Julie E H Nevins1,2, Sharon M Donovan3, Linda Snetselaar4, Kathryn G Dewey5, Rachel Novotny6, Jamie Stang7, Elsie M Taveras8,9, Ronald E Kleinman8, Regan L Bailey10, Ramkripa Raghavan1,2, Sara R Scinto-Madonich1,2, Sudha Venkatramanan1,2, Gisela Butera1,2, Nancy Terry11, Jean Altman12, Meghan Adler12, Julie E Obbagy2, Eve E Stoody12, Janet de Jesus13. 1. Panum Group, Bethesda, MD, USA. 2. Nutrition Evidence Systematic Review team, Office of Nutrition Guidance and Analysis, Center for Nutrition Policy and Promotion, Food and Nutrition Service, USDA, Alexandria, VA, USA. 3. Department of Food Science and Human Nutrition, University of Illinois, Urbana-Champaign, IL, USA. 4. Department of Epidemiology, University of Iowa, Iowa City, IA, USA. 5. Department of Nutrition, University of California, Davis, CA, USA. 6. Department of Human Nutrition, Food and Animal Science, University of Hawaii at Manoa, Manoa, HI, USA. 7. Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA. 8. Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. 9. Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA. 10. Department of Nutrition Science, Purdue University, West Lafayette, IN, USA. 11. NIH Library, Bethesda, MD, USA. 12. Office of Nutrition Guidance and Analysis, Center for Nutrition Policy and Promotion, Food and Nutrition Service, USDA, Alexandria, VA, USA. 13. Office of Disease Prevention and Health Promotion, HHS, United States Department of Agriculture, Food and Nutrition Service, Center for Nutrition Policy and Promotion, Alexandria, VA, USA.
Abstract
BACKGROUND: Maternal nutrition during pregnancy and lactation has profound effects on the development and lifelong health of the child. Long-chain PUFAs are particularly important for myelination and the development of vision during the perinatal period. OBJECTIVES: We conducted a systematic review to examine the relationship between supplementation with omega-3 fatty acids during pregnancy and/or lactation and neurodevelopment in children, to inform the Scientific Report of the 2020 Dietary Guidelines Advisory Committee. METHODS: We identified articles on omega-3 fatty acid supplementation in pregnant and lactating women that included measures of neurodevelopment in their children (0-18 y) by searching PubMed, CENTRAL, Embase, and CINAHL Plus. After dual screening articles for inclusion, we qualitatively synthesized and graded the strength of evidence using pre-established criteria for assessing risk of bias, consistency, directness, precision, and generalizability. RESULTS: We included 33 articles from 15 randomized controlled trials (RCTs) and 1 prospective cohort study. Of the 8 RCTs that delivered omega-3 fatty acid dietary supplements during pregnancy alone (200-2200 mg/d DHA and 0-1100 mg/d EPA for approximately 20 wk), 5 studies reported ≥1 finding that supplementation improved measures of cognitive development in the infant or child by 6%-11% (P < 0.05), but all 8 studies also reported ≥1 nonsignificant (P > 0.05) result. There was inconsistent or insufficient evidence for other outcomes (language, social-emotional, physical, motor, or visual development; academic performance; risks of attention deficit disorder, attention-deficit/hyperactivity disorder, autism spectrum disorder, anxiety, or depression) and for supplementation during lactation or both pregnancy and lactation. Populations with a lower socioeconomic status and adolescents were underrepresented and studies lacked racial and ethnic diversity. CONCLUSIONS: Limited evidence suggests that omega-3 fatty acid supplementation during pregnancy may result in favorable cognitive development in the child. There was insufficient evidence to evaluate the effects of omega-3 fatty acid supplementation during pregnancy and/or lactation on other developmental outcomes.
BACKGROUND: Maternal nutrition during pregnancy and lactation has profound effects on the development and lifelong health of the child. Long-chain PUFAs are particularly important for myelination and the development of vision during the perinatal period. OBJECTIVES: We conducted a systematic review to examine the relationship between supplementation with omega-3 fatty acids during pregnancy and/or lactation and neurodevelopment in children, to inform the Scientific Report of the 2020 Dietary Guidelines Advisory Committee. METHODS: We identified articles on omega-3 fatty acid supplementation in pregnant and lactating women that included measures of neurodevelopment in their children (0-18 y) by searching PubMed, CENTRAL, Embase, and CINAHL Plus. After dual screening articles for inclusion, we qualitatively synthesized and graded the strength of evidence using pre-established criteria for assessing risk of bias, consistency, directness, precision, and generalizability. RESULTS: We included 33 articles from 15 randomized controlled trials (RCTs) and 1 prospective cohort study. Of the 8 RCTs that delivered omega-3 fatty acid dietary supplements during pregnancy alone (200-2200 mg/d DHA and 0-1100 mg/d EPA for approximately 20 wk), 5 studies reported ≥1 finding that supplementation improved measures of cognitive development in the infant or child by 6%-11% (P < 0.05), but all 8 studies also reported ≥1 nonsignificant (P > 0.05) result. There was inconsistent or insufficient evidence for other outcomes (language, social-emotional, physical, motor, or visual development; academic performance; risks of attention deficit disorder, attention-deficit/hyperactivity disorder, autism spectrum disorder, anxiety, or depression) and for supplementation during lactation or both pregnancy and lactation. Populations with a lower socioeconomic status and adolescents were underrepresented and studies lacked racial and ethnic diversity. CONCLUSIONS: Limited evidence suggests that omega-3 fatty acid supplementation during pregnancy may result in favorable cognitive development in the child. There was insufficient evidence to evaluate the effects of omega-3 fatty acid supplementation during pregnancy and/or lactation on other developmental outcomes.
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