Improving Maternal and Child Health Through Prenatal Fatty Acid Supplementation

Study Overview
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Brief Summary
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The purpose of the study is to test whether nutritional supplementation during pregnancy is associated with 1) improved maternal health during pregnancy; 2) improved infant birth and neurodevelopmental outcomes, and 3) whether the association between nutritional supplementation during pregnancy and infant outcomes is partially mediated by reductions in maternal perceived stress and stress reactivity during pregnancy.

Detailed Description
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Low-income pregnant women often experience chronic stress and consequently higher levels of stress hormones. In utero exposure to high levels of stress hormones can negatively affect the developing fetus and the infant's capacity for emotion and behavioral regulation. This program of research is designed to reduce the negative impact of prenatal stress on infant health and development via nutritional supplementation of docosahexaenoic acid (DHA) during pregnancy. DHA is a long-chain polyunsaturated fatty acid member of the omega-3 fatty acid family. DHA is found in its highest concentrations in neural cell membranes, affecting receptor function, neurotransmitter uptake, and signal transmission. There is growing evidence that low levels of dietary DHA intake are associated with suboptimal response to stress and that DHA supplementation can modulate stress response. One hundred sixty-two pregnant women will be randomly assigned to receive 450 mg/daily of DHA or placebo beginning at 9-12 weeks of gestation through the end of pregnancy. Perceived stress, stressful life events, anxiety, and depression, inflammatory markers, DHA levels and response to a laboratory stressor will be assessed at baseline and at 24, 30, and 36 weeks of pregnancy. Neonatal outcomes (e.g., gestational age, birth weight, delivery complications) will be collected from medical records, and infant neurodevelopmental outcomes and stress reactivity will be assessed at 1, 4 and 9 months of age. Coded data will be analyzed by the Investigators at University of Chicago and University of Pittsburgh

Official Title
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Improving Maternal and Child Health Through Prenatal Fatty Acid Supplementation: A Randomized Controlled Study in African American Women Living in Low-income Urban Environments

Conditions
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Pregnancy, Child Development

Intervention / Treatment
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* Dietary Supplement: DHA
* Dietary Supplement: Sugar pill


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age between 18 and 34 Household recipient of public assistance (e.g. Medicaid insurance) due to low income Low levels of DHA consumption as defined as less than two fish servings per week Exclusion Criteria: Reports of known medial complications Regular use of steroid medications, alcohol, cigarettes, or illegal substances (by maternal report) Use of blood thinners or anti-coagulants Use of psychotropic medications Allergy to iodine and/or soy

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 34 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Oral supplement for pregnant women<br>450 mg/daily of DHA beginning at 10-16 weeks of gestation through the end of pregnancy | Dietary Supplement: DHA<br>* 2 dietary supplement gel capsules providing 450 mg of DHA twice daily by oral intake for 24 weeks<br>* Other names: docosahexaenoic acid;|
| Placebo Comparator: Sugar pill<br>450 mg/daily of sugar pill beginning at 10-16 weeks of gestation through the end of pregnancy | Dietary Supplement: Sugar pill<br>* 2 dietary supplement gel capsules providing 450 mg of soybean oil twice daily by oral intake for 24 weeks<br>* Other names: soybean oil;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Average change in Perceived Stress Scale (PSS) score | Will be assessed at baseline and at 24, 30, and 36 weeks of pregnancy, and at 1, 4 and 9 months after giving birth | 16 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Omega-3, Fatty acid, docosahexaenoic, Pregnant, neurodevelopment, stress, urban, african-american, supplement, nutrition, mental health