectiveness of the intervention . Developing strategies for overcoming these inadequacies should be a top priority in fatty acid intervention trials
Background The potential role of ω-3 long chain polyunsaturated fatty acid ( LCPUFA ) supplementation during pregnancy on subsequent risk of obesity outcomes in the offspring is not clear and there is a need to synthesis e this evidence .