Effect of Prenatal DHA Supplements on Infant Development

描述(由首席研究人员提供)：这项竞争性更新建立在墨西哥库尔纳瓦卡成功完成怀孕期间补充DHA的双盲随机对照试验(RCT)的基础上，是休伯特全球卫生部、佐治亚州亚特兰大的埃默里大学和墨西哥库尔纳瓦卡的国家公共卫生研究所(INSP)共同努力的结果。总体目标是将孕期补充二十二碳六烯酸(DHA)对母体后代的影响的检查扩展到5岁。我们的中心假设是，怀孕期间补充DHA将促进儿童早期发育。在最初的试验中，1094名孕妇随机接受怀孕18-22周期间每日补充400毫克DHA或安慰剂。目前正在对973名活产婴儿进行跟踪调查，直到18岁，以衡量生长发育情况。我们计划在5岁时研究出生队列。我们计划收集一套全面的儿童早期发展(ECD)指标，这些指标被认为可以预测未来的智力功能。主要结果包括全球运动和智力发展，执行功能，特别是注意力和记忆，以及抑制过程。还将获得有关饮食摄入量、健康和在家中和户外接触儿童早期刺激的更多数据。所有测量将由训练有素和经验丰富的现场团队获得；许多团队成员参与了家长研究，并与研究人员建立了良好的融洽关系。我们希望招募至少85%的合格出生队列，并将有足够的能力来检测0.3S.D.的效果大小。我们将把这些新数据与我们在产前、出生时以及1、3、6、9、12和18岁时收集的非常丰富的数据系列联系起来。除了着重于补充DHA的总体影响的分析外，我们还将探索关于发育轨迹的假设。这些数据还将使我们能够在他们上学的早期继续跟踪这一队列。与公共卫生相关：这次HD43099补助金的竞争性续期的目的是继续我们对怀孕期间二十二碳六酸(DHA)对5岁儿童发育的影响的检查。这个项目建立在我们在墨西哥库埃纳瓦卡成功完成的产前补充DHA的大型双盲随机对照试验的基础上；我们建议在4年重新调查出生队列(973名活产)以保持联系，并在5年重新调查以获得一套全面的儿童早期发展衡量标准(ECD)。此次续签将加强我们与墨西哥库埃纳瓦卡国家公共卫生研究所之间的持续合作，并将提供科学证据，为怀孕期间为DHA提供适当的饮食建议，以改善人类健康和表现，特别是教育能力。

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.