Omega-3 Fatty Acid Intake during Pregnancy and Child Neuropsychological Development: A Multi-Centre Population-Based Birth Cohort Study in Spain

Abstract

Background: There are few studies that look at the intake of all types of omega-3 polyunsaturated fatty acids (n-3 PUFAs) during the different stages of pregnancy along with a long-term neuropsychological follow-up of the child. This study aims to explore the association between maternal n-3 PUFA intake during two periods of pregnancy and the child’s neuropsychological scores at different ages. Methods: Prospective data were obtained for 2644 pregnant women recruited between 2004 and 2008 in population-based birth cohorts in Spain. Maternal n-3 PUFA intake during the first and third trimester of pregnancy was estimated using validated food frequency questionnaires. Child neuropsychological functions were assessed using Bayley Scales of Infant Development version one (BSID) at 1 year old, the McCarthy Scale of Children’s Abilities (MSCA) at 4 years old, and the Attention Network Test (ANT) at 7 years old. Data were analysed using multivariate linear regression models and adjusted for potential covariates, such as maternal social class, education, cohort location, alcohol consumption, smoking, breastfeeding duration, and energy intake. Results: Compared to participants in the lowest quartile (<1.262 g/day) of n-3 PUFA consumption during the first trimester, those in the highest quartile (>1.657 g/day) had a 2.26 points (95% confidence interval (CI): 0.41, 4.11) higher MSCA general cognitive score, a 2.48 points (95% CI: 0.53, 4.43) higher MSCA verbal score, and a 2.06 points (95% CI: 0.166, 3.95) higher MSCA executive function score, and a 11.52 milliseconds (95% CI: −22.95, −0.09) lower ANT hit reaction time standard error. In the third pregnancy trimester, the associations were weaker. Conclusions: Positive associations between n-3 PUFA intake during early pregnancy and child neuropsychological functions at 4 and 7 years of age were found, and further clinical research is needed to confirm these findings.

Keywords: children; maternal diet; neurodevelopment; omega-3 fatty acids; population-based cohort.

Figure 1

Flowchart of study population from Spanish Childhood and Environment (INMA) project, 2004–2016. Note: Numbers of excluded may not add up to next total number due to likely missing data or incomplete test. All percentages in brackets are portions of number of subjects relevant to the 2644 recruited women.

Figure 2

Fully adjusted regression coefficients ^a of the n-3 PUFA intakes during the first and third pregnancy trimesters and the main child neuropsychological outcomes: comparison of the associations of the two intake periods. (^a Multivariate linear regression models adjusted for sex of child, child’s age at testing, cohort, quality of the test (none for ANT), maternal energy intake, birthweight of the child, gestational age, duration of breastfeeding, maternal alcohol consumption, maternal education, maternal smoking, maternal social class, pre-pregnancy BMI, number of pregnancies, number of miscarriages, and maternal country of origin).