The Effect of DHA Supplements During Pregnancy on Infant Deaths

It is well known that docosahexaenoic acid (DHA) supplementation improves immunity and reduces inflammation. However, no reported literature exists on whether maternal DHA supplementation during pregnancy can influence infant morbidity. The present study aims at evaluating the same. The study compared the infant morbidity between babies born to mothers supplemented with prenatal DHA and babies of mothers supplemented with placebo. The results of the study reveal that DHA supplementation during pregnancy reduced the occurrence of colds and the duration of illness in the infants.

The major reason for infant deaths in today’s world is due to infection aggravated by poor nutrition, unsafe environmental factors and poor health of mothers. Strengthening an infant’s immune system is essential for prolonging survival and good health of the child. The immune system of infants develops and starts functioning in the mother’s uterus itself. Long chain polyunsaturated fatty acids (LCPUFAs) such as DHA and arachidonic acid are known to improve immune system functioning. Supplementation with these fatty acids improves maternal health during pregnancy, increases their concentration in breast milk and thus improves infant status. However, no in-clinic study has investigated whether LCPUFA supplementation of a pregnant mother (during the second half of pregnancy) affects infant morbidity (reduction of illness symptoms). The present study aimed at examining the same.

* The study was conducted on 1094 women, aged between 18 and 35 years, in gestational week 18 to 22 and who planned to breastfeed at least for 3 months and planned to live in the same area for two years. Of these, 849 participants completed the full study.
* Fifty percent of the women supplemented with 400 mg of DHA daily and another 50 percent supplemented with similar-looking placebos. The compliance was monitored by field workers.
* Mothers brought their child at 1, 3 and 6 months for a check-up. The mothers answered a questionnaire about child illnesses such as cold (questions on phlegm, nasal congestion, nasal secretion or cough), fever, rashes, vomiting and other illnesses in the last 15 days.

Data/Results/Key findings
* At 1 and 3 months, the DHA infants experienced lower incidence of cold related illness (37.6 percent in DHA group and 44.6 percent in placebo group) and for a lesser duration than the placebo counterpart. However, they experienced slightly higher incidence of rashes (29 percent in DHA and 26.1 percent in placebo group) and for a longer duration of time as compared to the placebo group.
* At 3 months, the duration of illness was lower by 14 percent in the DHA group infants, but they experienced a longer duration of nasal congestion compared to the placebo group.
* At 6 months, DHA group infants experienced shorter duration of illness related to nasal secretion, breathing difficulty, fever, rash and other illness but longer duration of vomiting.

Next steps/Shortcomings
Illness symptoms of infants were recorded on the basis of maternal recall and were not confirmed by healthcare professionals. Explanations are not available on higher incidence of rashes, nasal congestion and vomiting in the DHA group compared to the placebo group. Future studies should aim at both biologically and clinically relevant outcomes on infant immune function due to DHA supplementation during pregnancy.

The study provides conclusive evidence that DHA supplementation during pregnancy improves the overall health status and immune system of infants. As the baseline characteristics were similar in both the treatment groups and the study was double-blinded, the chances of biased results are low. Also, the outcomes are statistically significant. Previously reported literatures show that the concentration of immunoglobulin A in breast milk is proportional to the maternal DHA content. It is also known that children supplemented with DHA showed lower occurrence of respiratory and other illnesses. Therefore, prenatal DHA supplementation of pregnant women will help in improving the immunity of infants and reduce infant morbidity rates.

For More Information:
Prenatal Docosahexaenoic Acid Supplementation and Infant Morbidity: Randomized Controlled Trial
Publication Journal: Pediatrics, August 2011
By Beth Imhoff-Kunsch, PhD; Aryeh D. Stein, PhD; Emory University, Atlanta, Georgia

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