Effects of docosahexaenoic acid supplementation during pregnancy on gestational age and size at birth: randomized, double-blind, placebo-controlled trial in Mexico.
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, randomized, placebo-controlled trial in Cuernavaca, Mexico. We randomly 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.
Ramakrishnan
Usha
U
Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, USA. uramakr@emory.edu
Stein
Aryeh D
AD
Parra-Cabrera
Socorro
S
Wang
Meng
M
Imhoff-Kunsch
Beth
B
Juárez-Márquez
Sergio
S
Rivera
Juan
J
Martorell
Reynaldo
R
D000293:Adolescent; D000328:Adult; D000375:Aging; D001724:Birth Weight; D049628:Body Size; D019587:Dietary Supplements / Q000009:adverse effects; D004281:Docosahexaenoic Acids / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D005260:Female; D005317:Fetal Growth Retardation / Q000517:prevention & control; D005865:Gestational Age; D020073:Gravidity; D006257:Head / Q000254:growth & development; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008800:Mexico; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000517:prevention & control; D039401:Prenatal Nutritional Physiological Phenomena; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult
D004281:Docosahexaenoic Acids