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孕期补充n-3长链多不饱和脂肪酸会提高学龄儿童的智商吗?一项随机对照试验的随访研究

Does n-3 LCPUFA supplementation during pregnancy increase the IQ of children at school age? Follow-up of a randomised controlled trial.

作者信息

Gould Jacqueline F, Treyvaud Karli, Yelland Lisa N, Anderson Peter J, Smithers Lisa G, Gibson Robert A, McPhee Andrew J, Makrides Maria

机构信息

Women's & Children's Health Research Institute, North Adelaide, South Australia, Australia South Australian Health and Medical Research Institute, Adelaide, Australia.

Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.

出版信息

BMJ Open. 2016 May 17;6(5):e011465. doi: 10.1136/bmjopen-2016-011465.

Abstract

INTRODUCTION

Despite recommendations that pregnant women increase their docosahexaenoic acid (DHA) intake to support fetal brain development, a recent systematic review found a lack of high-quality data to support the long-term effects of DHA supplementation on children's neurodevelopment.

METHODS AND ANALYSIS

We will assess child neurodevelopment at 7 years of age in follow-up of a multicentre double-blind randomised controlled trial of DHA supplementation in pregnancy. In 2010-2012, n=2399 Australian women with a singleton pregnancy <21 weeks' gestation were randomised to receive 3 capsules daily containing a total dose of 800 mg DHA/day or a vegetable oil placebo until birth. N=726 children from Adelaide (all n=97 born preterm, random sample of n=630 born at term) were selected for neurodevelopmental follow-up and n=638 (preterm n=85) are still enrolled at 7 years of age. At the 7-year follow-up, a psychologist will assess the primary outcome, IQ, with the Wechsler Abbreviated Scale of Intelligence, Second Edition. Specific measures of executive functioning (Fruit Stroop and the Rey Complex Figure), attention (Test of Everyday Attention for Children), memory and learning (Rey Auditory Verbal Learning Test), language (Clinical Evaluation of Language Fundamentals, Fourth Edition) and basic educational skills (Wide Range Achievement Test, Fourth Edition) will also be administered. Caregivers will be asked to complete questionnaires measuring behaviour and executive functioning. Families, clinicians and research personnel are blinded to group assignment with the exception of families who requested unblinding prior to the follow-up. All analyses will be conducted according to the intention-to-treat principal.

ETHICS AND DISSEMINATION

All procedures will be approved by the relevant institutional ethics committees prior to start of the study. The results of this study will be disseminated in peer-reviewed journal publications and academic presentations.

TRIAL REGISTRATION NUMBERS

ACTRN12605000569606 and ACTRN12614000770662.

摘要

引言

尽管有建议称孕妇应增加二十二碳六烯酸(DHA)的摄入量以支持胎儿大脑发育,但最近的一项系统评价发现,缺乏高质量数据来支持补充DHA对儿童神经发育的长期影响。

方法与分析

我们将在一项关于孕期补充DHA的多中心双盲随机对照试验的随访中,评估7岁儿童的神经发育情况。2010年至2012年期间,n = 2399名单胎妊娠且孕周小于21周的澳大利亚女性被随机分组,每天服用3粒胶囊,其中一组每天总剂量为800毫克DHA,另一组服用植物油安慰剂直至分娩。从阿德莱德选取了n = 726名儿童(其中97名早产,630名足月出生的随机样本)进行神经发育随访,7岁时仍有n = 638名(早产85名)参与研究。在7岁随访时,一名心理学家将使用韦氏儿童智力量表第二版评估主要结局指标——智商。还将进行执行功能(水果色词测验和雷氏复杂图形测验)、注意力(儿童日常注意力测验)、记忆与学习(雷氏听觉词语学习测验)、语言(语言基本能力临床评价第四版)以及基本教育技能(广泛成就测验第四版)的具体测量。将要求照料者完成测量行为和执行功能的问卷。除了在随访前要求揭盲的家庭外,家庭、临床医生和研究人员均对分组情况不知情。所有分析将按照意向性分析原则进行。

伦理与传播

在研究开始前,所有程序将获得相关机构伦理委员会的批准。本研究结果将在同行评审的期刊出版物和学术报告中发表。

试验注册号

ACTRN12605000569606和ACTRN12614000770662。

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