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Effects of Prenatal DHA Supplementation on Child Development at age 5 years in Mexico

Docosahexanoic acid (DHA) is an important constituent of the brain that accretes during the first 1000 days of life. Evidence of long‐term benefits of increasing DHA intakes during pregnancy is sparse. We have completed the age 5 y follow‐up of offspring of women who participated in a double‐blind randomized controlled trial of prenatal DHA supplementation in Cuernavaca, Mexico. Pregnant women (n=1094) were randomized to receive a daily supplement of 400 mg of DHA or placebo from 18–22 weeks of pregnancy until delivery. We assessed child development at age 5 y for 798 children (82% of live births) using the Spanish language version of the McCarthy Test for Global Development. Loss to follow‐up did not differ by treatment group and the groups remained balanced for maternal baseline and infant birth characteristics. Intent to treat analysis showed no significant differences by treatment group (p>;0.05) for measures of global development. We however find evidence of selective effects by quality of home environment (measured at age 12 mo; p<0.05 for interaction). Among children from poor home environments, those exposed to DHA in utero had better verbal, memory and overall scores compared to those in the placebo group. No difference was observed for children from better home environments. Children lacking an enriched learning environment may be able to “catch‐up” to their peers by DHA supplementation in pregnancy. (Support: NIH – HD043099).