Impact of Omega-3 Intake During Pregnancy on Maternal Stress and Infant Outcome

怀孕期间 Omega-3 摄入量对母亲压力和婴儿结局的影响

• 批准号: 7660952
• 负责人: Kathryn Elizabeth Keenan
• 金额: $ 19万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-06 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7660952
• 关键词: Affect; Anxiety; Area; Attention; Behavior; Behavioral; Brain; Cell membrane; Child; Child Mental Health; Chronic stress; Cognitive; Development; Diet; Docosahexaenoic Acids; Emotional; Emotions; Erythrocytes; Essential Fatty Acids; Event; Exposure to; Family; Fatty Acids; Fetus; Fish Oils; Fishes; Funding; Glucocorticoids; Goals; Hormonal; Hormones; Human; Hydrocortisone; Infant; Infant Development; Infant Health; Inflammatory Response; Intake; Intervention; Laboratories; Life; Measures; Mediating; Mental Health; Mothers; National Institute of Mental Health; Neurons; Norepinephrine; Nutritional; Omega-3 Fatty Acids; Outcome; Patient Self-Report; Perinatal Exposure; Physiological; Pilot Projects; Placebos; Polyunsaturated Fatty Acids; Poverty; Pregnancy; Pregnant Women; Prevention; Psychological Stress; Psychosocial Stress; Randomized; Randomized Controlled Trials; Recovery; Regulation; Reporting; Research; Research Design; Research Personnel; Risk; Rodent; Role; Signal Transduction; Source; Stimulus; Stress; Supplementation; System; Temperament; Testing; Time; Translational Research; Trier Social Stress Test; Woman; Work; base; biological adaptation to stress; biological systems; clinical care; cognitive function; depression; dietary supplements; emotion regulation; environmental stressor; experience; health disparity; infant outcome; infant temperament; inner city; innovation; maternal stress; member; neurotransmitter uptake; nonhuman primate; nutrition; offspring; prenatal stress; programs; psychological stressor; public health relevance; receptor function; response; stem; stressor; transmission process

DESCRIPTION (provided by applicant): Pregnant women living in poverty often experience chronic stress, and consequently higher levels of stress hormones. In utero exposure to high levels of stress hormones can negatively affect the developing fetus and later, the infant's capacity for emotion and behavioral regulation. In this proposal we describe a developing program of research designed to reduce the negative impact of prenatal stress on infant health and development via nutritional supplementation of docosahexaenoic acid (DHA) during pregnancy. DHA is a long-chain polyunsaturated fatty acid member of the omega-3 fatty acid family. DHA is found in its highest concentrations in neural cell membranes, affecting receptor function, neurotransmitter uptake, and signal transmission. There is growing evidence that low levels of dietary DHA intake are associated with suboptimal response to stress and that DHA supplementation can modulate stress response. Aims: The goals of the proposed study are to explore whether DHA supplementation during pregnancy is associated with 1) a reduction in maternal perceived stress during pregnancy; 2) a more modulated maternal cortisol response to a stress stimulus during pregnancy, and 3) more optimal regulation of emotion and behavior in the infant. Approach: Sixty-five pregnant women living in inner-city poverty, who consume less than two servings of fish per week, will be randomly assigned to receive 450 mg/daily of DHA or placebo beginning at 16-20 weeks gestation through the end of pregnancy. Perceived stress, pregnancy related stress, stressful life events, anxiety, and depression will be assessed at baseline and at 24, 30, and 36 weeks of pregnancy and at 4 months post-partum. DHA levels will be assessed at baseline and at 36 weeks of pregnancy. Cortisol response to the Trier Social Stress Test will be measured at baseline, 24, and 30 weeks. At 4 months post-partum infant temperament, cognitive development and stress reactivity will be assessed in the laboratory. Investigators: This proposal stems from an NIMH R21 Translational Science Network on prenatal stress and mental health outcomes in the offspring. Three members of that network, Drs. Keenan, Carter, and Glover, are all funded investigators in the area of prenatal stress and child mental health, which is a prioritized area of exploratory research that could directly impact clinical care. They are collaborating on the present application. Innovation: This will be the first randomized controlled study of the effect of DHA supplementation on stress response in pregnant women living in inner-city poverty, and the first study of maternal DHA supplementation on emotion and stress regulation in their infants. Relevance: If DHA supplementation is associated with reductions in perceived stress, more modulated maternal cortisol response to stress, and more optimal emotional and behavioral regulation in the infant, even within the context inner-city poverty, then a comprehensive program of research on the mechanisms by which these associations evolve and the potential for broad-based prevention of poor developmental outcomes among children born to women living in poverty can be launched. PUBLIC HEALTH RELEVANCE: This will be the first study of the effect of essential fatty acid supplementation in pregnant women living in inner-city poverty on the stress response system during pregnancy. If essential fatty acid supplementation is associated with reductions in the experience of stress, more modulated hormonal response to stress, and more optimal regulation of emotion and attention in the infant, even within the context inner-city poverty, then a comprehensive program of research on the role of nutrition on stress during pregnancy can be launched. This study may be the first step toward broad-based prevention of poor developmental outcomes among children born to women living in poverty.

描述(申请人提供)：生活在贫困中的孕妇经常经历长期的压力，因此压力荷尔蒙水平较高。在子宫内暴露于高水平的应激激素会对发育中的胎儿产生负面影响，随后会对婴儿的情绪和行为调节能力产生负面影响。在这项提案中，我们描述了一项正在开发的研究计划，旨在通过在怀孕期间补充二十二碳六烯酸(DHA)来减少产前应激对婴儿健康和发育的负面影响。DHA是omega-3脂肪酸家族中的一种长链多不饱和脂肪酸。DHA在神经细胞膜中的浓度最高，影响受体功能、神经递质摄取和信号传递。越来越多的证据表明，饮食中低水平的DHA摄入量与对压力的次优反应有关，补充DHA可以调节压力反应。目的：这项拟议研究的目标是探索怀孕期间补充DHA是否与以下因素有关：1)减少孕妇在怀孕期间感受到的压力；2)孕妇在怀孕期间对压力刺激做出更有规律的皮质醇反应；以及3)对婴儿的情绪和行为进行更优化的调节。方法：65名居住在市中心贫困地区的孕妇，每周食用不到两份鱼，将被随机分配到从怀孕16-20周开始每天服用450毫克DHA或安慰剂，直到怀孕结束。将在基线、怀孕24周、30周、36周以及产后4个月评估感知压力、妊娠相关压力、应激性生活事件、焦虑和抑郁。DHA水平将在基线和怀孕36周时进行评估。皮质醇对Trier社会压力测试的反应将在基线、24周和30周进行测量。在产后4个月，婴儿的气质、认知发展和应激反应将在实验室进行评估。研究人员：这一建议源于NIMHR21翻译科学网络关于产前压力和后代心理健康结果的研究。该网络的三名成员基南、卡特和格洛弗博士都是产前应激和儿童心理健康领域的研究人员，这是可能直接影响临床护理的优先探索性研究领域。他们正在就本应用程序进行合作。创新：这将是第一项关于补充DHA对生活在市中心贫困地区的孕妇压力反应影响的随机对照研究，也将是第一项关于孕妇补充DHA对婴儿情绪和压力调节的研究。相关性：如果补充DHA与感知压力的减少、母亲对压力的更有调节的皮质醇反应以及婴儿更理想的情绪和行为调节有关，即使在市中心贫困的背景下也是如此，那么就可以启动一项全面的研究计划，研究这些联系的演变机制，以及广泛预防贫困妇女所生儿童发育不良结果的可能性。公共卫生相关性：这将是对生活在市中心贫困地区的孕妇补充必需脂肪酸对怀孕期间压力反应系统影响的第一项研究。如果补充必需脂肪酸与减少压力体验、更多调节荷尔蒙对压力的反应以及对婴儿情绪和注意力的更优化调节有关，即使在市中心贫困的背景下，也可以启动一项关于营养对怀孕期间压力的作用的综合研究计划。这项研究可能是向广泛预防贫困妇女所生儿童的不良发展结果迈出的第一步。