Maternal LC-PUFA status during pregnancy and child problem behavior: the Generation R Study

Abstract

Background: Omega 3 (n-3) and 6 (n-6) long-chain polyunsaturated fatty acids (LC-PUFAs) and the n-3:n-6 ratio are important for brain development. Whether maternal LC-PUFA status during pregnancy affects risk of problem behavior in later childhood is unclear. Methods: Within a population-based cohort, we measured maternal plasma docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), and arachidonic acid (AA) concentrations and n-3:n-6-ratio in mid-pregnancy. Child emotional and behavioral problems at 6 y of age were assessed by parents (child behavior checklist), teachers (teacher report form), and combined parent/teacher report. results: Higher maternal DHA and n-3:n-6 ratio were associated with fewer child emotional problems using parent (odds ratio (OR) DHA = 0.82; 95% confidence interval (CI): 0.70, 0.96; P = 0.02 and OR n-3:n-6 = 0.83; 95% CI: 0.71, 0.96; P = 0.01; n = 5,307) and combined parent/teacher scores (OR DHA = 0.79; 95% CI: 0.66, 0.95; P = 0.01 and OR n-3:n-6 = 0.77; 95% CI: 0.65, 0.92; P < 0.01; n = 2,828). Higher AA was associated with more child behavioral problems using teacher (OR = 1.10; 95% CI: 1.00, 1.20; P = 0.04; n = 3,365) and combined parent/teacher scores (OR = 1.12; 95% CI: 1.02, 1.22; P = 0.02; n = 2,827). Maternal EPA was not associated with child problem behavior. conclusion: Indications of associations of maternal LC-PUFA status with child emotional and behavioral problems were found. Future research is needed to identify LC-PUFAsensitive periods of fetal brain development by including multiple assessments of prenatal LC-PUFA status. t wo families of polyunsaturated fatty acids (PUFAs), the omega 3 (n-3) and 6 (n-6) fatty acids (FAs), are nutrients that play a major role in brain development and functioning. They affect numerous processes, including membrane fluidity, neurotransmission, and gene expression (1). The long-chain PUFAs (LC-PUFAs), eicosapentaenoic acid (EPA; C20:5n-3), docosahexaenoic acid (DHA; C22:6n-3), and arachidonic acid (AA; C20:4n-6) are the main FAs that are metabolically active.In addition, the ratio between n-3 and n-6 FAs is important for optimal brain functioning. During the last century, however, the Western diet has provided a lower n-3 and higher n-6 intake than that in previous generations, diminishing the n-3:n-6 ratio (2).Because of their role in brain function and development, maternal LC-PUFAs during fetal development have been hypothesized to affect child problem behavior. Approximately half of the dry weight of the brain is lipid, of which 35% are PUFA, most of which is LC-PUFA (1). Increase in AA and DHA content of brain tissue starts during the third trimester of pregnancy (3), indicating that the fetal period possibly is a sensitive period. Moreover, the fetus mostly depends on maternal LC-PUFA supply for its development, because fetal LC-PUFA synthesis is limited (4).Research in this field is however scarce, and results are conflicting. Two studies on maternal fish intake, a major source of DHA, during pregnancy and offspring problem beha...

Association between maternal intake of n-6 to n-3 fatty acid ratio during pregnancy and infant neurodevelopment at 6 months of age: results of the MOCEH cohort study

“…Several cohort studies reported a negative relation between maternal n-6/n-3 PUFAs status and infant and child neurodevelopment assessed by various tests [4, 7–9] and these reports partly confirmed our results. The Seychelles Child Development Nutrition Study (SCDS) [4] reported that maternal n-6/n-3 PUFAs in serum was negatively associated with the BSID-II PDI at 9 months of age but not at 30 months.…”

“…The EDEN mother-child cohort in France showed that maternal dietary n-6/n-3 PUFAs intakes among never-breastfed children were negatively associated with the MacArthur Communicative Development Inventory (CDI) at 2 years of age and with the ASQ at 3 years of age [8], while the n-6/n-3 PUFAs in colostrum among breastfed children was negatively associated with the ASQ at 3 years of age [9]. Recently, the Generation R study in the Netherlands [7] demonstrated that a higher maternal plasma n-3/n-6 PUFAs was associated with fewer emotional problems in children at 6 years of age.…”

“…Cohort studies in Seychelles [4] and France [9], reported that maternal n-6/n-3 PUFAs, in serum and in colostrum, respectively, were negatively associated with the Bayley scales of infant development edition II (BSID-II) at 9 months of age and with the ages and stages questionnaire (ASQ) at 3 years of age, respectively. A recent cohort study in the Netherlands reported that higher maternal DHA and n-3/n-6 PUFAs were associated with fewer emotional problems in children at 6 years [7]. Recent experimental studies suggested that an imbalance in the maternal n-6/n-3 PUFAs and ratio of LA-to-ALA (LA/ALA), induced impaired neocortical neurogenesis in offspring and anxiety-related behavior in adulthood [13, 14].…”

Cow’s milk allergy: towards an update of DRACMA guidelines

“…Interventional studies failed to find evidence that prenatal fish-oil (and folic acid) supplementation may influence the cognitive development of children at 6.5 y of age, but a high DHA in maternal erythrocytes at delivery was associated with a Mental Processing Composite Score higher than the 50th percentile in the offspring [25]. Also, associations of maternal LC-PUFA status with child emotional and behavioral problems were found in an epidemiologic study [26]. Nowadays, special formulae for the treatment of CMA are not in line with these characteristics of HM (Table 1).…”

The Role of Omega-3 Fatty Acids in Diets

“…According to the abovementioned study, higher AA levels were identified in children with behavioral problems. A high maternal DHA and w-3:w-6 ratio were associated with few children with emotional problems [5].…”