The effect of long chain polyunsaturated fatty acid supplementation on intelligence in low birth weight infant during lactation: A meta-analysis

<div><p>Background</p><p>Low birth weight infant (LBWIs) are prone to mental and behavioural problems. As an important constituent of the brain and retina, long chain polyunsaturated fatty acids are essential for foetal infant mental and visual development. The effect of lactation supplemented with long chain polyunsaturated fatty acids (LCPUFA) on the improvement of intelligence in low birth weight children requires further validation.</p><p>Methods</p><p>In this study, a comprehensive search of multiple databases was performed to identify studies focused the association between intelligence and long chain polyunsaturated fatty acid supplementation in LBWIs. Studies that compared the Bayley Scales of Infant Development (BSID) or the Wechsler Abbreviated Scale of Intelligence for Children (WISC) scores between LBWIs who were supplemented and controls that were not supplemented with LCPUFA during lactation were selected for inclusion in the meta-analysis.</p><p>Results</p><p>The main outcome was the mean difference in the mental development index (MDI) and psychomotor development index (PDI) of the BSID and the full scale intelligence quotient (FSIQ), verbal intelligence quotient (VIQ) and performance intelligence quotient (PIQ) of the WISC between LBWIs and controls. Our findings indicated that the mean BSID or WISC scores in LBWIs did not differ between the supplemented groups and controls.</p><p>Conclusion</p><p>This meta-analysis does not reveal that LCPUFA supplementation has a significant impact on the level of intelligence in LBWIs.</p></div

Forest plot of the MDI score in the different mean birth weight of long chain polyunsaturated fatty acids supplementation groups vs. controls; standardized mean differences with the 95% confidence interval and weight percentage are shown.

<p>Subtotals are for the Forest plot of the MDI score in the different birth weight at less than 1500g and more than 1500g. Fish/fungal oil: long chain polyunsaturated fatty acids from fish/fungal oil. Egg/fish oil: long chain polyunsaturated fatty acids from egg-de-rived triglyceride/fish oil. LCP1: supplements of evening primrose oil (18:3ω6 0.32 mol/100 mol) and a single dosage of purified fish oil (LCPω-3 0.38mol/100 mol). LCP2: supplements of evening primrose oil (18:3ω6 0.32 mol/100 mol) and double dosage of purified fish oil (LCPω-3 0.8mol/100 mol).</p

Forest plot of MDI scores in the long chain polyunsaturated fatty acid supplementation groups vs. controls; standardized mean differences with 95% confidence intervals and weight percentage are shown.

<p>Fish/fungal oil: long chain polyunsaturated fatty acids from fish/fungal oil. Egg/fish oil: long chain polyunsaturated fatty acids from egg-derived triglyceride/fish oil. LCP1: supplements of evening primrose oil (18:3ω6 0.32 mol/100 mol) and a single dose of purified fish oil (LCPω-3 0.38 mol/100 mol). LCP2: supplements of evening primrose oil (18:3ω6 0.32 mol/100 mol) and a double dose of purified fish oil (LCPω-3 0.8 mol/100 mol).</p

Flow chart of the selection of studies for the meta-analysis.

<p>Flow chart of the selection of studies for the meta-analysis.</p

Forest plot of PIQ score in the long chain polyunsaturated fatty acid supplementation groups vs. the controls; standardized mean differences with the 95% confidence interval and weight percentage are shown.

<p>Forest plot of PIQ score in the long chain polyunsaturated fatty acid supplementation groups vs. the controls; standardized mean differences with the 95% confidence interval and weight percentage are shown.</p

Forest plot of the PDI scores by the different components of polyunsaturated fatty acid supplementation groups vs. the controls; standardized mean differences with the 95% confidence interval and weight percentage are shown.

<p>Subtotals are for the forest plot of the MDI scores for the different supplement compositions of DHA+AA, DHA+EPA+DPA and DHA+AA+EPA. Fish/fungal oil: long chain polyunsaturated fatty acids from fish/fungal oil. Egg/fish oil: long chain polyunsaturated fatty acids from egg-derived triglyceride/fish oil. LCP1: supplements of evening primrose oil (18:3ω6 0.32 mol/100 mol) and a single dose of purified fish oil (LCPω-3 0.38 mol/100 mol). LCP2: supplements of evening primrose oil (18:3ω6 0.32 mol/100 mol) and a double dose of purified fish oil (LCPω-3 0.8 mol/100 mol).</p

Forest plot of PDI scores in the long chain polyunsaturated fatty acid supplementation groups vs. controls; standardized mean differences with the 95% confidence interval and weight percentage are shown.

<p>Fish/fungal oil: long chain polyunsaturated fatty acids from fish/fungal oil. Egg/fish oil: long chain polyunsaturated fatty acids from egg-derived triglyceride/fish oil. LCP1: supplements of evening primrose oil (18:3ω6 0.32 mol/100 mol) and a single dose of purified fish oil (LCPω-3 0.38 mol/100 mol). LCP2: supplements of evening primrose oil (18:3ω6 0.32 mol/100 mol) and a double dose of purified fish oil (LCPω-3 0.38 mol/100 mol).</p

Forest plot of the PDI scores in groups with different durations of supplementation with long chain polyunsaturated fatty acids vs. the controls; standardized mean differences with the 95% confidence interval and weight percentage are shown.

<p>Subtotals are for the forest plot of the PDI scores for the supplementation durations of less than 3 mo, 4 to 6 mo, and 7–12 mo. Fish/fungal oil: long chain polyunsaturated fatty acids from fish/fungal oil. Egg/fish oil: long chain polyunsaturated fatty acids from egg-de-rived triglyceride/fish oil. LCP1: supplements of evening primrose oil (18:3ω6 0.32 mol/100 mol) and a single dose of purified fish oil (LCPω-3 0.38 mol/100 mol). LCP2: supplements of evening primrose oil (18:3ω6 0.32 mol/100 mol) and a double dose of purified fish oil (LCPω-3 0.8 mol/100 mol).</p

Forest plot of the MDI scores by supplementation duration for the long chain polyunsaturated fatty acid supplementation groups vs. controls; standardized mean differences with the 95% confidence interval and weight percentage are shown.

<p>Subtotals are for the forest plot of the MDI scores for supplementation durations of less than 3 mo, 4 to 6 mo, and 7–12 mo. Fish/fungal oil: long chain polyunsaturated fatty acids from fish/fungal oil. Egg/fish oil: long chain polyunsaturated fatty acids from egg-derived triglyceride/fish oil. LCP1: supplements of evening primrose oil (18:3ω6 0.32 mol/100 mol) and a single dose of purified fish oil (LCPω-3 0.38 mol/100 mol). LCP2: supplements of evening primrose oil (18:3ω6 0.32 mol/100 mol) and a double dose of purified fish oil (LCPω-3 0.8 mol/100 mol).</p

Forest plot of VIQ score in the long chain polyunsaturated fatty acids supplementation groups vs. the controls; standardized mean differences with the 95% confidence interval and weight percentage are shown.

<p>Forest plot of VIQ score in the long chain polyunsaturated fatty acids supplementation groups vs. the controls; standardized mean differences with the 95% confidence interval and weight percentage are shown.</p