孕期和哺乳期摄入的ω-3 脂肪酸膳食补充剂与儿童神经发育：系统评价。

Omega-3 Fatty Acid Dietary Supplements Consumed During Pregnancy and Lactation and Child Neurodevelopment: A Systematic Review.

机构信息

Panum Group, Bethesda, MD, USA.

Nutrition Evidence Systematic Review team, Office of Nutrition Guidance and Analysis, Center for Nutrition Policy and Promotion, Food and Nutrition Service, USDA, Alexandria, VA, USA.

出版信息

J Nutr. 2021 Nov 2;151(11):3483-3494. doi: 10.1093/jn/nxab238.

DOI:10.1093/jn/nxab238

PMID:34383914

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8764572/

Abstract

BACKGROUND

Maternal nutrition during pregnancy and lactation has profound effects on the development and lifelong health of the child. Long-chain PUFAs are particularly important for myelination and the development of vision during the perinatal period.

OBJECTIVES

We conducted a systematic review to examine the relationship between supplementation with omega-3 fatty acids during pregnancy and/or lactation and neurodevelopment in children, to inform the Scientific Report of the 2020 Dietary Guidelines Advisory Committee.

METHODS

We identified articles on omega-3 fatty acid supplementation in pregnant and lactating women that included measures of neurodevelopment in their children (0-18 y) by searching PubMed, CENTRAL, Embase, and CINAHL Plus. After dual screening articles for inclusion, we qualitatively synthesized and graded the strength of evidence using pre-established criteria for assessing risk of bias, consistency, directness, precision, and generalizability.

RESULTS

We included 33 articles from 15 randomized controlled trials (RCTs) and 1 prospective cohort study. Of the 8 RCTs that delivered omega-3 fatty acid dietary supplements during pregnancy alone (200-2200 mg/d DHA and 0-1100 mg/d EPA for approximately 20 wk), 5 studies reported ≥1 finding that supplementation improved measures of cognitive development in the infant or child by 6%-11% (P < 0.05), but all 8 studies also reported ≥1 nonsignificant (P > 0.05) result. There was inconsistent or insufficient evidence for other outcomes (language, social-emotional, physical, motor, or visual development; academic performance; risks of attention deficit disorder, attention-deficit/hyperactivity disorder, autism spectrum disorder, anxiety, or depression) and for supplementation during lactation or both pregnancy and lactation. Populations with a lower socioeconomic status and adolescents were underrepresented and studies lacked racial and ethnic diversity.

CONCLUSIONS

Limited evidence suggests that omega-3 fatty acid supplementation during pregnancy may result in favorable cognitive development in the child. There was insufficient evidence to evaluate the effects of omega-3 fatty acid supplementation during pregnancy and/or lactation on other developmental outcomes.

摘要

背景

母亲在怀孕和哺乳期的营养对孩子的发育和终生健康有着深远的影响。长链多不饱和脂肪酸（PUFAs）对围产期髓鞘形成和视力发育尤为重要。

目的

我们进行了系统评价，以研究怀孕期间和/或哺乳期补充ω-3 脂肪酸与儿童神经发育的关系，为 2020 年膳食指南咨询委员会科学报告提供信息。

方法

我们通过搜索 PubMed、CENTRAL、Embase 和 CINAHL Plus，确定了关于孕妇和哺乳期妇女补充 ω-3 脂肪酸的文章，这些文章的儿童（0-18 岁）神经发育指标。经过双重筛选纳入的文章，我们使用预先确定的评估偏倚风险、一致性、直接性、精确性和普遍性的标准，对证据进行定性综合和分级。

结果

我们纳入了 15 项随机对照试验（RCT）和 1 项前瞻性队列研究的 33 篇文章。在 8 项仅在孕期补充 ω-3 脂肪酸膳食补充剂的 RCT 中（200-2200mg/d DHA 和 0-1100mg/d EPA 约 20 周），有 5 项研究报告了≥1 项发现，补充剂使婴儿或儿童的认知发育提高了 6%-11%（P<0.05），但所有 8 项研究也报告了≥1 项无显著性差异（P>0.05）的结果。对于其他结局（语言、社会情感、身体、运动或视觉发育；学业成绩；注意缺陷障碍、注意缺陷/多动障碍、自闭症谱系障碍、焦虑或抑郁的风险）以及哺乳期或孕期和哺乳期补充，证据不一致或不足。社会经济地位较低的人群和青少年代表性不足，且研究缺乏种族和民族多样性。