Prenatal Maternal Docosahexaenoic Acid (DHA) Supplementation and Newborn Anthropometry in India: Findings from DHANI

Abstract

Long-chain omega-3 fatty acid status during pregnancy may influence newborn anthropometry and duration of gestation. Evidence from high-quality trials from low- and middle-income countries (LMICs) is limited. We conducted a double-blind, randomized, placebo-controlled trial among 957 pregnant women (singleton gestation, 14–20 weeks’ gestation at enrollment) in India to test the effectiveness of 400 mg/day algal docosahexaenoic acid (DHA) compared to placebo provided from enrollment through delivery. Among 3379 women who were screened, 1171 were found eligible; 957 were enrolled and were randomized. The intervention was two microencapsulated algal DHA (200 × 2 = 400 mg/day) or two microencapsulated soy and corn oil placebo tablets to be consumed daily from enrollment (≤20 weeks) through delivery. The primary outcome was newborn anthropometry (birth weight, length, head circumference). Secondary outcomes were gestational age and 1 and 5 min Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score. The groups (DHA; n = 478 and placebo; n = 479) were well balanced at baseline. There were 902 live births. Compliance with the intervention was similar across groups (DHA: 88.5%; placebo: 87.1%). There were no significant differences between DHA and placebo groups for birth weight (2750.6 ± 421.5 vs. 2768.2 ± 436.6 g, p = 0.54), length (47.3 ± 2.0 vs. 47.5 ± 2.0 cm, p = 0.13), or head circumference (33.7 ± 1.4 vs. 33.8 ± 1.4 cm, p = 0.15). The mean gestational age at delivery was similar between groups (DHA: 38.8 ± 1.7 placebo: 38.8 ± 1.7 wk, p = 0.54) as were APGAR scores at 1 and 5 min. Supplementing mothers through pregnancy with 400 mg/day DHA did not impact the offspring‘s birthweight, length, or head circumference.

Standardization and validation of assay of selected omega-3 and omega-6 fatty acids from phospholipid fraction of red cell membrane using gas chromatography with flame ionization detector

“…The method described above is specific, accurate and precise and can be standardized with short training. The validated method has been used for the analysis of omega-3 and omega-6 fatty acids in DHANI study (Khandelwal et al, 2020, Khandelwal et al 2021. The method can also be used for evaluation of fatty acids in large nutritional trials and as biomarker assessment for large epidemiological studies.…”

Fish Oil And/Or Probiotics Intervention in Overweight/Obese Pregnant Women and Overweight Risk in 24-Month-Old Children

“…In 1 trial, probiotics administration during pregnancy is associated with lower excessive weight-gain in 4-year-old children (13). However, not all studies have found associations between these supplements and child's growth, weight, or body composition (14)(15)(16). Fish oil and probiotics potentially have co-effects on maternal metabolism (17), but this view has not been yet studied with regards to child's growth.…”

Special Issue “Maternal DHA Impact on Child Neurodevelopment”

“…Khandelwal et al [ 4 ] reported the impact of maternal supplementation of 400 mg algal DHA/day on newborn anthropometry; appearance, pulse, grimace, activity, and respiration (APGAR) score; duration of gestation; and birth weight among Indian women. They supplemented women ( n = 478) from 14–20 weeks’ gestation till delivery in a double-blind, randomized, placebo-controlled (placebo; n = 479) trial in pregnant women.…”

“…The mean gestational age at delivery and APGAR scores were similar between the two groups. They concluded that supplementing pregnant mothers with 400 mg/day DHA did not impact the offspring’s birth weight, length, or head circumference [ 4 ].…”