Meta-analysis or Systematic Review

M - Click here for explanation of classification scheme.

NEUTRAL: See Quality Criteria Checklist below.

To evaluate the effect of long chain polyunsaturated fatty acids (LCPUFA) during pregnancy and lactation on visual and cognitive function during infancy and later childhood.

• Randomized controlled trials (include observational studies only if there are less than three trials on a particular topic)
• LCPUFA supplementation lasted at least four weeks
• LCPUFA as sole variable differing between treatment and controls
• Measured visual or cognitive development.

None except not meeting all inclusion criteria.

 

Database

Literature databases of Web of Science. Search year was not reported.

Search terms

Long chain polyunsaturated fatty acids, docosahexaenoic acid, eicosapentaenoic acid, linolenic acid, arachidonic acid, linoleic acid, omega-3 fatty acids, omega-6 fatty acids" with "infants, children, pre-schoolers, toddlers, complementary feeding, neonates, offspring, babies", with "cognition, development, mental, learning, brain, visual acuity, neurology". 

Design

Systematic review.

Meta-analysis methods

No meta-analysis was performed.

Data extraction tools and personnel was not described. No methodological quality assessment for primary studies.

Study characteristics collected include:

• Study year
• Study country of origin
• Number of subjects
• Treatment timing, duration and dose
• Outcome assessment timing and method.

Outcomes collected include:

• Visual development: Retinal function per electroretinography, visual acuity per visual evoked potentials
• Cognitive development: Including Bayley Scales of Infant Development, Kaufman Assessment Battery for Children, Wechsler tests.

 

 

• Total number of studies identified from the search: Not reported
• Total number of studies meeting the inclusion criteria: Six
• Location of these studies vary: United Kingdom, Bangladesh, Norway, Australia, Denmark, and United States of America
• Two CRTs studied the effect of supplementation during pregnancy only, one studied supplementation during pregnancy and lactation, and three studied supplementation during lactation only.

Overview of RCTs on effect of omega-3 supplementation in pregnant and lactating women on visual and cognitive development of infants.

Author, Location, Year	N	Supplementation to Mothers		Functional Measurements: Age at Assessment	Significant Effects of Supplementation
		Period	Dose per Day		Functional
Malcolm, United Kingdom, 2003	63	Week 15 to delivery	I: 200mg DHA+36mg	Flash VEP: Zero to five days	None
			C: 400mg oleic acid	Flash and pattern-reversal VEP: 50, 66 weeks PCA
				ERG: zero to seven days
Tofail, Bangladesh, 2006	249	Week 25 to delivery	I: 1,200mg DHA+1,800mg EPA	BSID: 10 months	None
			C: 2,250mg LA+270mg ALA
Helland, Norway, 2001	341	Week 17–19 to three months post-partum	I: 1,183mg DHA+803mg EPA+160mg LA	EEG: Two days, three months	None
			C: 8.3mg DHA+4,747mg LA	FT: 27, 39 weeks
Helland, Norway, 2003	90	Week 17–19 to three months post-partum	I: 1183 mg DHA+803 mg EPA+160 mg LA	IQ (K-ABC): Four years	Positive: IQ 4.1 points higher in I vs. C
			C: 8.3 mg DHA+4747 mg LA
Gibson, Australia, 1997	52	12 weeks post-partum	I1: 0g DHA	VEP: 12, 16 weeks	None
			I2: 0.2g DHA	BSID: One, two year
			I3: 0.4g DHA
			I4: 0.9g DHA
			I5: 1.3g DHA
Lauritzen Denmark, 2004, 2005	97	16 weeks post-partum	I: 1.3g DHA+EPA+DPA	VEP: Two, Four months	Positive: MPS intention scores 2.0 points higher in I vs. C in girls
			C: Olive oil	Motor function: Two, four, nine months	Negative: MACI vocabulary comprehension 17 points lower in I vs. C; 33 points lower in I vs. C in boys; sentence complexity 3.0 points lower in I vs. C in boys
				MPS: Nine months
				MACI: 12, 24 months
Jensen, USA, 2005	160	Four months post-partum	I: 200mg DHA	TAC, VEP: Four, eight months GGM, CLAMS	Positive: BSID-PDI 8.4 points higher in I vs. C
			C: Soy+corn oil	CAT: 12, 30 months

I, intervention group; C, control group; DHA, docosahexaenoic acid; EPA, eicosapentaenoic acid; LA, linoleic acid; ALA, α-linolenic acid; DPA, docosapentaenoic acid; VEP, visual evoked potential; PCA, post-conceptional age; ERG, electroretinography; BSID, Bayley Scales of Infant Development; EEG, electroencephalogram; FT, Fagan Test of Infant Intelligence, K-ABC, Kaufman Assessment Battery for Children; MPS, Means-end Problem Solving; MACDI, MacArthur Communicative Development Inventories; TAC, Teller Acuity Card procedure; GGM, Gesell Gross Motor; CLAMS, Clinical Linguistic and Auditory Milestone Scale; CAT, Clinical Adaptive Test; IQ, Intelligence Quotient; PDI, Psychomotor Development Index; ND, not determined; HM, human milk.

Maternal DHA supplementation during pregnancy and lactation has no effect on visual development, and may have some positive effects on psychomotor and cognitive development.

Industry:

None.