(P20-108-24) Protective Effects of Prenatal Fatty Acid Supplementation on Infant Wheeze and Asthma in Black Children

Objectives: Black children are at higher risk for developing asthma and experience greater asthma related morbidity and mortality than White children. In urban communities of color, approximately 25% of youth are reported to have asthma. Several observational and controlled studies have shown that prenatal fatty acid supplementation is associated with a reduced incidence of wheezing and asthma; these studies were done in primarily white populations. We tested the association between prenatal fatty acid levels and childhood asthma in Black American families.

Methods: Data were from a randomized, double-blind controlled trial of prenatal DHA supplementation in Black women with Medicaid insurance and living in under-resourced, urban environments. Healthy women with low sea fish intake ( < 2 servings of sea fish/week) were recruited at 10-17 weeks of gestation and randomly assigned to active supplement (450 mg DHA; n= 112) or placebo (n=56). DHA was measured as percent of total fatty acids in venous blood samples. Mothers (n=85) reported on infant wheeze or asthma using the infant (n=50) or early childhood version (n=35) of the Airways Outcomes Questionnaire (Gern et al., 2019).

Results: Of the 85 children in the study, 13 (15.3%) were reported to have a history of or current infant wheeze or asthma; 5 of the 27 children (18.5%) whose mothers were assigned to placebo and 8 of the 58 children (13.8%) whose mothers received active supplement; a reduction of about 25% for offspring of women in the active supplement group. This difference was not statistically different. DHA blood levels at the end of the trial (32-36 weeks of gestations) differed as a function of child asthma: mothers of children with a history of or current infant wheeze or asthma had a DHA level of 5.8% compared to 6.8% for mothers of children without a history or current infant wheeze or asthma (t = 2.11, p = .02).

Conclusions: Although not statistically significant, a reduction in the rate of asthma of 25% among offspring of mothers assigned to prenatal DHA supplementation is clinically meaningful. Together with the significant effect of prenatal DHA levels, regardless of group assignment, on offspring asthma the data suggest that increasing prenatal levels of DHA could be considered as a potential prevention for asthma in Black children.

Funding Sources: R01 HD084586; R01 HL162644