Essential Fatty Acid (EFA) Nutrition 5-Year-Olds Follow-Up Study
Condition: Docosahexanoic Acid (DHA) Status
Study type: Observational

Summary: 
      Docosahexanoic acid (DHA) is concentrated in the human brain. Before birth, DHA is
      transferred across the placenta, but transfer depends on maternal DHA intake. After birth,
      DHA is provided by breast milk or the child's diet. This study addresses whether DHA intakes
      are adequate to support human brain development.

      In a previous study "N-3 Fatty Acid Requirements for Human Development" (C03-0242), pregnant
      women were randomly assigned to 400 mg/day DHA or placebo from 16 weeks of gestation until
      infant delivery. Blood DHA in gestation, and infant development to 18 months were assessed.
      This follow-up study will assess if maternal DHA in gestation has long-term influence on
      child development when assessed at 5 years and the impact of the child's own diet.
    

Detailed description: 
      This research is a prospective follow-up on an existing cohort of women and their children to
      determine whether dietary intakes of docosahexaenoic acid (DHA) during pregnancy have effects
      lasting into early childhood. The purpose of this study is to assess the relationship between
      maternal DHA status in gestation, which is known, and the child 's own diet and relevant
      genetic variables on the child's neural, cognitive and behavioral development. Hypotheses: 1.
      maternal DHA status in gestation has a lasting effect on infant development evident when
      assessed in early childhood 2. Children with low DHA status will be at increased risk for
      poor scores on tests of development. 3. Genetic variation in fatty acid metabolism will
      influence blood fatty acids in preschool children.

      Objectives: 1. To determine if low maternal DHA status in gestation is related to child
      development at 5 years of age; 2. To determine the DHA status of children 5 years-of-age in
      relation to scores on tests of development; 3. To identify the dietary patterns that place
      children at risk for poor DHA status; 4. To assess if genetic variation in fatty acid
      metabolism alters blood lipid fatty acids in children This research is a prospective
      follow-up of 209 children that were last assessed at age 18 months and for whom maternal DHA
      status in gestation is known. The children with their parents are invited to attend our
      nutrition lab at the Child and Family Research Institute where the child will complete
      play-like developmental assessments. Measurement of blood pressure, heart rate, height and
      weight will be completed and blood samples will be collected to measure DHA, other relevant
      nutrient that impact development and genetic variables relevant to fatty acids. The parent
      will provide information on the child' diet and health. Baseline characteristics for the
      subjects will be summarized using descriptive statistics. Logistic regression will be used to
      assess the relationship of DHA status to cognitive development with multi-variable-adjusted
      odds ratios (ORs) of a negative outcome and corresponding 95% confidence interval (CI).
      Regressions will also be run with the outcomes in continuous form to assess the changes in
      scores associated with increments of child DHA status. For all multivariate regression
      models, potential confounders will be screened in stepwise fashion, and any covariate with a
      regression coefficient P-value < 0.05 (two-sided) will be retained. Variables will include
      gender, birth weight, gestation length, maternal intelligence quotient (IQ), ethnicity,
      breast-feeding duration, birth order, and dichotomized variables of child health, eating
      behavior and martial status. Children will grouped in quintiles of DHA status and descriptive
      statistics will be used to present intakes of total fat, individual fatty acids. ANOVA will
      be used to determine if genetic variables influence blood DHA status.
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Mothers who participated in study (REB # C03-0242 and C&W W03-0084) and who have already
        provided written consent for re-contact to participate with their 5 year old child will
        participate in this follow-up study
      
Biospecimen description: 
      Plasma and blood cells
    
Keywords: essential fatty acids; DHA status; preschool children; gestation