Double-Blinded Randomised Controlled Trial: Effect of Prenatal long chain polyunsaturated fatty acids (LCPUFA) Supplementation on Newborn Brain MRI Volumetrics

Background: Docosahexaenoic acid (DHA), and arachidonic acid (ArA) are essential omega-3 and omega-6 long chain polyunsaturated fatty acids (LCPUFAs) required for fetal brain development. In the last trimester of pregnancy, fetal brains experience growth spurts, with significant increase in cerebral content of ArA and DHA obtained from mother, hence dependent replete status. Brain grey matter is relatively rich in DHA and white matter, in ArA. However no reported studies have hitherto examined the effect of maternal LCPUFA status supplementation on newborn infants’ brain size measured on MRI scan. This study addresses that.

Objective: Determine effect of maternal prenatal LCPUFA ‘fish oil’ supplementation on the newborn infants’ brain volumes measured using MRI scan techniques.

Methods: Babies of women randomised in FOSS study to receive, LCPUFA ‘fish oil’ supplementation or placebo during pregnancy had Brain MRI scans measurements of their brain volumes. Statistical comparisons to determine effect of placebo versus supplement utilised student t test/Mann Whitney U test for continuous variables and chi-squared test for categorical variables with SPSS and Stata statistical packages.

Results: Of 86 babies scanned, 49(57%) were male. Infants of LCPUFA supplemented mothers had birth head circumference (HC) (p=0.014) and were taller (p=0.018), most marked in males for both HC (p=0.005) and birth length (p=0.003).

Brain MRI-scan findings: Male infants of LCPUFA supplemented mothers had larger corpus callosum (p = 0.021), total brain (p = 0.028), total grey matter (p=0.027) and cortical (p = 0.026) volumes compared to placebo group.

Conclusion: This study is first to demonstrate this positive effect of maternal prenatal LCPUFA supplementation with increase of both total and sub-regional brain volumes of newborn infants, with novel anatomical evidence. Furthermore, differential male sex sensitivity of developing fetal brains.to maternal LCPUFA supplementation was also shown.