Location: Children's Nutrition Research Center
Project Number: 3092-10700-067-002-S
Project Type: Non-Assistance Cooperative Agreement
Start Date: Apr 1, 2024
End Date: Mar 31, 2029
Objective:
Objective 1: Determine whether supplementary feeding of malnourished pregnant women with added docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), and choline prolongs gestation and improves offspring cognition.
Sub-objective 1.A: Conduct a randomized, investigator-blinded, controlled clinical trial to determine whether supplementary feeding of malnourished pregnant women with added DHA, EPA, and choline (maternal ready-to-use supplementary food +, M-RUSF+) prolongs gestation compared with M-RUSF without added DHA, EPA, and choline (M-RUSF).
Sub-objective 1.B: Conduct a randomized, investigator-blinded, controlled clinical trial to determine whether provision of M-RUSF+ to undernourished pregnant women improves infant cognitive development as compared with provision of M-RUSF.
Objective 2: Determine effects of docosahexaenoic acid (DHA) and choline supplementation on cord blood and placental indicators of DHA status and trafficking.
Sub-objective 2.A: Within the clinical trial of Objective 1, assess markers of DHA and other long chain fatty acids status in cord blood and placental tissue.
Approach:
Worldwide, maternal undernutrition is common, affecting about 10% of women, increasing risks both for mother and child. Antenatal omega-3 long-chain polyunsaturated fatty acid (LC-PUFA) supplementation reduces preterm births among well-nourished mothers and may promote infant cognitive development. Antenatal choline supplementation increases LC-PUFA transport and membrane integration. Previously we demonstrated a 55% reduction in neonatal mortality as well as longer, heavier newborns when two doses of azithromycin and monthly malaria chemoprophylaxis were added to high-quality supplementary food during pregnancy. Combining this anti-infective treatment bundle with further improvements in the supplementary food product (addition of choline and omega-3 LC-PUFA) has the potential to yield even greater benefits for these mothers and their children. We hypothesize that adding omega-3 LC-PUFAs and choline to a supplementary food product provided to undernourished pregnant women will prolong gestation and improve infant cognitive development. This will be tested with the most powerful methodology available, a randomized controlled clinical trial, to determine its validity. If effective, our results will have implications for millions of women and children across the world by providing healthier newborns with improved cognitive function. Targeted, precision nutrition strategies utilizing fish oil and choline to promote healthy pregnancies, if warranted, will optimize health of both the mother and the newborn child throughout the child’s life cycle.
