Centers for Biobehavioral Health and
Centers for Biobehavioral Health and.
Pediatrics. 2020 Oct;146(4). doi: 10.1542/peds.2020-0284. Epub 2020 Sep 4.
Children born preterm experience socioemotional difficulties, including increased risk of autism spectrum disorder (ASD). In this secondary analysis, we tested the effect of combined docosahexaenoic acid (DHA) and arachidonic acid (AA) supplementation during toddlerhood on caregiver-reported socioemotional outcomes of children born preterm. We hypothesized that children randomly assigned to DHA + AA would display better socioemotional outcomes compared with those randomly assigned to a placebo.
Omega Tots was a single-site randomized, fully masked, parallel-group, placebo-controlled trial. Children ( = 377) were 10 to 16 months at enrollment, born at <35 weeks' gestation, and assigned to 180 days of daily 200-mg DHA + 200-mg AA supplementation or a placebo (400 mg corn oil). Caregivers completed the Brief Infant-Toddler Social and Emotional Assessment and the Pervasive Developmental Disorders Screening Test-II, Stage 2 at the end of the trial. Liner mixed models and log-binomial regression compared socioemotional outcomes between the DHA + AA and placebo groups.
Outcome data were available for 83% of children ( = 161; = 153). Differences between DHA + AA and placebo groups on Brief Infant-Toddler Social and Emotional Assessment scores were of small magnitude (Cohen's ≤ 0.15) and not statistically significant. Children randomly assigned to DHA + AA had a decreased risk of scoring at-risk for ASD on the Pervasive Developmental Disorders Screening Test-II, Stage 2 (21% vs 32%; risk ratio = 0.66 [95% confidence interval: 0.45 to 0.97]; risk difference = -0.11 [95% confidence interval: -0.21 to -0.01]) compared with children randomly assigned to a placebo.
No evidence of benefit of DHA + AA supplementation on caregiver-reported outcomes of broad socioemotional development was observed. Supplementation resulted in decreased risk of clinical concern for ASD. Further exploration in larger samples of preterm children and continued follow-up of children who received DHA + AA supplementation as they approach school age is warranted.
早产儿经历社会情感困难，包括自闭症谱系障碍（ASD）的风险增加。在这项二次分析中，我们测试了在幼儿期补充二十二碳六烯酸（DHA）和花生四烯酸（AA）对早产儿的照顾者报告的社会情感结果的影响。我们假设，与随机分配到安慰剂的儿童相比，随机分配到 DHA+AA 的儿童的社会情感结果会更好。
Omega Tots 是一项单站点随机、完全盲法、平行组、安慰剂对照试验。儿童（n=377）在入组时为 10 至 16 个月，出生于<35 周的妊娠，并被分配到 180 天的每日 200mg DHA+200mg AA 补充剂或安慰剂（400mg 玉米油）。在试验结束时，照顾者完成了简短的婴儿-幼儿社会和情感评估以及广泛性发育障碍筛查测试-II，第 2 阶段。线性混合模型和对数二项式回归比较了 DHA+AA 和安慰剂组之间的社会情感结果。
83%的儿童（n=161）有结局数据，83%的儿童（n=153）有结局数据。DHA+AA 组和安慰剂组在简短婴儿-幼儿社会和情感评估评分上的差异很小（Cohen's ≤0.15），且无统计学意义。与随机分配到安慰剂的儿童相比，随机分配到 DHA+AA 的儿童在广泛性发育障碍筛查测试-II，第 2 阶段的 ASD 风险评分较低（21% vs 32%；风险比=0.66[95%置信区间：0.45 至 0.97]；风险差异=-0.11[95%置信区间：-0.21 至-0.01]）。
没有证据表明 DHA+AA 补充剂对广泛社会情感发育的照顾者报告结果有获益。补充剂可降低 ASD 的临床关注风险。在更大的早产儿样本中进一步探索，并继续对接受 DHA+AA 补充剂的儿童进行随访，直至他们接近学龄期，是必要的。
