Height and BMI at five years of age following prenatal supplementation with docosahexaenoic acid in Mexico (256.8)

Abstract

Prenatal supplementation with docosahexaenoic acid (DHA) improves birth outcomes such as preterm delivery and birth size, but less is known if these differences translate into improved postnatal growth. We examined growth patterns through age 5 y in a cohort of 802 Mexican children (82% of the original cohort) whose mothers participated in a randomized controlled trial of daily supplementation with 400 mg/day of DHA or a placebo from week 18‐22 of gestation through delivery. Overall, means (standard deviation) of height for age and body mass index (BMI) for age z‐scores relative to the WHO growth reference were ‐0.49 (0.91) and 0.13 (1.11) respectively. Intent‐to‐treat analyses revealed no significant differences by treatment group (DHA‐placebo, mean, 95% confidence interval) for height (‐0.01, ‐0.42, 40 cm), or BMI (‐0.02, ‐0.26, 0.22 kg/m2) at age 5. Post‐hoc analysis revealed significant (p=0.001) heterogeneity by breastfeeding status for height: among children not breastfed at 3 months of age, those exposed to DHA were 2.20 cm (95% CI 0.62, 3.79) taller at age 5 than those in the placebo group; among children receiving mixed or exclusive breastfeeding at 3 months there was no effect of DHA supplementation on size at age 5. This same heterogeneity was observed at age 4 y but not at younger ages. Prenatal DHA supplementation may have differential long‐term effects on linear growth of children depending on breastfeeding history.Grant Funding Source: Supported by NIH grants 5R01HD043099‐06 and 5R01HD058818‐04