随机对照试验：母亲在孕期和幼儿期补充ω-3 长链多不饱和脂肪酸对注意力、工作记忆和抑制控制的影响。
Randomized controlled trial of maternal omega-3 long-chain PUFA supplementation during pregnancy and early childhood development of attention, working memory, and inhibitory control.
机构信息
Women's and Children's Health Research Institute, Adelaide, Australia (JFG and MM); the Disciplines of Paediatrics (JFG and MM) and Public Health (LGS), the University of Adelaide, Adelaide, Australia; the South Australian Health and Medical Research Institute, Adelaide, Australia (MM); and the Schiefelbusch Institute for Life Span Studies and Department of Psychology, University of Kansas, Lawrence, KS (JC).
出版信息
Am J Clin Nutr. 2014 Apr;99(4):851-9. doi: 10.3945/ajcn.113.069203. Epub 2014 Feb 12.
BACKGROUND
Docosahexaenoic acid (DHA) accumulates in the hippocampus and frontal lobes of the fetal brain during the last trimester of pregnancy. These areas of the brain contribute to attention and working memory and inhibitory control (WMIC).
OBJECTIVE
We evaluated the effect of maternal omega-3 (n-3) long-chain polyunsaturated fatty acid supplementation in pregnancy on child attention and WMIC.
DESIGN
A total of 185 term-born children of mothers who were randomly allocated to consume 800 mg DHA/d (treatment) or a placebo (control) from ∼20 wk of gestation until birth were assessed with multiple measures of attention and WMIC at a mean (± SD) of 27 ± 2 mo. Primary outcomes were the average time it took to be distracted when playing with a toy (distractibility) and the accuracy of remembering a new hiding location while inhibiting a learned response to search in the previous location (WMIC).
RESULTS
Assessments were completed by 81 children in the treatment group (mean ± SD age: 835 ± 50.4 d) and 77 children in the control group (839 ± 65.6 d). There was no effect of supplementation on primary outcomes [distractibility mean difference: -0.2 s (95% CI: -0.7, 0.4 s); WMIC mean difference: 8.9 mm (95% CI: -10.6, 28.3 mm)]. There was no difference between DHA-supplemented and control groups except that treatment-group children looked away from the toys fewer times than controls when presented with multiple toys competing for attention but less accurately remembered a repeated hiding location. These secondary effects were not consistent with any other outcomes and may have been a result of chance. Cord plasma DHA was not consistently associated with attention and WMIC.
CONCLUSION
Maternal DHA supplementation during pregnancy does not enhance attention or WMIC in term-born preschoolers. The DHA for Maternal and Infant Outcomes trial was registered at www.anzctr.org.au as ACTRN1260500056906.
背景
二十二碳六烯酸（DHA）在妊娠末期三个月内积聚在胎儿大脑的海马体和额叶。大脑的这些区域有助于注意力和工作记忆以及抑制控制（WMIC）。
目的
我们评估了孕妇在怀孕期间补充ω-3（n-3）长链多不饱和脂肪酸对儿童注意力和 WMIC 的影响。
设计
共有 185 名足月出生的儿童，其母亲在妊娠约 20 周时被随机分配服用 800mg DHA/d（治疗组）或安慰剂（对照组），直至出生，在平均（± SD）27 ± 2 个月时，使用注意力和 WMIC 的多项测量进行评估。主要结局是在玩玩具时分散注意力所需的平均时间（分散性）和在抑制对前一个位置的学习反应的同时记住新的隐藏位置的准确性（WMIC）。
结果
治疗组有 81 名儿童（平均年龄±SD：835 ± 50.4 天）和对照组有 77 名儿童（839 ± 65.6 天）完成了评估。补充剂对主要结局没有影响[分散性平均差异：-0.2 秒（95% CI：-0.7，0.4 秒）；WMIC 平均差异：8.9 毫米（95% CI：-10.6，28.3 毫米）]。DHA 补充组和对照组之间没有差异，除了在呈现多个争夺注意力的玩具时，治疗组的儿童比对照组的儿童更少地将目光从玩具上移开，但对重复的隐藏位置的记忆准确性较低。这些次要效应与其他任何结果不一致，可能是偶然的结果。脐带血浆 DHA 与注意力和 WMIC 不一致。
结论
孕妇在怀孕期间补充 DHA 并不能提高足月学龄前儿童的注意力或 WMIC。产妇和婴儿结局试验（DHA for Maternal and Infant Outcomes trial）在 www.anzctr.org.au 注册，注册号为 ACTRN1260500056906。
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