Prenatal Omega-6:Omega-3 Ratio and Attention Deficit and Hyperactivity Disorder Symptoms

• Published in: The Journal of pediatrics 2019-06, Vol.209, p.204-211.e4
• Main Authors: López-Vicente, Mónica, Ribas Fitó, Núria, Vilor-Tejedor, Natalia, Garcia-Esteban, Raquel, Fernández-Barrés, Sílvia, Dadvand, Payam, Murcia, Mario, Rebagliato, Marisa, Ibarluzea, Jesús, Lertxundi, Aitana, Fernández-Somoano, Ana, Tardón, Adonina, López-Sabater, M. Carmen, Romaguera, Dora, Vrijheid, Martine, Sunyer, Jordi, Julvez, Jordi
• Format: Article
• Language: English
• Subjects: Attention Deficit Disorder with Hyperactivity - epidemiology; Attention Deficit Disorder with Hyperactivity - etiology; Child; Child, Preschool; children; Fatty Acids, Omega-3 - blood; Fatty Acids, Omega-6 - blood; Female; Fetal Blood - chemistry; Humans; long-chain polyunsaturated fatty acids; Male; neurodevelopment; population-based cohort; Pregnancy; Prenatal Nutritional Physiological Phenomena; Prospective Studies
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2019.02.022

To evaluate whether higher omega-6:omega-3 (n-6:n-3) long-chain polyunsaturated fatty acid ratio in cord plasma is associated with more symptoms of attention deficit and hyperactivity disorder (ADHD) at 4 and 7 years of age. This study was based on a population-based birth cohort in Spain. N-6 arachidonic acid and n-3 eicosapentaenoic and docosahexaenoic acid concentrations were measured in cord plasma. At 4 years old, ADHD symptoms were reported by teachers through the ADHD Diagnostic and Statistical Manual of Mental Disorders, 4th ed checklist (n = 580). At 7 years old, ADHD symptoms were reported by parents through the Conners’ Rating Scale-Revised (short form; n = 642). The ADHD variable was treated as continuous (score) and as dichotomous (symptom diagnostic criteria). Child and family general characteristics were prospectively collected through questionnaires. We applied pooled zero-inflated negative binomial and logistic regressions adjusted for covariates. A higher omega-6:omega-3 long-chain polyunsaturated fatty acid ratio in cord plasma was associated with a higher ADHD index (incidence rate ratio, 1.13; 95% CI, 1.03, 1.23) at 7 years old. The association was not observed at 4 years old (incidence rate ratio, 1.04; 95% CI, 0.92-1.18). No associations were found using ADHD symptom diagnostic criteria. High prenatal omega-6:omega-3 long-chain polyunsaturated fatty acid ratio preceded the appearance of subclinical ADHD symptoms during mid-childhood. Our findings suggest that maternal diet during pregnancy may modulate the risk to develop long-term ADHD symptoms in the offspring.