Obstetrics and Gynecology International

Research Article

The Effects of Maternal Supplementation of Polyunsaturated Fatty Acids on Visual, Neurobehavioural, and Developmental Outcomes of the Child: A Systematic Review of the Randomized Trials

Table 1

Description of included studies.
Study (year)Jadad scoreTreatments—maternal diet supplementationOutcomeNTest results
Treatments and outcomes for studies considered—retinal development
Malcolm [17] 3Controls (C): 2 placebo capsules (323 mg sunflower oil)/day
Treatment: 2 fish oil capsules (blended fish oil, Marinol D40: 100 mg DHA)/day
From wk 15 of pregnancy until delivery		Age: 50 and 66 wks after conceptional age—visual evoked potential (transient VEP peak latencies (ms))DHA:
C: 		No effect of group at any time
Judge [16, 24] 4Controls: 3,5, or 7 placebo cereal bars (corn oil)/wk
Treatment: 3, 5, or 7 cereal bars (300 mg DHA)/wk (average was 5 bars/wk: 214 mg/d of DHA)
From wk 24 of pregnancy until delivery		Age: 4 and 6 mo
Teller Acuity Cards 		DHA:
C: 		4 months
DHA: 3.7 ± 1.3 c/d
C: 3.2 ± 1.3 c/d
No difference at 6 months
Malcolm [18] 4Controls: 2 placebo capsules (sunflower oil)/dayDHA:
Treatment: 2 fish oil capsules (Marinol D40: 100 mg DHA)/day, total 200 mg/d from wk 15 of pregnancy until deliveryAge: within 1 wk of birth Scotopic electroretinogram C: No effect of group on VEP maturity
Treatments and outcomes for studies considered—neurodevelopment
Tofail [23] 4Controls: 4 placebo capsules (soybean oil: total 2.25 g LA and 0.27 g LNA)/day Treatment: 4 fish oil capsules (total 1.2 g DHA and 1.8 g EPA)/day
From wk 25 of pregnancy until delivery		Age: 10 mo
Bayley Scales of Infant Development II,
Mental Developmental Index (MDI)
Psychomotor Developmental Index (PDI) 		Fish oil

Soy oil
Mental developmental index:
Fish 102.5 (8.0) Soy 101.5 (7.8)
95% CI of difference between means: −0.98, 3.0 Psychomotor developmental index Fish 101.7 (10.9)
Soy 100.5 (10.1)
95% CI of difference between means: −1.3, 3.8
Judge [16, 24] 3Controls: 3, 5, or 7 placebo cereal bars (corn oil)/wk
Treatment: 3,5, or 7 cereal bars (300 mg DHA)/wk (overall average of 214 mg/d of DHA)
From wk 24 of pregnancy until delivery		Age: 9 mo
Infant planning test (IPT)
Fagan test of infant intelligence (FTII) 		IPT
DHA:
C:
FTII
DHA:
C: 		Infant planning test
(1) Intention score
DHA = 8 (2.3),
C = 6.7 (3)

(2) Intentional solutions DHA = 2.5 (1.3),
C = 1.7 (1.5)

Fagan test Scores for 5 different variables, no significant difference in any
Helland [20–22] 4Controls: 10 ml corn oil (4747 mg LA, 92 mg alpha LA)/day
Treatment: 10 ml cod liver oil (1183 mg DHA, 803 mg EPA)/day
From wk 17–19 of pregnancy until 3 months after delivery		Age: 2nd day and 3 mo EEG
Age: 6 mo and 9 mo:
Fagan test 		2nd day
EEG
T:
C:
3 mo
T:
C:
Fagan 6 mo
T:
C:
9 mo:
T:
C: 		EEG: no difference b/w groups at both ages. Fagan: no difference at either time.
Helland [20–22] 4Controls: 10 ml corn oil (4747 mg LA, 92 mg alpha LA)/day
Treatment: 10 ml cod liver oil (1183 mg DHA, 803 mg EPA)/day From wk 18 of pregnancy until 3 months after delivery		Age: 4 yrs
Kaufman Assessment Battery for Children (K-ABC) 		Cod oil:

Corn oil:
K-ABC mental processing composite 4 yrs: 106.4 (7.4) versus 102.3 (11.3) for control
Helland [20–22] 3Controls: 10 ml corn oil (4747 mg LA, 92 mg alpha LA)/day
Treatment: 10 ml cod liver oil (1183 mg DHA, 803 mg EPA)/day From wk 18 of pregnancy until 3 months after delivery		Age: 7 yrs
Kaufman Assessment Battery for Children (K-ABC) 		Cod:

Corn:
K-ABC mental processing composite—no difference
Dunstan [19] 3Controls: 4–1 g olive oil capsules (total 2.7 g n9 oleic acid)/day
Treatment: 4–1g fish oil capsules (total 1.1 g EPA, 2.2 g DHA)/day (3.7 g of ω-3 PUFA/d) From wk 20 of pregnancy until delivery		Age: 2.5 yr
Griffiths Mental Development Scales (GMDS)
Peabody picture vocabulary test IIIA
Child Behavior checklist 1.5–5 y 		T:
C: 		Hand and eye coordination
T ( ): 114 (10.2) C
( ): 108 (11.3)
No significant difference on other tests