Abstract

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 randomized placebo controlled trial.

Setting: Perth, Western Australia.

Patients: Pregnant women (n=98) received the supplementation from 20 weeks gestation until delivery. Their infants (n=72) were assessed at 2½ years of age.

Interventions: Fish oil (2.2g docosahexaenoic acid (DHA) plus 1.1g eicosapentaenoic acid (EPA)/day) or olive oil from 20 weeks gestation until delivery.

Main outcome measures: Effects on infant growth and developmental quotients (Griffiths Mental Development Scales), receptive language (Peabody Picture Vocabulary Test) and behaviour (Child Behavior Checklist).

Results: Children in the fish oil supplemented group (n= 33) attained a significantly higher score for eye-hand coordination (mean score 114 SD 10.2) than the placebo group (n=39, mean score 108, SD 11.3) (P=0.021, adjusted P=0.008). Eye-hand coordination scores correlated with n-3 PUFA levels in cord blood erythrocytes (EPA: r=0.320, P=0.007 and 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 2 1/2 years of age.

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 hand coordination. Further studies are needed to determine the significance of this finding.