Uncertainty about the benefits of dietary docosahexaenoic acid (DHA) for pregnant
women and their children exists, despite international recommendations that pregnant
women increase their DHA intakes.
To determine whether increasing DHA during the last half of pregnancy will result
in fewer women with high levels of depressive symptoms and enhance the neurodevelopmental
outcome of their children.
A double-blind, multicenter, randomized controlled trial (DHA to Optimize Mother Infant
Outcome [DOMInO] trial) in 5 Australian maternity hospitals of 2399 women who were
less than 21 weeks' gestation with singleton pregnancies and who were recruited between
October 31, 2005, and January 11, 2008. Follow-up of children (n = 726) was completed
December 16, 2009.
Docosahexaenoic acid-rich fish oil capsules (providing 800 mg/d of DHA) or matched
vegetable oil capsules without DHA from study entry to birth.
High levels of depressive symptoms in mothers as indicated by a score of more than
12 on the Edinburgh Postnatal Depression Scale at 6 weeks or 6 months postpartum.
Cognitive and language development in children as assessed by the Bayley Scales of
Infant and Toddler Development, Third Edition, at 18 months.
Of 2399 women enrolled, 96.7% completed the trial. The percentage of women with high
levels of depressive symptoms during the first 6 months postpartum did not differ
between the DHA and control groups (9.67% vs 11.19%; adjusted relative risk, 0.85;
95% confidence interval [CI], 0.70-1.02; P = .09). Mean cognitive composite scores
(adjusted mean difference, 0.01; 95% CI, -1.36 to 1.37; P = .99) and mean language
composite scores (adjusted mean difference, -1.42; 95% CI, -3.07 to 0.22; P = .09)
of children in the DHA group did not differ from children in the control group.
The use of DHA-rich fish oil capsules compared with vegetable oil capsules during
pregnancy did not result in lower levels of postpartum depression in mothers or improved
cognitive and language development in their offspring during early childhood.
anzctr.org.au Identifier: ACTRN12605000569606.