The Kansas University DHA Outcomes Study (KUDOS) clinical trial: long-term behavioral follow-up of the effects of prenatal DHA supplementation.

Authors:
John Colombo
John Colombo
University of Kansas
United States
Kathleen Gustafson
Kathleen Gustafson
University of Kansas Medical Center
United States
Byron J Gajewski
Byron J Gajewski
University of Kansas Medical Center
United States
Jocelynn M Thodosoff
Jocelynn M Thodosoff
University of Kansas
United States
Elizabeth Kerling
Elizabeth Kerling
University of Kansas Medical Center
Susan E Carlson
Susan E Carlson
University of Kansas Medical Center
United States

Am J Clin Nutr 2019 May;109(5):1380-1392

Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS.

Background: Docosahexaenoic acid (DHA) is a long-chain polyunsaturated fatty acid that has been linked to improved vision and cognition in postnatal feeding studies and has been consistently associated with reduction of early preterm birth in prenatal supplementation trials. This is a report of the first long-term follow-up of infants from mothers receiving prenatal DHA supplementation in a US cohort.

Objective: Our objective was to evaluate the efficacy of the prenatal supplementation on both global and granular longitudinal assessments of cognitive and behavioral development.

Methods: In a randomized double-blind clinical trial, mothers received either 600 mg/d of DHA or a placebo beginning at 14.5 weeks of gestation and capsules were provided until delivery. Children from those pregnancies were followed by cognitive and behavioral assessments administered from 10 mo through 6 y of age. From 301 mothers in the initial study, ∼200 infants completed the longitudinal schedule.

Results: Although this intervention had been shown to reduce high-risk pregnancies and improve visual attention in infants during the first year, only a few positive long-term effects of prenatal DHA supplementation emerged from analyses of this follow-up. Increases in maternal blood DHA during pregnancy were related to verbal and full scale intelligence quotient (IQ) scores at 5 and 6 y, but these effects disappeared after controlling for SES. Maternal blood DHA concentrations at delivery were unrelated to outcomes, although maternal DHA at enrollment was related to productive vocabulary at 18 mo.

Conclusions: Although prenatal DHA supplementation substantially reduced early preterm birth and improved visual attention in infancy in this sample, no consistent long-term benefits were observed into childhood. Increases in maternal blood DHA concentration in pregnancy were related to higher IQs but this effect was confounded with SES and disappeared when SES was statistically controlled. This trial was registered at http://www.clinicaltrials.gov as NCT00266825 and NCT02487771.

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Source
https://academic.oup.com/ajcn/advance-article/doi/10.1093/aj
Publisher Site
http://dx.doi.org/10.1093/ajcn/nqz018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6499507PMC

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May 2019
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References

(Supplied by CrossRef)
Effect of maternal docosahexaenoic (DHA) supplementation on milk and infant plasma DHA
Jensen et al.
Pediatr Res 1996
Relationship of prenatal LCPUFA status to infant visual and cognitive function
Forsyth et al.
J Reprod Infant Psyc 2003
Long-chain polyunsaturated fatty acid supplementation in infancy and cognitive function in later childhood
Willatts et al.
J Reprod Infant Psyc 2003

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