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dc.contributor.authorKerling, Elizabeth H.
dc.contributor.authorHilton, Jamie M.
dc.contributor.authorThodosoff, Jocelynn M.
dc.contributor.authorWick, Jo
dc.contributor.authorColombo, John
dc.contributor.authorCarlson, Susan E.
dc.identifier.citationKerling, E. H., Hilton, J. M., Thodosoff, J. M., Wick, J., Colombo, J., & Carlson, S. E. (2019). Effect of Prenatal Docosahexaenoic Acid Supplementation on Blood Pressure in Children With Overweight Condition or Obesity: A Secondary Analysis of a Randomized Clinical Trial. JAMA network open, 2(2), e190088.
dc.descriptionThis work is licensed under a Creative Commons Attribution 4.0 International License.en_US
dc.description.abstractImportance The blood pressure–lowering property of docosahexaenoic acid (DHA) in children and adults is known, and an observational study from the Netherlands has linked higher intrauterine DHA exposure to lower childhood blood pressure. However, the association of prenatal intake of DHA supplement with childhood blood pressure has not been evaluated in randomized clinical trials.

Objective To determine the effect of DHA supplementation during pregnancy on childhood blood pressure.

Design, Setting, and Participants This prespecified secondary analysis of the Kansas University DHA Outcome Study (KUDOS), a phase 3, double-blind, randomized, placebo-controlled clinical trial was conducted at several local hospitals in the Kansas City, Kansas, metropolitan area. Pregnant women (n = 350) were enrolled in the KUDOS trial between January 10, 2006, and November 17, 2009, and were followed up until their children were 18 months of age. During pregnancy, the women received either 3 capsules per day of placebo or 600 mg per day of DHA from a mean (SD) of 14.5 (3.7) weeks’ (all before 20 weeks) gestation until birth. The parents of 190 children consented to additional follow-up of their children until 6 years, which ended April 29, 2016. Study personnel involved in testing were blind to the randomization until all children had completed the trial. Data analysis was performed from May 23, 2017, to July 10, 2018.

Interventions Pregnant women were assigned to either 600 mg per day of DHA or a placebo that was half soy and half corn oil. Both placebo and DHA were provided in 3 capsules per day.

Main Outcomes and Measures Childhood blood pressure was a planned secondary outcome of a study powered to measure cognitive development. The hypothesis was that DHA would lower blood pressure prior to data analysis. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured at 4, 4.5, 5, 5.5, and 6 years and were analyzed for possible covariates using mixed models to generate a final model.

Results In total, 171 children (88 [51.5%] female) were included in this analysis. Of these children, 89 (52.0%) were randomized to the DHA group and 82 (47.9%) to the placebo group. A statistically significant interaction was found between treatment (placebo or DHA) and child weight status (5-year body mass index ≤85th or >85th percentile) for both SBP and DBP. Children who were overweight or obese whose mothers received placebo during pregnancy had higher SBP and DBP compared with children who were overweight or obese whose mothers received DHA (mean [SE] SBP, 104.28 [1.37] mm Hg vs 100.34 [1.02] mm Hg; DBP, 64.7 [1.23] mm Hg vs 59.76 [0.91] mm Hg). No differences in the SBP and DBP were found between children who were overweight or obese whose mothers received DHA and children who were not overweight or obese. In the mixed model analysis, the child’s age at blood pressure measurement and the maternal prepregnancy body mass index were the only other statistically significant variables (child age, SBP: F = 7.385; P = .001; DBP: F = 7.39; P = .001; prepregnancy BMI, SBP: r = 0.284; P = .001; DBP: r = 0.216; P = .01).

Conclusions and Relevance Maternal docosahexaenoic acid intake during pregnancy appeared to mitigate the association between childhood overweight condition or obesity and blood pressure.
dc.publisherAmerican Medical Associationen_US
dc.rights© 2019 Kerling EH et al. JAMA Network Open.en_US
dc.titleEffect of Prenatal Docosahexaenoic Acid Supplementation on Blood Pressure in Children With Overweight Condition or Obesityen_US
dc.title.alternativeA Secondary Analysis of a Randomized Clinical Trialen_US
kusw.kuauthorWick, Jo
kusw.kuauthorColombo, John
kusw.oanotesPer Sherpa Romeo 11/23/2020:

Jama Network Open [Open panel below]Publication Information TitleJama Network Open [English] ISSNsElectronic: 2574-3805 URL PublishersAmerican Medical Association [Society Publisher] DOAJ Listing Requires APCYes [Data provided by DOAJ] [Open panel below]Publisher Policy Open Access pathways permitted by this journal's policy are listed below by article version. Click on a pathway for a more detailed view.

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NoneCC BYPMC Any Website, Journal Website, +1 OA PublishingThis pathway includes Open Access publishing EmbargoNo Embargo LicenceCC BY Copyright OwnerAuthors Publisher DepositPubMed Central Location Any Website Named Repository (PubMed Central) Journal Website ConditionsPublished source must be acknowledged with citation
kusw.oaversionScholarly/refereed, publisher versionen_US
kusw.oapolicyThis item meets KU Open Access policy criteria.en_US

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© 2019 Kerling EH et al. JAMA Network Open.
Except where otherwise noted, this item's license is described as: © 2019 Kerling EH et al. JAMA Network Open.