Effect of Prenatal DHA Supplements on Infant Development

描述（由主要研究者提供）：这项竞争性更新是在墨西哥库埃尔纳瓦卡成功完成的一项怀孕期间补充DHA的双盲随机对照试验（RCT）的基础上进行的，是佐治亚州亚特兰大埃默里大学休伯特全球卫生部和墨西哥库埃尔纳瓦卡国家公共卫生研究所（INSP）之间的合作成果。总的目标是延长到5岁，我们的检查对后代的影响，母亲补充剂在怀孕期间与二十二碳六烯酸（DHA）。我们的中心假设是，怀孕期间补充DHA将改善儿童早期发育。在最初的试验中，1094名孕妇从怀孕18-22周随机接受每天补充400毫克DHA或安慰剂。目前正在对973例活产婴儿进行随访，直至18个月，以测量生长和发育。我们建议研究5岁时的出生队列。我们计划收集一套全面的儿童早期发展（ECD）的措施，已知预测以后的智力功能。主要结果包括整体运动和心理发展，执行功能，特别是注意力和记忆力，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暴露于幼儿期刺激的其他数据。所有测量值将由训练有素且经验丰富的现场团队获得;许多团队成员参与了母研究，并与研究人群建立了良好的关系。我们预计将招募至少85%的合格出生队列，并将有足够的把握度检测0.3 S.D.的效应量。我们将把这些新数据与我们在产前、出生时、1岁、3岁、6岁、9岁、12岁和18岁时收集的非常丰富的数据阵列联系起来。除了分析补充DHA的整体影响外，我们还将探讨有关发育轨迹的假设。这些数据也将使我们能够在他们的早期上学期间继续跟踪这一群体。公共卫生相关性：此次竞争性更新资助HD 43099的目的是继续研究妊娠期间二十二碳六烯酸（DHA）对5岁儿童发育的影响。该项目建立在我们在墨西哥库埃尔纳瓦卡成功完成的产前DHA补充的大型双盲随机对照试验的基础上;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育（ECD）指标。此次更新将加强我们与位于墨西哥库埃尔纳瓦卡的埃默里大学国家公共卫生研究所之间的持续合作，并将为制定怀孕期间DHA的适当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.