DHA Supplementation and Pregnancy Outcome

描述(由申请人提供)：本申请旨在续签R01 HD047315项目，该项目支持进行产前高水平补充二十二碳六烯酸(DHA)的随机临床试验(ClinicalTrials.gov ID：NCT00266825)。我们实现了最初随机对照试验的登记和后续目标，最重要的是，对于当前的提案，我们保留了父母试验中登记的妇女所生的大量儿童的计划。在这项试验中登记并跟踪到18个月大的婴儿现在进入了一个特别重要的认知和智力发展时期，成功保留当前样本可以提供一个前所未有的机会来确定产前补充DHA是否会影响学龄前和学龄儿童的结果，这些结果可以预测成功的学校表现和适应行为。在这些年龄段出现的不同技能建立在早期认知成分的基础上，这些认知成分在观察性研究和临床试验中都与较高的DHA地位呈正相关。我们建议每半年对这些婴儿进行一次测试，从24个月到72个月，使用评估对成年后的健康、适应和幸福感至关重要的四个发育领域的结果：(A)高级认知(记忆、注意力和执行功能)，(B)语言处理和识字前技能，(C)适应调节(与行为问题、学习表现和儿童精神病理学有关的自我调节技能)，以及(D)智力。拟议的评估将使我们能够确定产前补充DHA是否会影响儿童的健康和发育。这一发现可能有助于制定基于证据的产前营养政策。此外，此次更新的证据将解决有关胎儿编程和人类行为的假设，这些假设目前处于健康、发展和营养领域的前沿。

DESCRIPTION (provided by applicant): This application seeks to renew project R01 HD047315, which supported the conduct of a randomized clinical trial of a high level of supplementation of docosahexaenoic acid (DHA) during the prenatal period (ClinicalTrials.gov ID: NCT00266825). We achieved the enrollment and follow-up goals of the original RCT and, most importantly for the current proposal, we have retained the planned large cohort of children born to women enrolled in the parent trial. Infants enrolled and followed to 18 months of age in this trial are now entering a particularly important period of cognitive and intellectual development, and the successful retention of the current sample allows for an unprecedented opportunity to determine if prenatal supplementation of DHA affects preschool and school-age outcomes that predict successful school performance and adaptive behaviors. The different skills that emerge at these ages build on early components of cognition, which have been positively associated with higher DHA status in both observational studies and clinical trials. We propose to test these infants on a semi-annual basis from 24 through 72 months of age employing outcomes that assess four domains of development that are critical to health, adjustment, and well-being through adulthood: (a) higher-order cognition (memory, attention, and executive function), (b) language processing and preliteracy skills, (c) adaptive regulation (self-regulation skills related to behavioral problems, school performance, and child psychopathology), and (d) intelligence. The proposed assessments will allow us to determine whether prenatal nutritional supplementation with DHA affects child health and development. The findings could contribute to evidence-based policy on prenatal nutrition. In addition, the evidence from this renewal would address hypotheses concerning fetal programming and human behavior that are currently at the forefront within the field of health, development and nutrition.