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. 2021 Nov 2;151(11):3483-3494.
doi: 10.1093/jn/nxab238.

Omega-3 Fatty Acid Dietary Supplements Consumed During Pregnancy and Lactation and Child Neurodevelopment: A Systematic Review

Julie E H Nevins  1   2 , Sharon M Donovan  3 , Linda Snetselaar  4 , Kathryn G Dewey  5 , Rachel Novotny  6 , Jamie Stang  7 , Elsie M Taveras  8   9 , Ronald E Kleinman  8 , Regan L Bailey  10 , Ramkripa Raghavan  1   2 , Sara R Scinto-Madonich  1   2 , Sudha Venkatramanan  1   2 , Gisela Butera  1   2 , Nancy Terry  11 , Jean Altman  12 , Meghan Adler  12 , Julie E Obbagy  2 , Eve E Stoody  12 , Janet de Jesus  13
Affiliations

Omega-3 Fatty Acid Dietary Supplements Consumed During Pregnancy and Lactation and Child Neurodevelopment: A Systematic Review

Julie E H Nevins et al. J Nutr. .

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.

Keywords: anxiety; attention deficit disorder; attention-deficit hyperactivity disorder; autism spectrum disorder; cognition; depression; lactation; omega-3 fatty acids; pregnancy; systematic review.

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Figures

FIGURE 1
FIGURE 1
Analytic framework for the question related to the relationship between omega-3 fatty acid supplementation before and during pregnancy and/or lactation and neurodevelopment in the child.
FIGURE 2.
FIGURE 2.
Flowchart of literature and screening results.
See this image and copyright information in PMC

Comment in

  • DHA and Cognitive Development.
    Carlson SE, Colombo J. Carlson SE, et al. J Nutr. 2021 Nov 2;151(11):3265-3266. doi: 10.1093/jn/nxab299. J Nutr. 2021. PMID: 34590117 Free PMC article. No abstract available.

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