Journals / Haliç Üniversitesi Sağlık Bilimleri Dergisi / 2026 / Cilt: 9 Sayı: 2

The Effects of Prenatal Nutrition on Cognitive Development in Children: A Meta-Analysis

Prenatal Beslenmenin Çocukların Zihinsel Gelişimine Etkisi: Bir Meta-Analiz

Emine Elif Yılmaz(HALİÇ ÜNİVERSİTESİ)0000-0003-4754-0189
Mehmet Pala(HALİÇ ÜNİVERSİTESİ)0000-0003-3180-2383
Pages
49–60
Publication Date
2026-05-22
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Analyses were performed using Hedges’ g effect size.The findings indicated that omega-3 and folic acid supplementation did not produce consistent or significant effects on overall cognitive development.

📌 3 Key Takeaways

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Objective & Hypothesis:This meta-analysis aimed to evaluate the effects of omega-3 fatty acids, folic acid, and zinc supplementation administered from the second trimester of pregnancy until delivery on children’s cognitive development.
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Key Findings & Data:Analyses were performed using Hedges’ g effect size.The findings indicated that omega-3 and folic acid supplementation did not produce consistent or significant effects on overall cognitive development.
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Conclusion & Impact:Future large-scale randomized trials with longer follow-up periods are required to strengthen the evidence base and clarify the role of prenatal micronutrient supplementation in cognitive development.
🔬Design:Araştırma Makalesi
📍Scope:Comprehensive Sample
⚙️Variables:Omega-3 · folik asit · çinko

Abstract

This meta-analysis aimed to evaluate the effects of omega-3 fatty acids, folic acid, and zinc supplementation administered from the second trimester of pregnancy until delivery on children’s cognitive development. Eligible randomized controlled trials and clinical studies were identified through a systematic literature search conducted in accordance with PRISMA guidelines. Inclusion criteria were: initiation of supplementation from the second trimester, assessment of cognitive development with standardized tests (e.g., Bayley, WPPSI, DAS), sufficient statistical data, and studies conducted in human populations. Analyses were performed using Hedges’ g effect size.The findings indicated that omega-3 and folic acid supplementation did not produce consistent or significant effects on overall cognitive development. However, potential benefits were observed in specific domains, such as verbal skills and attention, particularly among children growing up in disadvantaged environments. Zinc supplementation showed no significant impact on cognitive outcomes.These results suggest that the effectiveness of prenatal micronutrient supplementation may depend not only on dosage and intervention duration but also on contextual factors, including maternal nutritional status, genetic background, and postnatal environmental conditions. This meta-analysis demonstrates that prenatal micronutrient supplementation does not exert a uniform effect on children’s cognitive development, and that outcomes may vary depending on individual and environmental differences. The limited number of included studies and the variability of cognitive assessment tools restrict the generalizability of these findings. Future large-scale randomized trials with longer follow-up periods are required to strengthen the evidence base and clarify the role of prenatal micronutrient supplementation in cognitive development.

Özet

takviyelerinin çocukların zihinsel gelişimi üzerindeki etkilerini değerlendirmeyi amaçlamaktadır. Çalışmaya dahil edilen randomize kontrollü çalışmalar ve klinik araştırmalar, PRISMA yönergelerine uygun olarak sistematik literatür taraması sonucunda belirlenmiştir. Dahil edilme kriterleri; müdahalenin gebeliğin ikinci trimesterinden itibaren başlaması, zihinsel gelişimin standart bilişsel testlerle (Bayley, WPPSI, DAS vb.) değerlendirilmiş olması, yeterli istatistiksel verinin sunulması ve çalışmanın insan popülasyonunda yürütülmüş olmasıdır. Analizler, Hedges’ g etki büyüklüğü kullanılarak gerçekleştirilmiştir. Sonuçlar, omega-3 ve folik asit takviyelerinin genel bilişsel gelişim üzerinde tutarlı ve anlamlı bir etki oluşturmadığını, ancak bazı alt alanlarda (ör. sözel beceriler, dikkat) ve dezavantajlı çevresel koşullarda büyüyen çocuklarda olumlu etkiler gözlenebileceğini göstermiştir. Çinko takviyesinin ise bilişsel gelişim üzerinde anlamlı bir katkısı bulunmamıştır. Bulgular, takviyelerin etkilerinin yalnızca doz veya süreye değil; anne beslenme durumu, genetik faktörler ve doğum sonrasında çevresel koşullar gibi bağlamsal değişkenlere bağlı olarak farklılık gösterebileceğini ortaya koymaktadır. Bu meta-analiz prenatal dönemde kullanılan mikrobesin takviyelerinin çocukların zihinsel gelişimi üzerinde tek tip bir etki göstermediğini, bu etkinin anne beslenme durumu ve çevresel koşullar gibi farklı faktörlere göre değişebileceğini ortaya koymaktadır. Dahil edilen çalışma sayısının sınırlı olması, kullanılan testlerin farklılık göstermesi sonuçların genellenilebilirliğini kısıtlamaktadır. Sonuçların daha net anlaşılabilmesi için gelecekte daha fazla katılımcıyla yapılacak ve uzun süre devam edecek çalışmalara ihtiyaç vardır.

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Cite This Article

Yılmaz, E. E., Pala, M. (2026). The Effects of Prenatal Nutrition on Cognitive Development in Children: A Meta-Analysis. Haliç Üniversitesi Sağlık Bilimleri Dergisi, Cilt: 9 Sayı: 2, 49–60. https://doi.org/10.48124/husagbilder.1788677

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References (30)

  1. Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, De Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382(9890):427-51. doi:10.1016/S0140-6736(13)60937-X
  2. Prado EL, Dewey KG. Nutrition and brain development in early life: updates and new perspectives. Annu Rev Nutr. 2022;42:1-25. doi:10.1146/annurev-nutr-062320-111447
  3. World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience. Geneva: World Health Organization; 2016.
  4. Dayı T, Pekcan G, Doğu Üniversitesi Y, Bilimleri Fakültesi S, Diyetetik Bölümü B, et al. Gebelerde folik asit desteği ve güncel yaklaşımlar. Florence Nightingale J Nutr Diet. 2019;5(2):128-38. doi:10.3153/FH19014
  5. Ouyang J, Cai W, Wu P, Tong J, Gao G, Yan S, et al. Association between dietary patterns during pregnancy and children's neurodevelopment: a birth cohort study. Nutrients. 2024;16(10):1530. doi:10.3390/nu16101530
  6. Basak S, Mallick R, Duttaroy AK. Maternal docosahexaenoic acid status during pregnancy and its impact on infant neurodevelopment. Nutrients. 2020;12(12):3615. doi:10.3390/nu12123615
  7. Hart KH, Syed A, Barrett J, Rankin J, Simms-Ellis R, McKenzie C, et al. Diet in pregnancy: a review of current challenges and recommendations. Nutrients. 2025;17(2):388. doi:10.3390/nu17020388
  8. Lv S, Qin R, Jiang Y, Lv H, Lu Q, Tao S, et al. Association of maternal dietary patterns during gestation and offspring neurodevelopment. Nutrients. 2022;14(4):730. doi:10.3390/nu14040730
  9. Steenweg-de Graaff J, Tiemeier H, Steegers-Theunissen RPM, Hofman A, Jaddoe VWV, Verhulst FC, et al. Maternal dietary patterns during pregnancy and child internalising and externalising problems: the Generation R Study. Clin Nutr. 2014;33(1):115-21. doi:10.1016/j.clnu.2013.03.002
  10. Galera C, Heude B, Forhan A, Bernard JY, Peyre H, Van Der Waerden J, et al. Prenatal diet and children's trajectories of hyperactivity-inattention and conduct problems from 3 to 8 years: the EDEN mother–child cohort. J Child Psychol Psychiatry. 2018;59(9):1003-11. doi:10.1111/jcpp.12880
  11. Freitas-Vilela AA, Pearson RM, Emmett P, Heron J, Smith ADAC, Emond A, et al. Maternal dietary patterns during pregnancy and intelligence quotients in the offspring at 8 years of age: findings from the ALSPAC cohort. Matern Child Nutr. 2017;14(1):e12431. doi:10.1111/mcn.12431
  12. Dai F, Wang P, Li Q, Zhang L, Yu L, Wu L, et al. Mediterranean diet during pregnancy and infant neurodevelopment: a prospective birth cohort study. Front Nutr. 2023;9:1078481. doi:10.3389/fnut.2022.1078481
  13. Heland S, Fields N, Ellery SJ, Fahey M, Palmer KR. The role of nutrients in human neurodevelopment and their potential to prevent neurodevelopmental adversity. Front Nutr. 2022;9:992120. doi:10.3389/fnut.2022.992120
  14. Irvine N, England-Mason G, Field CJ, Dewey D, Aghajafari F. Prenatal folate and choline levels and brain and cognitive development in children: a critical narrative review. Nutrients. 2022;14(2):364. doi:10.3390/nu14020364
  15. World Health Organization. WHO recommendations on maternal health: guidelines approved by the WHO Guidelines Review Committee. 2nd ed. Geneva: World Health Organization; 2025.
  16. Caffrey A, Irwin RE, McNulty H, Strain JJ, Lees-Murdock DJ, McNulty BA, et al. Gene-specific DNA methylation in newborns in response to folic acid supplementation during the second and third trimesters of pregnancy: epigenetic analysis from a randomized controlled trial. Am J Clin Nutr. 2018;107(4):566-75. doi:10.1093/ajcn/nqx069
  17. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. doi:10.1136/bmj.n71
  18. Eriksen MB, Frandsen TF. The impact of patient, intervention, comparison, outcome (PICO) as a search strategy tool on literature search quality: a systematic review. J Med Libr Assoc. 2018;106(4):420-31. doi:10.5195/jmla.2018.345
  19. Şen S, Yıldırım A. CMA ile Meta-Analiz Uygulamaları. Ankara: Nobel Akademik Yayıncılık; 2020.
  20. Ramakrishnan U, Stinger A, DiGirolamo AM, Martorell R, Neufeld LM, Rivera JA, et al. Prenatal docosahexaenoic acid supplementation and offspring development at 18 months: randomized controlled trial. PLoS One. 2015;10(8):e0120065. doi:10.1371/journal.pone.0120065
  21. Ramakrishnan U, Gonzalez-Casanova I, Schnaas L, DiGirolamo A, Quezada AD, Pallo BC, et al. Prenatal supplementation with DHA improves attention at 5 y of age: a randomized controlled trial. Am J Clin Nutr. 2016;104(4):1075-82. doi:10.3945/ajcn.114.101071
  22. Colombo J, Shaddy DJ, Gustafson K, Gajewski BJ, Thodosoff JM, Kerling E, et al. The Kansas University DHA Outcomes Study (KUDOS) clinical trial: long-term behavioral follow-up of the effects of prenatal DHA supplementation. Am J Clin Nutr. 2019;109(5):1380-92. doi:10.1093/ajcn/nqz018
  23. Gould JF, Treyvaud K, Yelland LN, Anderson PJ, Smithers LG, Gibson RA, et al. Does n-3 LCPUFA supplementation during pregnancy increase the IQ of children at school age? Follow-up of a randomised controlled trial. BMJ Open. 2016;6(5):e011465. doi:10.1136/bmjopen-2016-011465
  24. Meldrum S, Dunstan JA, Foster JK, Simmer K, Prescott SL. Maternal fish oil supplementation in pregnancy: a 12-year follow-up of a randomised controlled trial. Nutrients. 2015;7(3):2061-7. doi:10.3390/nu7032061
  25. Makrides M, Gould JF, Gawlik NR, Yelland LN, Smithers LG, Anderson PJ, et al. Four-year follow-up of children born to women in a randomized trial of prenatal DHA supplementation. JAMA. 2014;311(17):1802-4. doi:10.1001/jama.2014.2194
  26. Dunstan JA, Simmer K, Dixon G, Prescott SL. Cognitive assessment of children at age 2½ years after maternal fish oil supplementation in pregnancy: a randomised controlled trial. Arch Dis Child Fetal Neonatal Ed. 2008;93(1):F45-50. doi:10.1136/adc.2006.099085
  27. Hamadani JD, Fuchs GJ, Osendarp SJ, Huda SN, Grantham-McGregor SM. Zinc supplementation during pregnancy and effects on mental development and behaviour of infants: a follow-up study. Lancet. 2002;360(9329):290-4. doi:10.1016/S0140-6736(02)09551-X
  28. Tamura T, Goldenberg RL, Ramey SL, Nelson KG, Chapman VR. Effect of zinc supplementation of pregnant women on the mental and psychomotor development of their children at 5 y of age. Am J Clin Nutr. 2003;77(6):1512-6. doi:10.1093/ajcn/77.6.1512
  29. McNulty H, Rollins M, Cassidy T, Caffrey A, Marshall B, Dornan J, et al. Effect of continued folic acid supplementation beyond the first trimester of pregnancy on cognitive performance in the child: a follow-up study from a randomized controlled trial (FASSTT Offspring Trial). BMC Med. 2019;17(1):196. doi:10.1186/s12916-019-1432-4
  30. Caffrey A, McNulty H, Rollins M, Prasad G, Gaur P, Talcott JB, et al. Effects of maternal folic acid supplementation during the second and third trimesters of pregnancy on neurocognitive development in the child: an 11-year follow-up from a randomised controlled trial. BMC Med. 2021;19(1):73. doi:10.1186/s12916-021-01914-9