Table 4.
Summary characteristics of included observational studies (only DHA was included in the meta-analysis).
| Author, year, (country) | Sample tissue, sample time and participant (n, boys %) | Type of fatty acid | Confounders adjusted for | Results |
|---|---|---|---|---|
| Meher et al. (73) (India) | Placental tissues (at delivery) (n = 64, no information) | DHA | BMI, age, and gestation age | Low placenta DHA in low-birth-weight infants. |
| Vidakovic et al. (74) (Netherlands) Jelena Vidakovic et al. (75) Grootendorst et al. (76) Grootendorst et al. (77) |
Maternal plasma glyceroPL in week 20.5 (median) (n = 4,830, 50%) | DHA, EPA, TFA | BMI, smoking, gestational age at maternal blood sampling, child gender, maternal age, parity, educational level, alcohol use, folic acid supplement use, psychological symptoms and pregnancy complication, region. | High n-3:n-6 PUFA ratio associated with birth weight (β = 0.76 SD score, 95% CI 0.22, 1.29, P = 0.006). Maternal DHA and EPA levels not associated with BMI at 24 months or 6 years of age. High t18:1 was associated with low BW (β: −0.10; 95% CI: −0.15, −0.04; P < 0.001). |
| Bernard et al. (78) (Singapore) | Maternal plasma glyceroPL in weeks 26–28 (n = 979, no information) | DHA | Study center, ethnicity, child's sex, parity, fasting glucose levels, vitamin D levels, gestational weight gain at 26–28 weeks' gestation, maternal height and pre-pregnancy BMI, paternal height, familial income, maternal education and age. | High DHA not associated with child weight and BMI from birth to 5 years of age. |
| Elias et al. (32) (Canada) | Maternal and cord plasma TAG, PL, and CE in week 35 (n = 70, no information) | TFAs, EPA, DHA | No information | Maternal TFAs and n-3 LCPUFA were not associated with BW. TFAs were not related to the length of birth weight. |
| van Eijsden et al. (33) (the Netherlands) | Maternal plasma PL in week 13.5 ± 3.3 (n = 3,704, 48.8%) | EPA, DPA, DHA, TFAs | No | High TFA and low n-3 LCPUFA were associated with low BW (−52 to −172 g and −56 to −172 g, respectively). |
| Dirix et al. (79) (the Netherlands) | Umbilical vein plasma PL (and red blood cell) at birth (n = 730, 53.7%) | DHA, TFAs | BMI at study entry, maternal height, parity, alcohol during pregnancy, weight gain during pregnancy, gestational age, infant sex. | High plasma DHA and RBC PL TFA were associated with low BW (P < 0.001, R2 = 0.424, r2 = 0.033 and P = 0.004, R2 = 0.334, r2 = 0.058, respectively). |
| Moon et al. (80) (UK) | Maternal plasma in week 34 (n = 293, 52.2%) | n-3 and n-6 PUFA | Social class and highest educational qualification, pre-pregnancy body mass index, smoking status in late pregnancy, maternal age at delivery, parity, gestational weight, walking speed in late pregnancy, maternal mean daily intake of protein, fat and carbohydrate at 34 weeks gestation, the child's height and duration of breastfeeding. | n-3 LCPUFA correlated with high offspring lean mass at 4 and 6 years of age, but this was confounded by offspring height. |
| Stratakis et al. (72) (the Netherlands) | Umbilical vein plasma PL at birth (n = 250, 54.8%) | ALA, EPA+DHA n-3 LCPUFA | Maternal BMI at study entry, maternal smoking in pregnancy, parental education, child age terms (age0.5, age, age3), maternal age at birth, gestational weight gain, maternal alcohol intake in pregnancy, parity, breastfeeding status, and cross-products of each PUFA exposure with the child age terms. | No association between n-3 LCPUFA and BMI at 6 months to 23 years in both sexes. High n-3 LCPUFA was associated with length in male infants (β = 0.44, 95% CI = 0.07–0.82). Higher n-3:n-6 PUFA ratio was associated with high infant length in both sexes (β = 0.40, 95% CI = 0.01–0.78 and 0.42, 95% CI = 0.05–0.79 for males and females, respectively). |
| Cinelli et al. (81) (Italy) | Cord blood and maternal blood erythrocyte membranes at 12–24 h before birth (n = 607, 52.1%) | n-3 LCPUFA, DHA | Gestational weight gain, pre-pregnancy BMI, smoking, maternal age, offspring sex, gestational age, and parity. | High maternal and fetal DHA related to high birth weight (coefficient = 29.73, P = 0.007 and coefficient = −22.82, P = 0.037) and high maternal and fetal EPA related to long gestation (P = 0.001 and P = 0.039). |
| Kitamura et al. (82) (Japan) | Maternal venous blood at 36–38 weeks and cord venous blood (erythrocyte membranes) (n = 212, no information) | EPA, DHA, DPA, n-3LCPUFA | No | Maternal n-3 LCPUFA related to gestation length (EPA: r = 0.162, P = 0.018, DHA: r = 0.188, P = 0.006). n-3 LCPUFA was not associated with birth weight. |
| Maslova et al. (83) (USA) | Maternal and cord erythrocyte and plasma (n = 1,418, 51.3%) | EPA, DHA, EPA+DHA intake | Household income; pre-pregnancy BMI, smoking in pregnancy, maternal age; parity; maternal education (≥ and < college graduate); and offspring age and sex. Race/ethnicity was not included as we have previously shown that maternal fatty acid status was similar across race/ethnicity strata; 34 in a sensitivity analysis, adding race/ethnicity to the models did not change the results. Intermediary covariates (gestational weight gain, birth weight, and gestational age) were excluded to avoid over adjustment. | High maternal DHA+EPA and fish intake associated with low adiponectin at 3.2 years. High cord plasma DHA associated with low BMI z score and leptin at 3.2 years of age. |
BW, birth weight; PL, phospholipid.