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Effect of Omega-3 Supplementation During Pregnancy on Regulation of Stress (NAPS)

2018년 4월 30일 업데이트: University of Chicago

Impact of Omega-3 Intake During Pregnancy on Maternal Stress and Infant Outcome

This will be the first study of the effect of essential fatty acid supplementation in pregnant women living in inner-city poverty on the stress response system during pregnancy. The investigators proposed that essential fatty acid supplementation will be associated with reductions in the experience of stress, more modulated hormonal response to stress, and more optimal regulation of emotion and attention in the infant, even within the context inner-city poverty.

연구 개요

상세 설명

Significance: Pregnant women living in poverty often experience chronic stress, and consequently higher levels of stress hormones. In utero exposure to high levels of stress hormones can negatively affect the developing fetus and later, the infant's capacity for emotion and behavioral regulation. In this proposal we describe a developing program of research designed to reduce the negative impact of prenatal stress on infant health and development via nutritional supplementation of docosahexaenoic acid (DHA) during pregnancy. DHA is a long-chain polyunsaturated fatty acid member of the omega-3 fatty acid family. DHA is found in its highest concentrations in neural cell membranes, affecting receptor function, neurotransmitter uptake, and signal transmission. There is growing evidence that low levels of dietary DHA intake are associated with suboptimal response to stress and that DHA supplementation can modulate stress response. Aims: The goals of the proposed study are to explore whether DHA supplementation during pregnancy is associated with 1) a reduction in maternal perceived stress during pregnancy; 2) a more modulated maternal cortisol response to a stress stimulus during pregnancy, and 3) more optimal regulation of emotion and behavior in the infant. Approach: Sixty-five pregnant women living in inner-city poverty, who consume less than two servings of fish per week, will be randomly assigned to receive 450 mg/daily of DHA or placebo beginning at 16-20 weeks gestation through the end of pregnancy. Perceived stress, pregnancy related stress, stressful life events, anxiety, and depression will be assessed at baseline and at 24, 30, and 36 weeks of pregnancy and at 4 months post-partum. DHA levels will be assessed at baseline and at 36 weeks of pregnancy. Cortisol response to the Trier Social Stress Test will be measured at baseline, 24, and 30 weeks. At 4 months post-partum infant temperament, cognitive development and stress reactivity will be assessed in the laboratory. Investigators: This proposal stems from an National Institute of Mental Health R21 Translational Science Network on prenatal stress and mental health outcomes in the offspring. Three members of that network, Drs. Keenan, Carter, and Glover, are all funded investigators in the area of prenatal stress and child mental health, which is a prioritized area of exploratory research that could directly impact clinical care. They are collaborating on the present application. Innovation: This will be the first randomized controlled study of the effect of DHA supplementation on stress response in pregnant women living in inner-city poverty, and the first study of maternal DHA supplementation on emotion and stress regulation in their infants. Relevance: If DHA supplementation is associated with reductions in perceived stress, more modulated maternal cortisol response to stress, and more optimal emotional and behavioral regulation in the infant, even within the context inner-city poverty, then a comprehensive program of research on the mechanisms by which these associations evolve and the potential for broad-based prevention of poor developmental outcomes among children born to women living in poverty can be launched.

연구 유형

중재적

등록 (실제)

64

단계

  • 해당 없음

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 장소

    • Illinois
      • Chicago, Illinois, 미국, 60637
        • University of Chicago
    • Pennsylvania
      • Pittsburgh, Pennsylvania, 미국, 15213
        • University of Pittsburgh Medical Center

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

20년 (성인)

건강한 자원 봉사자를 받아들입니다

연구 대상 성별

여성

설명

Inclusion Criteria:

  • African American race
  • age between 20 and 34 years
  • 16-21 weeks gestation
  • household receipt of public assistance (e.g., Medicaid insurance) due to -low-income
  • low levels of DHA consumption as defined as less than two fish servings per week.

Exclusion Criteria:

  • known medical complications (e.g., gestational diabetes, pre-eclampsia), -regular use of steroid medications
  • alcohol use
  • cigarettes or use of illegal substances (by maternal report)
  • use of blood thinners or anti-coagulants
  • use of psychotropic medications
  • Body Mass Index >40
  • allergy to iodine and/or soy.

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 기초 과학
  • 할당: 무작위
  • 중재 모델: 병렬 할당
  • 마스킹: 삼루타

무기와 개입

참가자 그룹 / 팔
개입 / 치료
실험적: DHA supplementation
450 mg DHA daily beginning at 16-21 weeks gestation and continuing up to time of delivery
다른 이름들:
  • Nordic Naturals ProDHA
위약 비교기: Soybean Oil
soybean oils with strawberry flavoring

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Maternal Cortisol Levels
기간: Baseline (pre-stressor)
Maternal stress regulation at 30 weeks gestation
Baseline (pre-stressor)
Maternal Cortisol Levels
기간: 20 minutes post-stressor
Maternal stress regulation at 30 weeks gestation
20 minutes post-stressor
Maternal Cortisol Levels
기간: 45 minutes post stressor
Maternal stress regulation at 30 weeks gestation
45 minutes post stressor
Infant Cortisol Levels
기간: 4 months post-partum
Infant cortisol response to the Still-Face paradigm before stressor
4 months post-partum
Infant Cortisol Levels
기간: 4 months post-partum
Infant cortisol response to the Still-Face paradigm 20 minutes post-stressor
4 months post-partum
Infant Cortisol Levels
기간: 4 months post-partum
Infant cortisol response to the Still-Face paradigm 45 mins post-stressor
4 months post-partum

2차 결과 측정

결과 측정
측정값 설명
기간
Maternal Depression Symptoms
기간: 16-21 weeks gestation

Maternal depression symptoms at 16 to 24 weeks gestation, as measured by the Edinburgh Postnatal Depression Scale, a 10-item measure designed to assess pre- and postnatal depression.

Maximum score: 30 Minimum score: 0 Possible Depression: 10 or greater Mothers who score above 13 are likely to be suffering from a depressive illness of varying severity.

16-21 weeks gestation
Maternal Depression Symptoms
기간: 24 weeks

Maternal depression symptoms at 24 weeks gestation as measured by the Edinburgh Postnatal Depression Scale, a 10-item measure designed to assess pre- and postnatal depression.

Maximum score: 30 Minimum score: 0 Possible Depression: 10 or greater Mothers who score above 13 are likely to be suffering from a depressive illness of varying severity.

24 weeks
Maternal Depression Symptoms
기간: 30 weeks gestation

Maternal depression symptoms at 30 weeks gestation, as measured by the Edinburgh Postnatal Depression Scale, a 10-item measure designed to assess pre- and postnatal depression.

Maximum score: 30 Minimum score: 0 Possible Depression: 10 or greater Mothers who score above 13 are likely to be suffering from a depressive illness of varying severity.

30 weeks gestation
Maternal Perceived Stress Scale (PSS) Score
기간: Baseline: 16 - 21 weeks

Perceived stress as measured by the Perceived Stress Scale (Cohen et al, 1983) at baseline. There are 10 questions in this scale and they all refer to typical life stressors.

Individual scores on the PSS can range from 0 to 40 with higher scores indicating higher perceived stress.

  • Scores ranging from 0-13 would be considered low stress.
  • Scores ranging from 14-26 would be considered moderate stress.
  • Scores ranging from 27-40 would be considered high perceived stress
Baseline: 16 - 21 weeks
Maternal Perceived Stress Scale Score
기간: 24 weeks gestation

Perceived stress as measured by the Perceived Stress Scale (Cohen et al, 1983) at 24 weeks gestation.

There are 10 questions in this scale and they all refer to typical life stressors.

Individual scores on the PSS can range from 0 to 40 with higher scores indicating higher perceived stress.

  • Scores ranging from 0-13 would be considered low stress.
  • Scores ranging from 14-26 would be considered moderate stress.
  • Scores ranging from 27-40 would be considered high perceived stress
24 weeks gestation
Maternal Perceived Stress Scale Score
기간: 30 weeks gestation

Perceived stress as measured by the Perceived Stress Scale (Cohen et al, 1983) at 30 weeks gestation.

There are 10 questions in this scale and they all refer to typical life stressors.

Individual scores on the PSS can range from 0 to 40 with higher scores indicating higher perceived stress.

  • Scores ranging from 0-13 would be considered low stress.
  • Scores ranging from 14-26 would be considered moderate stress.
  • Scores ranging from 27-40 would be considered high perceived stress
30 weeks gestation
Infant Birth Weight
기간: Time of birth, total sample range: 27.60 to 41.60 weeks gestation
Weight of infant
Time of birth, total sample range: 27.60 to 41.60 weeks gestation
Percentage of Infants Who Had a 1-minute Apgar Scores of 9
기간: Time of birth, total sample range: 27.60 to 41.60 weeks gestation
Percentage of infants who had a 1-minute Apgar scores of 9 Sub scores from 5 categories( Breathing effort, Heart rate, Muscle tone, Reflexes, Skin color) are added together Score range: 1-10 A higher score is better where 7,8,9 are normal
Time of birth, total sample range: 27.60 to 41.60 weeks gestation
Gestational Age (GA)
기간: Time of birth, total sample range: 27.60 to 41.60 weeks gestation
Gestational Age at time of birth Total sample range: 27.60 to 41.60 weeks Below 37 considered premature Mothers typically induced after 41 weeks due to increased pregnancy risks after this time
Time of birth, total sample range: 27.60 to 41.60 weeks gestation
Infant's Receptive Communication Scaled Score
기간: 3 months old

Scaled Score on Receptive Communication subscale of Bayley Scale for Infant Development that determines how well a child recognizes sounds and how much a child understands spoken words and directions compared to a group of children within the same age range from across the United States. Subscale consists of 49 items. Child'e scaled score is calculated from total raw scores.

Scaled score range: 1 - 12 Lower scores indicate more developmental delay.

3 months old
Infant's Expressive Communication Scaled Score
기간: At approximately 3 months of age

Scaled Score for Expressive Communication subscale of Bayley Scale for Infant Development that determines how well a child recognizes sounds and how much a child communicates using sounds, gestures, or words compared to a group of children within the same age range from across the United States. Subscale consists of 48 items. Child'e scaled score is calculated from total raw scores.

Scaled score range: 2 - 9 Lower scores indicate more developmental delay.

At approximately 3 months of age
Infant's Fine Motor Skills Scaled Score
기간: Approximately 3 months of age

Fine motor skills subscale score from Bayley Scale for Infant Development. Determines how well a child recognizes sounds and how much a child can use his or her hands and fingers to do things compared to a group of children within the same age range from across the United States. Subscale consists of 66 items. Child's scaled score is calculated from total raw scores.

Scaled score range: 1 - 8 Lower scores indicate more developmental delay.

Approximately 3 months of age
Infant's Gross Motor Skills Scaled Score
기간: Approximately 3 months of age

Infants Gross Motor skills subscale score from Bayley Scale for Infant Development. Determines how well a child well your child can move his or her body compared to a group of children within the same age range from across the United States. Subscale consists of 72 items. Child's scaled score is calculated from total raw scores.

Scaled score range: 1 - 6 'Lower scores indicate more developmental delay.

Approximately 3 months of age

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여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

간행물 및 유용한 링크

연구에 대한 정보 입력을 담당하는 사람이 자발적으로 이러한 간행물을 제공합니다. 이것은 연구와 관련된 모든 것에 관한 것일 수 있습니다.

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작

2009년 12월 1일

기본 완료 (실제)

2013년 6월 1일

연구 완료 (실제)

2013년 6월 1일

연구 등록 날짜

최초 제출

2010년 6월 28일

QC 기준을 충족하는 최초 제출

2010년 7월 7일

처음 게시됨 (추정)

2010년 7월 8일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2018년 5월 30일

QC 기준을 충족하는 마지막 업데이트 제출

2018년 4월 30일

마지막으로 확인됨

2018년 4월 1일

추가 정보

이 연구와 관련된 용어

기타 연구 ID 번호

  • 09-190A
  • R21HD058269 (미국 NIH 보조금/계약)

이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .

Docosahexanoic Acid에 대한 임상 시험

3
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