1.
Effects of prenatal and/or postnatal supplementation with iron, PUFA or folic acid on neurodevelopment: update.
Chmielewska, A, Dziechciarz, P, Gieruszczak-Białek, D, Horvath, A, Pieścik-Lech, M, Ruszczyński, M, Skórka, A, Szajewska, H
The British journal of nutrition. 2019;(s1):S10-S15
Abstract
Neurodevelopment has been linked, among other factors, to maternal and early infant diets. The objective of this review, which is part of the NUTRIMENTHE research project 'The effect of diet on the mental performance of children' (www.nutrimenthe.com), was to update current evidence on the effects of nutritional interventions such as iron, folic acid or n-3 long-chain polyunsaturated fatty acid (LCPUFA) supplementation during pregnancy and/or in early life on the mental performance and psychomotor development of children. In May 2014, we searched MEDLINE and The Cochrane Database of Systematic Reviews for relevant studies published since 2009. The limited updated evidence suggests that iron supplementation of infants may positively influence the psychomotor development of children, although it does not seem to alter their mental development or behaviour. The use of multivitamin-containing folic acid supplements during pregnancy did not benefit the mental performance of the offspring. Evidence from randomised controlled trials (RCT) did not show a clear and consistent benefit of n-3 LCPUFA supplementation during pregnancy and/or lactation on childhood cognitive and visual development. Caution is needed when interpreting current evidence, as many of the included trials had methodological limitations such as small sample sizes, high attrition rates, and no intention-to-treat analyses. Taken together, the evidence is still inconclusive. Large, high-quality RCT to assess the effects of supplementation with iron, LCPUFA or folic acid are still needed to further clarify the effects of these, and other nutrients, on neurodevelopment. Recent recommendations from scientific societies are briefly presented.
2.
Effects of n-3 long-chain polyunsaturated fatty acid supplementation during pregnancy and/or lactation on neurodevelopment and visual function in children: a systematic review of randomized controlled trials.
Dziechciarz, P, Horvath, A, Szajewska, H
Journal of the American College of Nutrition. 2010;(5):443-54
Abstract
OBJECTIVE To systematically evaluate the effects of n-3 long-chain polyunsaturated fatty acids (n-3 LCPUFA) supplementation of pregnant and/or lactating women on the neurodevelopment and visual function of their children. METHODS Systematic review. Randomized controlled trials (RCTs) comparing n-3 LCPUFA maternal supplementation were identified through electronic databases (MEDLINE, EMBASE, the Cochrane Library) and the references of reviewed articles. RESULTS Overall, 13 publications, some with important methodological limitations, were included. With regard to supplementation during pregnancy, among 3 RCTs that evaluated this intervention, 1 RCT (n = 72) showed significantly better eye and hand coordination assessed with the Griffiths Mental Development Scales at 30 months of age. Another RCT (n = 29) demonstrated an effect of n-3 LCPUFA supplementation on the cloth step of intentional solutions of the 2-step problem-solving test. No other effects were demonstrated. There was no consistent effect of n-3 LCPUFA supplementation during pregnancy on the children's visual acuity. With regard to supplementation during lactation, among 3 RCTs that assessed this intervention, 1 RCT (n =133) showed significant improvement on the Bayley Psychomotor Development Index in 30-month-old children; however, there was no influence of such supplementation on the results of different tests performed in the same group of children or in others. There was no consistent effect of n-3 LCPUFA supplementation during lactation on the children's visual function. Supplementation during pregnancy and lactation (3 RCTs) did not affect child neurodevelopment assessed up to 7 years of age. CONCLUSION Evidence from RCTs does not demonstrate a clear and consistent benefit of n-3 LCPUFA supplementation during pregnancy and/or lactation on child neurodevelopment and visual acuity. These results should be interpreted with caution due to methodological limitations of the included studies.