Prenatal Supplementation With DHA Improves Attention at 5 Y of Age: A Randomized Controlled Trial

Am J Clin Nutr. 2016 Oct;104(4):1075-1082. doi: 10.3945/ajcn.114.101071. Epub 2016 Sep 7.


Background: Docosahexanoic acid (DHA) is an important constituent of the brain. Evidence from well-designed intervention trials of the long-term benefits of increasing DHA intake during pregnancy has been sparse.

Objective: We evaluated global cognition, behavior, and attention at age 5 y in the offspring of Mexican women who participated in a randomized controlled trial of prenatal DHA supplementation.

Design: A total of 1094 women were randomly assigned to receive 400 mg of either DHA or placebo/d from 18 to 22 wk of pregnancy until delivery. We assessed cognitive development and behavioral and executive functioning, including attention, in 797 offspring at age 5 y (82% of 973 live births) with the use of the McCarthy Scales of Children's Abilities (MSCA), the parental scale of the Behavioral Assessment System for Children, Second Edition (BASC-2), and the Conners' Kiddie Continuous Performance Test (K-CPT). We compared the groups on raw scores, T-scores, and standardized scores, as appropriate. We examined heterogeneity by the quality of the home environment, maternal intelligence, and socioeconomic status.

Results: There were no group differences for MSCA scores (P > 0.05), but the positive effect of the home environment at 12 mo on general cognitive abilities was attenuated in the DHA group compared with in the placebo group (P-interaction < 0.05). There were no differences between groups on the BASC-2. On the K-CPT, offspring in the DHA group showed improved mean ± SD T-scores compared with those of the placebo group for omissions (DHA: 47.6 ± 10.3; placebo: 49.6 ± 11.2; P < 0.01) with no differences (P > 0.05) for the other K-CPT scores or of the proportion who were clinically at risk of attention deficit hyperactivity disorders after Bonferroni correction for multiple comparisons.

Conclusion: Prenatal exposure to DHA may contribute to improved sustained attention in preschool children. This trial was registered at as NCT00646360.

Keywords: attention; child development; fatty acids; omega-3 fatty acids; prenatal supplementation; preschool cognitive development.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Attention / drug effects*
  • Attention Deficit Disorder with Hyperactivity / prevention & control
  • Child Behavior
  • Child Development / drug effects*
  • Child, Preschool
  • Cognition / drug effects*
  • Dietary Supplements*
  • Docosahexaenoic Acids / pharmacology*
  • Docosahexaenoic Acids / therapeutic use
  • Female
  • Humans
  • Intelligence
  • Male
  • Mexico
  • Mothers
  • Pregnancy
  • Prenatal Care*
  • Prenatal Nutritional Physiological Phenomena*
  • Psychological Tests
  • Social Class
  • Young Adult


  • Docosahexaenoic Acids

Associated data