Effect of Prenatal DHA Supplements on Infant Development

描述（由主要研究者提供）：这一竞争更新建立在墨西哥库尔纳瓦卡怀孕期间补充DHA的双盲随机对照试验（RCT）成功完成的基础上，是休伯特全球卫生学系、亚特兰大埃默里大学和墨西哥库尔纳瓦卡国家公共卫生研究所（INSP）的合作成果。总体目标是通过我们对怀孕期间母体补充二十二碳六烯酸（DHA）对后代的影响的检查扩展到5岁。我们的中心假设是，在怀孕期间补充DHA将改善儿童早期发育。在最初的试验中，1094名孕妇被随机分为两组，一组在怀孕18-22周期间每天服用400毫克DHA补充剂，另一组服用安慰剂。目前正在对973名活产婴儿进行随访，直到18岁以上，以测量其生长和发育情况。我们建议研究5岁的出生队列。我们计划收集一套全面的儿童早期发展（ECD）措施，这些措施已知可以预测后来的智力功能。主要结果包括整体运动和智力发展，执行功能，特别是注意和记忆，以及抑制过程。还将获得关于饮食摄入量、健康和在家庭和外部接受幼儿期刺激的更多数据。所有测量将由训练有素和经验丰富的现场团队进行；许多团队成员参与了家长研究，并与研究人群建立了良好的关系。我们期望招募至少85%的符合条件的出生队列，并将有足够的能力来检测0.3 sd的效应值。我们将这些新数据与我们非常丰富的数据阵列联系起来，这些数据是我们在产前，出生时以及1岁，3岁，6岁，9岁，12岁和18岁时收集的。除了分析DHA补充的总体影响外，我们还将探索有关发育轨迹的假设。这些数据也将使我们能够继续跟踪这批学生的早期学业。公共卫生相关性：本次竞争更新HD43099拨款的目的是继续我们对怀孕期间二十二碳己酸（DHA）对5岁儿童发育的影响的研究。该项目建立在我们在墨西哥库埃尔纳瓦卡成功完成的一项大型双盲随机对照产前DHA补充试验的基础上；我们建议在4岁时重新调查出生队列（973例活产），以保持联系，并在5岁时获得一套全面的儿童早期发展（ECD）措施。这项更新将加强我们与墨西哥库埃尔纳瓦卡国家公共卫生研究所之间的持续合作，并将为在怀孕期间提出适当的DHA饮食建议提供科学证据，以提高人类健康和表现，特别是可教育性。

DESCRIPTION (provided by principal investigator): This competing renewal builds on successful completion of a double blind randomized controlled trial (RCT) of DHA supplementation during pregnancy in Cuernavaca, Mexico, and is a collaborative effort between the Hubert Department of Global Health, Emory University in Atlanta GA and the National Institute of Public Health (INSP) in Cuernavaca, Mexico. The overall objective is to extend to age 5 y our examination of the effects on the offspring of maternal supplementation during pregnancy with docosahexaenoic acid (DHA). Our central hypothesis is that DHA supplementation during pregnancy will improve early childhood development. In the original trial, 1094 pregnant women were randomized to receive daily a supplement of 400 mg of DHA or a placebo from 18-22 weeks of pregnancy. The 973 live births are currently being followed up to age 18 mos for measures of growth and development. We propose to study the birth cohort at age 5 y. We plan to collect a comprehensive set of measures of early childhood development (ECD) that are known to predict later intellectual functioning. The primary outcomes include global motor and mental development, executive functioning, specifically attention and memory, and inhibitory processes. Additional data on dietary intakes, health and exposure to early childhood stimulation both at the home and outside will also be obtained. All measurements will be obtained by a well trained and experienced field team; many team members participated in the parent study and have developed good rapport with the study population. We expect to recruit at least 85 percent of the eligible birth cohort and will have adequate power to detect effect sizes of 0.3 S.D. We will link these new data to our extraordinarily rich array of data that we collected prenatally, at birth, and at ages 1, 3, 6, 9, 12 and 18 mos. In addition to analyses that focus on the overall impact of supplementation with DHA, we will explore hypotheses concerning developmental trajectories. These data will also position us to continue to follow this cohort during their early school years. PUBLIC HEALTH RELEVANCE: The objective of this competing renewal of grant HD43099 is to continue our examination of the effects of docosahexanoic acid (DHA) during pregnancy on child development at 5 years of age. This project builds on our successful completion of a large double blind randomized controlled trial of prenatal DHA supplementation in Cuernavaca, Mexico; we propose to resurvey the birth cohort (973 live births) at 4 years to maintain contact and at 5 years to obtain on a comprehensive set of measures of early childhood development (ECD). This renewal will strengthen our ongoing collaboration between Emory and National Institute of Public Health in Cuernavaca, Mexico and will provide the scientific evidence for making appropriate dietary recommendations for DHA during pregnancy to enhance human health and performance, especially educability.