The effect of prenatal docosahexaenoic acid supplementation on infant outcomes in African American women living in low-income environments: A randomized, controlled trial
The effect of prenatal docosahexaenoic acid supplementation on infant outcomes in African American women living in low-income environments: A randomized, controlled trial
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DOI：
10.1016/j.psyneuen.2016.05.023
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发表时间：
2016-09-01
影响因子：
3.7
通讯作者：
Magee, Kelsey
中科院分区：
文献类型：
--
作者：
Keenan, Kate;Hipwell, Alison;Magee, Kelsey
重要性：生活在城市低收入环境中的非裔美国妇女在怀孕期间营养不良和分娩并发症的风险很高。目的：检测产前补充二十二碳六烯酸（DHA）对匹兹堡市有医疗保险的非裔美国妇女出生结局和婴儿发育的影响。设计：营养与妊娠研究（NAPS）是一项在2012年至2014年间进行的关于产前DHA补充的双盲、随机对照试验。环境：参与者从匹兹堡大学医学中心的产科诊所招募。参与者：64名怀孕的非裔美国妇女在妊娠16-21周时被招募，并随机分配到450毫克/天的DHA (22:6n-3)（n = 43）或大豆安慰剂（n = 21）。4名女性（6.3%）退出研究：每组2名受试者；49名婴儿（76.5%）在3个月评估时获得完整数据。干预措施：补充DHA或安慰剂从入组开始一直持续到分娩。主要结果和措施：从医疗记录中收集出生结果数据。大约在产后3个月，母亲将婴儿带到实验室，在那里使用贝利婴儿发育量表（BSID-III），并评估皮质醇对面对面静止面孔（FFSF）范式的反应。结果：母亲补充DHA的婴儿出生体重（3.174g vs 2.890g）高于母亲接受安慰剂的婴儿（F [2.40] = 6.09, p = 0.018, eta = 0.36）， 1分钟Apgar评分大于8的可能性更大（OR = 5.99 [95% CI = 1.25-28.75], p = 0.025）。与接受安慰剂的母亲的婴儿相比，接受DHA的母亲的婴儿在FFSF范式下的皮质醇水平较低（F [1.32] = 5.36, p = 0.018, eta = 0.36）。BSID-III的评分与安慰剂相比没有任何不同。结论：生活在城市、低收入环境中接受DHA补充的妇女的婴儿有更理想的出生结果和更调节的皮质醇对压力源的反应。补充DHA可能有效地减轻产前应激对后代发育的负面影响。(C) 2016 Elsevier Ltd.版权所有。
Importance: African American women living in urban, low-income environments are at high risk for poor nutrition during pregnancy and birth complications.Objective: To test the effectiveness of prenatal docosahexaenoic acid (DHA) supplementation on birth outcomes and infant development in a sample of African American women with Medicaid insurance and living in the city of Pittsburgh.Design: The Nutrition and Pregnancy Study (NAPS) is a double-blind, randomized controlled trial of prenatal DHA supplementation conducted between 2012 and 2014.Setting: Participants were recruited from obstetric clinics at the University of Pittsburgh Medical Center.Participants: Sixty-four pregnant, African American women were enrolled at 16-21 weeks of gestation and randomized to either 450 mg/day of DHA (22:6n-3)(n = 43) or a soybean placebo (n = 21). Four women (6.3%) withdrew from the study: two participants from each study arm; complete data were obtained for 49 infants (76.5%) at the 3-month assessment.Interventions: Supplementation with DHA or placebo continued from the beginning of enrollment through delivery.Main outcome and measures: Data on birth outcomes were collected from medical records. At approximately 3 months post-partum, mothers brought their infants to the laboratory where the Bayley Scales of Infant Development (BSID-III) were administered and cortisol response to the Face-to-Face Still-Face (FFSF) paradigm was assessed.Results: Infants of mothers who received DHA supplementation had higher birth weight (3.174g versus 2.890g) than infants of mothers receiving placebo (F [2.40] = 6.09, p = 0.018, eta = 0.36), and were more likely to have a 1-min Apgar score greater than 8 (OR = 5.99 [95% CI = 1.25-28.75], p = 0.025). Infants of mothers who received DHA compared with infants of mothers receiving placebo had lower levels of cortisol in response to the FFSF paradigm (F [1.32] = 5.36, p = 0.018, eta = 0.36). None of the scores on the BSID-III differed as a function of active supplement versus placebo.Conclusions: Infants of women living in urban, low-income environments who received DHA supplementation had more optimal birth outcomes and more modulated cortisol response to a stressor. DHA supplementation may be effective in attenuating the negative effects of prenatal stress on offspring development. (C) 2016 Elsevier Ltd. All rights reserved.