Fatty Acid Supplementation and Socioemotional Outcomes: Secondary Analysis of a Randomized Trial
Kelly M Boone1, Andria Parrott2, Joseph Rausch2,3
1Centers for Biobehavioral Health and kelly.boone@nationwidechildrens.org.
Insights
Docosahexaenoic acid (DHA) and arachidonic acid (AA) supplementation did not improve general socioemotional outcomes in preterm children. However, DHA + AA supplementation reduced the risk of autism spectrum disorder (ASD) in this vulnerable population.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Nutritional Science
Background:
- Children born preterm are at higher risk for socioemotional challenges, including autism spectrum disorder (ASD).
- Docosahexaenoic acid (DHA) and arachidonic acid (AA) are crucial for neurodevelopment.
- Supplementation with DHA and AA may offer benefits for preterm infants' socioemotional development.
Purpose of the Study:
- To investigate the effect of combined DHA and AA supplementation on socioemotional outcomes in children born preterm.
- To assess caregiver-reported social and emotional development and ASD risk in supplemented versus placebo groups.
Main Methods:
- A randomized, double-blind, placebo-controlled trial (Omega Tots) involving 377 preterm infants (born <35 weeks gestation).
- Participants received 180 days of daily DHA + AA supplementation or a placebo.
- Caregiver-reported socioemotional assessments were conducted using standardized tools.
Main Results:
- No significant differences in general socioemotional outcomes were observed between the DHA + AA and placebo groups.
- Children receiving DHA + AA supplementation showed a statistically significant decreased risk of scoring at-risk for ASD (21% vs 32%).
Conclusions:
- Combined DHA + AA supplementation did not improve broad socioemotional development in preterm children.
- Supplementation demonstrated a potential benefit in reducing the risk of clinical concerns for ASD.
- Further research with larger cohorts and long-term follow-up is recommended.
Background And Objectives:
Children born preterm experience socioemotional difficulties, including increased risk of autism spectrum disorder (ASD). In this secondary analysis, we tested the effect of combined docosahexaenoic acid (DHA) and arachidonic acid (AA) supplementation during toddlerhood on caregiver-reported socioemotional outcomes of children born preterm. We hypothesized that children randomly assigned to DHA + AA would display better socioemotional outcomes compared with those randomly assigned to a placebo.
Methods:
Omega Tots was a single-site randomized, fully masked, parallel-group, placebo-controlled trial. Children (N = 377) were 10 to 16 months at enrollment, born at <35 weeks' gestation, and assigned to 180 days of daily 200-mg DHA + 200-mg AA supplementation or a placebo (400 mg corn oil). Caregivers completed the Brief Infant-Toddler Social and Emotional Assessment and the Pervasive Developmental Disorders Screening Test-II, Stage 2 at the end of the trial. Liner mixed models and log-binomial regression compared socioemotional outcomes between the DHA + AA and placebo groups.
Results:
Outcome data were available for 83% of children (n treatment = 161; n placebo = 153). Differences between DHA + AA and placebo groups on Brief Infant-Toddler Social and Emotional Assessment scores were of small magnitude (Cohen's d ≤ 0.15) and not statistically significant. Children randomly assigned to DHA + AA had a decreased risk of scoring at-risk for ASD on the Pervasive Developmental Disorders Screening Test-II, Stage 2 (21% vs 32%; risk ratio = 0.66 [95% confidence interval: 0.45 to 0.97]; risk difference = -0.11 [95% confidence interval: -0.21 to -0.01]) compared with children randomly assigned to a placebo.
Conclusions:
No evidence of benefit of DHA + AA supplementation on caregiver-reported outcomes of broad socioemotional development was observed. Supplementation resulted in decreased risk of clinical concern for ASD. Further exploration in larger samples of preterm children and continued follow-up of children who received DHA + AA supplementation as they approach school age is warranted.
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