DHA Supplementation and Pregnancy Outcome

描述（由申请人提供）：本申请旨在更新项目R01 HD 047315，该项目支持在产前期间进行高水平补充二十二碳六烯酸（DHA）的随机临床试验（ClinicalTrials.gov ID：NCT 00266825）。我们实现了最初RCT的入组和随访目标，最重要的是，对于当前的提案，我们保留了计划中的大型儿童队列，这些儿童是入组母试验的女性所生。在这项试验中登记并随访至18个月的婴儿现在正进入一个特别重要的认知和智力发展时期，当前样本的成功保留为确定产前补充DHA是否影响学龄前和学龄期结果提供了前所未有的机会，这些结果预测了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认知的早期组成部分上，这与观察性研究和临床试验中较高的DHA状态呈正相关。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，采用评估四个发展领域的结果，这些发展领域对成年后的健康、适应和幸福至关重要：（a）高阶认知（记忆、注意力和执行功能），（B）语言处理和识字前技能，（c）适应性调节（与行为问题、学校表现和儿童精神病理学相关的自我调节技能），以及（d）智力。拟议的评估将使我们能够确定产前补充DHA是否会影响儿童健康和发育。这些发现可能有助于制定基于证据的产前营养政策。此外，来自这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，发育和营养领域的最前沿。

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.