Docosahexaenoic Acid Supplementation During Pregnancy and Lactation and Infant Morbidity: Findings from DHANI Trial

Abstract

Objective: To assess the impact of maternal supplementation with docosahexaenoic acid (DHA) during pregnancy and lactation on the immune and inflammatory functions in infants and specific infant morbidities.

Methods: A double-blinded, parallel-group, randomized, placebo-controlled trial was conducted among healthy pregnant women aged 18-35 years, from ≤ 20 weeks gestation through 6 months postpartum, to investigate the effectiveness of supplementation of 400 mg algal-derived DHA compared to placebo. Of 3379 women who were screened, 1171 were eligible, and 957 were randomized. Occurrences of 11 common morbidity symptoms including cough, nasal congestion, difficulty in breathing, cyanosis, convulsions, fever, vomiting, rash, ear discharge, excessive crying, and diarrhea were assessed for the offspring at 1, 6, and 12 months via maternal recall.

Results: Overall, there were 902 (out of 957) live births. Morbidity data were available for 871, 847, and 878 infants at 1, 6 and 12 months, respectively. The history of cough, difficulty in breathing, cyanosis, convulsions, fever, and vomiting at 1, 6, or 12 months were similar across DHA and placebo groups. At 1-month of age, fewer infants in the DHA group experienced any respiratory infection symptoms (cough, nasal congestion, and/or difficulty in breathing) as compared to placebo [29.3% vs 34.9%, P = 0.04; OR (95% CI) 0.74 (0.55, 0.98)]. At 6 months, there were fewer occurrences of 'other' symptoms like anemia, constipation, conjunctivitis, jaundice, and urinary tract infections in the DHA group [1.4% vs 4.8%, P = 0.005; OR (95% CI) 0.29 (0.11, 0.72)].

Conclusions: Pre- and postnatal maternal DHA supplementation did not show major differences in the incidence of common morbidity symptoms among infants at 1, 6, and 12 months. Meticulously planned and implemented studies on morbidity during infancy will be required to assess impact of maternal DHA supplementation on the morbidity during infancy.

Keywords: DHA Supplementation; Pregnancy; Randomized controlled trial; Respiratory infections.