Fish oil-derived fatty acids during pregnancy and risk of neurodevelopmental disorders in children at age 10 - A randomized controlled trial

cohort of 700 mother-child pairs, we investigated whether i) maternal DHA + EPA blood concentrations in mid-pregnancy and ii) fish oil supplementation in a randomized trial in late pregnancy influence neurodevelopmental outcomes at age 10. Maternal blood DHA + EPA concentrations were measured at 24 weeks gestation, followed by randomization to 2.4 g daily fish oil (37% DHA, 55% EPA) or placebo until one-week postpartum. Psychopathology was assessed in the children at age 10 using the Kiddie Schedule for Affective Disorders and Schizophrenia -Present and Lifetime version and parental-rated questionnaires Statistical analyses included logistic and linear regression models. Higher maternal DHA + EPA concentrations were associated with reduced ADHD risk (OR 0.71, p = 0.03) and ADHD symptom load (β = -1.14, p < 0.001) in unadjusted analyses but not after confounder adjustment (OR 0.82, p = 0.24; β = -0.49, p = 0.21). Similar trends were observed for autistic traits (β = -1.96, [-1.11; -0.24] p = 0.01), but not significant after confounder adjustment. Fish oil supplementation showed no significant reduction in ADHD (OR 0.79, p = 0.37) or ASD risk (OR 0.56, p = 0.42). A secondary analysis suggested a protective effect for ADHD Predominantly Inattentive Presentation, although it did not hold significance after correction for multiple testing (OR 0.41; p = 0.03; FDRp=0.12). Thus, potential effects on inattentive ADHD symptoms should be explored in future studies.