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围产期补充鱼油对婴儿神经发育和生长的影响:一项随机对照试验。

The effect of perinatal fish oil supplementation on neurodevelopment and growth of infants: a randomized controlled trial.

机构信息

Nutrition Research Centre, Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran.

Faculty of Nursing and Midwifery, Neuroscience Research Center, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran.

出版信息

Eur J Nutr. 2018 Oct;57(7):2387-2397. doi: 10.1007/s00394-017-1512-1. Epub 2017 Jul 27.

Abstract

INTRODUCTION

Long-chain polyunsaturated fatty acids, the most abundant fatty acids in the brain, are essential for the growth and development of the brain and the retina.

OBJECTIVE

To evaluate the effect of fish oil supplementation on the development (primary outcome) and growth of 4- and 6-month-old infants.

METHODS

In this triple-blind randomized controlled trial, 150 pregnant women aged 18-35 years, who were referred to healthcare centres of Tabriz-Iran, were randomly allocated into two groups. One group of women consumed fish oil supplementation (containing 120 mg docosahexaenoic acid and 180 mg eicosapentaenoic acid) daily, while the other consumed a placebo from the 20th week of pregnancy till 30 days after childbirth in a parallel design by a computer-generated block randomization scheme. The neurodevelopment of infants was the primary outcome; it was assessed using the ages and stages questionnaire (ASQ) at 4- and a-6 months of age. The growth of these infants was measured using weight, length and head circumference. The participants, the caregivers, and those assessing the outcomes were blind to the group assignment.

RESULTS

Only one woman in the placebo group discontinued the intervention because of persistent severe nausea. All 75 neonates aged 4- and a-6 months in the fish oil supplementation group, along with 73 and 71 neonates aged 4 and 6 months, respectively in the placebo group, were followed and analysed. Although the mean scores of neurodevelopment at the end of 4 and 6 months were higher in the supplemented group than in the placebo group in each ASQ domain, a statistically significant difference was observed only in the communication domain at the 4th month (adjusted mean difference 2.63; 95% confidence interval 0.36-4.89). There was no significant difference in weight, length, or head circumference between the two groups of infants aged 4 and 6 months (P ≥ 0.05).

CONCLUSION

Based on the results, perinatal fish oil supplementation is beneficial for the communication domain of neurodevelopment of 4-month-old infants. The study results relating to the supplementation effect on other domains are inconclusive. There ought to be further studies with up-to-date lipidomic analysis to find biochemical correlate compared to an intervention and developmental finding.

摘要

简介

长链多不饱和脂肪酸是大脑中含量最丰富的脂肪酸,对大脑和视网膜的生长发育至关重要。

目的

评估鱼油补充剂对 4 至 6 个月大婴儿发育(主要结局)和生长的影响。

方法

在这项三盲随机对照试验中,将 150 名年龄在 18-35 岁之间的孕妇随机分为两组,这些孕妇均来自伊朗大不里士的医疗中心。一组孕妇从妊娠第 20 周开始每天服用鱼油补充剂(含有 120mg 二十二碳六烯酸和 180mg 二十碳五烯酸),另一组则服用安慰剂,持续至产后 30 天。平行设计采用计算机生成的区组随机化方案。婴儿的神经发育是主要结局,在 4 个月和 6 个月时使用年龄和阶段问卷(ASQ)进行评估。通过体重、身长和头围测量婴儿的生长情况。参与者、照顾者和评估结果的人员均对分组情况不知情。

结果

只有 1 名安慰剂组的女性因持续严重恶心而退出干预。在鱼油补充剂组,有 75 名 4 个月大和 6 个月大的新生儿,以及安慰剂组的 73 名和 71 名 4 个月大和 6 个月大的新生儿被随访和分析。虽然在每个 ASQ 领域,补充组在 4 个月和 6 个月结束时的神经发育平均评分均高于安慰剂组,但只有在 4 个月时的沟通领域存在统计学显著差异(调整后的平均差异为 2.63;95%置信区间 0.36-4.89)。两组 4 个月大和 6 个月大的婴儿在体重、身长或头围方面无显著差异(P≥0.05)。

结论

基于研究结果,围产期补充鱼油对 4 个月大婴儿的沟通领域神经发育有益。关于补充剂对其他领域影响的研究结果尚无定论。应该进行进一步的研究,采用最新的脂质组学分析,与干预和发育发现相比,寻找生物化学相关性。

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