Effect of prenatal DHA supplements on infant development

描述(申请人提供)：我们的研究是关于多不饱和脂肪酸(PUFAs)对人类发育的意义。具体地说，我们将通过在墨西哥库埃纳瓦卡进行的随机对照干预试验来评估怀孕期间补充二十二碳六烯酸(DHA)对婴儿生长和发育的影响。这将是国际卫生系、罗林斯公共卫生学院、埃默里大学、国家萨鲁德公共卫生研究所(INSP)和墨西哥库埃纳瓦卡墨西哥社会研究所(IMSS)之间的合作努力。在IMSS综合医院第一医院就诊的994名孕妇将在怀孕20-24周时被招募，并随机分配到分娩前每天接受DHA(200毫克)或安慰剂治疗。主要研究终点包括：a)出生大小、胎龄、脐带血DHA水平和神经发育，b)产后1个月和3个月的母血和母乳DHA水平，c)出生后前18个月的生长发育和d)3、12和18个月的婴儿DHA状况。所有数据收集将在研究总部(IMSS)进行，但家庭环境将在6点和12点家访期间进行评估。由训练有素的护士和心理学家分别在出生时1、3、6、9、12和18个月测量体格生长(长度、体重和头围)和婴儿发育(Braelton&Fagan测试、视觉和听觉诱发电位和贝利婴儿发育量表)。还将获得关于社会经济状况、产科病史、母亲饮食、人体测量和智力、家庭环境质量和婴儿喂养做法的数据。数据分析将包括确保随机有效性后的组比较(意向治疗)，以及结构方程建模，以检查怀孕期间补充DHA影响儿童生长和发育的各种途径。该项目的发现将大大有助于我们理解怀孕期间补充DHA的功能后果。

DESCRIPTION (provided by applicant): Our research is about the significance of polyunsaturated fatty acids (PUFAs) for human development. Specifically, we will assess the effect of docasohexanoic acid (DHA) supplementation during pregnancy on infant growth and development through a randomized controlled intervention trial in Cuernavaca, Mexico. This will be a collaborative effort among the Department of International Health, Rollins School of Public Health, Emory University, the Instituto Nacional de Salud Publica (INSP) and the Instituto Mexicano del Seguro Social (IMSS), Cuernavaca, Mexico. Pregnant women (n=994) attending the IMSS General Hospital I will be recruited at 20-24 wks gestation and assigned randomly to receive either DHA (200 mg) or a placebo daily until delivery. The main study endpoints include a) birth outcomes: birth size, gestational age, cord blood levels of DHA and neurodevelopment, b) maternal blood and breast milk DHA levels at 1 and 3 mo post-partum), c) postnatal growth and development during the first 18 mo of age and d) infant DHA status at 3, 12 and 18 mo. All data collection will be carried out at the study headquarters (IMSS) except for home environment that will be assessed during home visits at 6 and 12 mo. Physical growth (length, weight, and head circumference) and infant development (Brazelton & Fagan test, visual and auditory evoked potentials, and Bayley scales of infant development) will be measured at birth, 1, 3, 6, 9, 12 and 18 mo by trained nurses and psychologists, respectively. Data will also be obtained on socioeconomic status, obstetric history, maternal diet, anthropometry and intelligence, quality of home environment and infant feeding practices. Data analyses will include group comparisons (intent-to-treat) after ensuring effectiveness of randomization, and structural equation modeling to examine the various pathways by which DHA supplementation during pregnancy affects child growth and development. The findings of this project will contribute significantly to our understanding of the functional consequences of DHA supplementation during pregnancy.