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Lipids and cardiovascular disease

Impact of the n-6:n-3 long-chain PUFA ratio during pregnancy and lactation on offspring neurodevelopment: 5-year follow-up of a randomized controlled trial

European Journal of Clinical Nutrition volume 71, pages 1114–1120 (2017)Cite this article

Subjects

Abstract

Background/Objectives:

Evidence regarding the effect of n-3 long-chain polyunsaturated fatty acid (LCPUFA) supplementation during pregnancy on offspring’s neurodevelopment is not conclusive.

Subjects/Methods:

In this analysis, the effect of a reduced n-6:n-3 LCPUFA ratio in the diet of pregnant/lactating women (1.2 g n-3 LCPUFA together with an arachidonic acid (AA)-balanced diet between 15th wk of gestation-4 months postpartum vs control diet) on child neurodevelopment at 4 and 5 years of age was assessed. A child development inventory (CDI) questionnaire and a hand movement test measuring mirror movements (MMs) were applied and the association with cord blood LCPUFA concentrations examined.

Results:

CDI questionnaire data, which categorizes children as ‘normal’, ‘borderline’ or ‘delayed’ in different areas of development, showed no significant evidence between study groups at 4 (n=119) and 5 years (n=130) except for the area ‘letters’ at 5 years of age (P=0.043). Similarly, the results did not strongly support the hypothesis that the intervention has a beneficial effect on MMs (for example, at 5 years: dominant hand, fast: adjusted mean difference, −0.08 (−0.43, 0.26); P=0.631). Children exposed to higher cord blood concentrations of docosahexaenoic acid, eicosapentaenoic acid and AA, as well as a lower ratio of n-6:n-3 fatty acids appeared to show beneficial effects on MMs, but these results were largely not statistically significant.

Conclusions:

Our results do not show clear benefits or harms of a change in the n-6:n-3 LCPUFA ratio during pregnancy on offspring’s neurodevelopment at preschool age. Findings on cord blood LCPUFAs point to a potential influence on offspring development.

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Acknowledgements

We kindly thank Karina Pusch for her support in data collection and trial management. We also thank all families and their children for participating in the study. The study was supported by grants from the Else Kröner-Fresenius Foundation, Bad Homburg; the European Union-funded Early Nutrition Programming Project (EARNEST) consortium (FOOD-CT-2005-007036); and the German Ministry of Education and Research via the Competence Network Obesity (Kompetenznetz Adipositas, 01GI0842). HH has received grants from Riemser and Weight Watchers for clinical trials and payment for lectures from Novartis, Roche Germany and Sanofi-Aventis.

Disclaimer

The analysis of fatty acids was performed by the Laboratory of Lipid Research, Danone Research—Center for Specialised Nutrition using coded samples. There was no intervention from any sponsor with any of the research aspects of the study, including study design, intervention, data collection, data analysis and interpretation, as well as writing of the manuscript.

Author contributions

HH designed the research; RE and FH were involved in the methodological design and gave scientific advice; CB and SB were responsible for the data collection and trial management; PDW and JH developed the algorithm for the mirror movement analysis, provided scientific advice regarding the analysis and edited previous versions of the manuscript; CB analyzed the data; CB and LS were responsible for statistical analysis; CB wrote the manuscript; and all authors contributed to the critical revision of the manuscript.

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Authors and Affiliations

  1. Else Kröner-Fresenius Center for Nutritional Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany

    C Brei, L Stecher, S Brunner & H Hauner

  2. Department of General Pediatrics, Neonatology and Pediatric Cardiology, Experimental Pediatrics and Metabolism, University Children’s Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany

    R Ensenauer

  3. Research Center, Dr von Hauner Children’s Hospital, Ludwig-Maximilians-Universität München, Munich, Germany

    R Ensenauer

  4. Department of Pediatric Neurology and Developmental Medicine, Dr von Hauner Children’s Hospital, Ludwig-Maximilians-Universität München, Munich, Germany

    F Heinen

  5. Department of Sport and Health Sciences, Institute of Human Movement Science, Technische Universität München, Munich, Germany

    P D Wagner & J Hermsdörfer

  6. ZIEL – Institute for Food and Health, Nutritional Medicine Unit, Technische Universität München, Freising, Germany

    H Hauner

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Brei, C., Stecher, L., Brunner, S. et al. Impact of the n-6:n-3 long-chain PUFA ratio during pregnancy and lactation on offspring neurodevelopment: 5-year follow-up of a randomized controlled trial. Eur J Clin Nutr 71, 1114–1120 (2017). https://doi.org/10.1038/ejcn.2017.79

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