human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: CONTEXT Uncertainty about the benefits of dietary docosahexaenoic acid ( DHA ) for pregnant women and their children exists , despite international recommendations that pregnant women increase their DHA intakes . OBJECTIVE To determine whether increasing DHA during the last half of pregnancy will result in fewer women with high levels of depressive symptoms and enhance the neurodevelopmental outcome of their children . DESIGN , SETTING , AND PARTICIPANTS A double-blind , multicenter , r and omized controlled trial ( DHA to Optimize Mother Infant Outcome [ DOMInO ] trial ) in 5 Australian maternity hospitals of 2399 women who were less than 21 weeks ' gestation with singleton pregnancies and who were recruited between October 31 , 2005 , and January 11 , 2008 . Follow-up of children ( n = 726 ) was completed December 16 , 2009 . INTERVENTION Docosahexaenoic acid-rich fish oil capsules ( providing 800 mg/d of DHA ) or matched vegetable oil capsules without DHA from study entry to birth . MAIN OUTCOME MEASURES High levels of depressive symptoms in mothers as indicated by a score of more than 12 on the Edinburgh Postnatal Depression Scale at 6 weeks or 6 months postpartum . Cognitive and language development in children as assessed by the Bayley Scales of Infant and Toddler Development , Third Edition , at 18 months . RESULTS Of 2399 women enrolled , 96.7 % completed the trial . The percentage of women with high levels of depressive symptoms during the first 6 months postpartum did not differ between the DHA and control groups ( 9.67 % vs 11.19 % ; adjusted relative risk , 0.85 ; 95 % confidence interval [ CI ] , 0.70 - 1.02 ; P = .09 ) . Mean cognitive composite scores ( adjusted mean difference , 0.01 ; 95 % CI , -1.36 to 1.37 ; P = .99 ) and mean language composite scores ( adjusted mean difference , -1.42 ; 95 % CI , -3.07 to 0.22 ; P = .09 ) of children in the DHA group did not differ from children in the control group . CONCLUSION The use of DHA-rich fish oil capsules compared with vegetable oil capsules during pregnancy did not result in lower levels of postpartum depression in mothers or improved cognitive and language development in their offspring during early childhood . TRIAL REGISTRATION anzctr.org.au Identifier : ACTRN12605000569606 A preventive effect of dietary marine n-3 fatty acids on  early delivery  and toxaemia has recently been hypothesized . In only one published controlled trial fish oil has been given to pregnant women , namely in that conducted during 1938 - 9 in London by the People 's League of Health with a dietary supplement containing vitamins , minerals , and halibut liver oil . Although it was of high quality and its findings are hitherto unexplained , neglect and misinterpretation of the trial seem to occur commonly in review s. Of the 5644 women who were enrolled the 622 withdrawals were independent of treatment . Alternate allocation to treatment was used , producing two groups that were well balanced as to age and parity . The supplement was given from about week 20 . The control group did not receive any supplement . Reductions of 20.4 % ( 95 % confidence interval 9 - 30 % , P = 0.00083 ) and 31.5 % ( 95 % confidence interval 11 - 47 % , P = 0.0047 ) were seen in odds of delivering before 40 weeks of gestation and pre-eclampsia respectively . No significant effects were seen on perinatal mortality , average birth weight , deliveries after 40 weeks , hypertension in the absence of oedema and proteinuria , duration of labour , sepsis or breast-feeding occurrence . Later controlled trials with vitamins or minerals given in the same amounts as in this trial have largely failed to show convincing effects as seen here . A controlled trial assessing the isolated effects of fish oil in pregnancy is warranted Dietary DHA enhances infant  attention and visual development . Because the DHA content of red blood cells and plasma lipids varies approximately threefold in pregnancy , maternal DHA status may influence subsequent infant function . It would be feasible to study the effects of higher maternal  DHA intake on infant development if dietary intake of DHA could be increased by a reliable means . This study was design ed to determine whether women provided with one dozen high-DHA hen eggs ( 135 mg DHA/egg ) would consume the eggs and have higher blood DHA levels than women consuming ordinary eggs  ( 18 mg DHA/egg ) . The study was a r and omized , double-masked comparison of the effect of eggs with different concentrations of DHA on intake and blood lipid DHA content of women and their infants . A third nonr and omized group ate few eggs . In this study , DHA intake reported from eggs was eightfold higher in the high-DHA egg group compared to the ordinary egg group . Including all groups , DHA intake ranged from 0 to 284 mg/d . In this intake range , maternal blood lipid DHA content at enrollment best predicted DHA content at delivery , accounting for 36.5 and 51.7 % of the variance in ordinary and high-DHA egg intake groups , respectively . The high-DHA vs. ordinary egg groups had similar maternal and cord blood lipid DHA , but there was a positive relationship between maternal plasma phospholipid DHA and daily DHA intake from eggs controlled for study duration ( r=0.278 , P=0.048 ) . DHA intake and birth weight were also correlated ( r=0.299 , P=0.041 ) . High-DHA eggs were well accepted and increased DHA intake . Other benefits of DHA intake during pregnancy were also suggested Summary High-DHA eggs appear to be a practical way to increase maternal DHA status . The data suggest that high-DHA eggs could decrease the incidence of preterm and low-birth-weight births , and this could be tested in a study with more statistical power . The neurodevelopment of infants from women fed low- and high-DHA eggs  could also provide helpful information Background DHA is accumulated in the central nervous system ( CNS ) before birth and is involved in early developmental processes , such as neurite outgrowth and gene expression . Objective To determine whether fetal DHA insufficiency occurs and constrains CNS development in term gestation infants . Design A risk reduction model using a r and omized prospect i ve study of term gestation single birth healthy infants born to women ( n = 270 ) given a placebo or 400 mg/day DHA from 16 wk gestation to delivery . Fetal DHA deficiency sufficient to constrain CNS development was assessed based on increased risk that infants in the placebo group would not achieve neurodevelopment scores in the top quartile of all infants in the study . Results Infants in the placebo group were at increased risk of lower language development assessed as words understood ( OR 3.22 , CL 1.49–6.94 , P = 0.002 ) and produced ( OR 2.61 , CL 1.22–5.58 , P = 0.01 ) at 14 mo , and words understood ( OR 2.77 , CL 1.23–6.28 , P = 0.03 ) and sentences produced ( OR 2.60 , CL 1.15–5.89 , P = 0.02 ) at 18 mo using the McArthur Communicative Developmental Inventory ; receptive ( OR 2.23 , CL 1.08–4.60 , P = 0.02 ) and expressive language ( OR 1.89 , CL 0.94–3.83 , P = 0.05 ) at 18 mo using the Bayley Scales of Infant Development III ; and visual acuity ( OR 2.69 , CL 1.10–6.54 , P = 0.03 ) at 2 mo . Trial Registration Clinical Trials.gov OBJECTIVE There have been indications that high intake of n-3 long-chain polyunsaturated fatty acids ( PUFAs ) during pregnancy may increase birth weight and gestational length . In addition , n-3 long-chain PUFAs may be important for the neurobiological development of the infants . High levels of docosahexaenoic acid ( DHA , 22:6 n-3 ) are found in the gray matter of the cerebral cortex and in the retina , and it seems as if the availability of long-chain PUFAs may be limiting cerebral development . The fetus and the newborn are dependent on a high supply from their mothers , either via the placenta or via breast milk . We supplemented pregnant and lactating women with n-3 or n-6 long-chain PUFAs to evaluate the effect on birth weight , gestational length , and infant development . DESIGN We performed a double-blind , r and omized study recruiting 590 pregnant , healthy , nulli- or primiparous women ( 19 - 35 years old ) in weeks 17 to 19 of pregnancy . The women were provided 10 mL of either cod liver oil or corn oil daily until 3 months after delivery . MAIN OUTCOME MEASURES Primary outcomes were gestational length and birth weight . Electroencephalography ( EEG ) was done on the second day of life and at 3 months of age . Novelty preference ( Fagan test ) was used as an indicator of cognitive function at 6 and 9 months of age . The fatty acid pattern in umbilical plasma phospholipids and in breast milk was measured , and dietary assessment s were performed , both on the mothers during pregnancy and on the infants at 3 months of age . The growth of the infants was followed up to 1 year of age . RESULTS Three hundred forty-one mothers took part in the study until delivery . There were no significant differences in maternal body mass index before pregnancy and at birth , or parity between the 2 groups . Smoking habits and parental education were also similar in the 2 groups . The mean age of the mothers receiving cod liver oil was , by chance , 1 year higher than the age of the mothers receiving corn oil ( 28.6 [ 3.4 ] vs 27.6 [ 3.2 ] years ) . The maternal dietary intake in the 2 groups receiving cod liver oil or corn oil was similar , except for the supplementation . There were no differences in gestational length or birth weight between the cod liver oil group and the corn oil group ( 279.6 [ 9.2 ] vs 279.2 [ 9.3 ] days ; 3609 [ 493 ] vs 3618 [ 527 ] g , respectively ) . Birth length , head circumference , and placental weight were also similar in the 2 groups . The concentrations of the n-3 fatty acids eicosapentaenoic acid ( 20:5 n-3 ) , docosapentaenoic acid ( 22:5 n-3 ) , and DHA in umbilical plasma phospholipids were higher in the cod liver oil group compared with the corn oil group ( 10.8 [ 7.6 ] vs 2.5 [ 1.8 ] microg/mL , 5.0 [ 2.6 ] vs 2.9 [ 1.3 ] microg/mL , 55.8 [ 20.6 ] vs 45.3 [ 12.8 ] microg/mL , respectively ) . Neonates with high concentration of DHA in umbilical plasma phospholipids ( upper quartile ) had longer gestational length than neonates with low concentration ( lower quartile ; 282.5 [ 8.5 ] vs 275.4 [ 9.3 ] days ) . No differences in EEG scores or Fagan scores were found , but neonates with mature EEG ( N = 70 ) had a higher concentration of DHA in umbilical plasma phospholipids than neonates with immature EEG ( N = 51 ) on the second day of life . Dietary information from 251 infants at 3 months of age was collected and 85 % of these infants were exclusively breastfed , in addition to 12 % who were partly breastfed . The breast milk of mothers supplemented with cod liver oil contained more n-3 long-chain PUFAs and less n-6 long-chain PUFAs than breast milk of mothers supplemented with corn oil . There were no significant differences in infant growth during the first year of life between the 2 groups . CONCLUSIONS This study shows neither harmful nor beneficial effects of maternal supplementation of long-chain n-3 PUFAs regarding pregnancy outcome , cognitive development , or growth , as compared with supplementation with n-6 fatty acids . However , it confirms that DHA concentration may be related to gestational length and cerebral maturation of the newborn OBJECTIVE To hypothesize that higher intake of docosahexaenoic acid , an n-3 long chain polyunsaturated fatty acid , would increase duration of gestation and birth weight in US women . METHODS This was a r and omized , double-blind , controlled , clinical trial . Subjects were enrolled in an ambulatory clinic where they received prenatal care . This was a population -based sample . Most subjects received government assistance for  medical care and most were black ( 73 % ) . Subjects were enrolled between the 24th and 28th week of pregnancy and consumed docosahexaenoic acid ( 33 or 133 mg ) from eggs until parturition . Gestational age and birth weight were the main study outcomes . Infant length and head circumference , preterm birth , and low birth weight were secondary outcomes . RESULT 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: CONTEXT Uncertainty about the benefits of dietary docosahexaenoic acid ( DHA ) for pregnant women and their children exists , despite international recommendations that pregnant women increase their DHA intakes . OBJECTIVE To determine whether increasing DHA during the last half of pregnancy will result in fewer women with high levels of depressive symptoms and enhance the neurodevelopmental outcome of their children . DESIGN , SETTING , AND PARTICIPANTS A double-blind , multicenter , r and omized controlled trial ( DHA to Optimize Mother Infant Outcome [ DOMInO ] trial ) in 5 Australian maternity hospitals of 2399 women who were less than 21 weeks ' gestation with singleton pregnancies and who were recruited between October 31 , 2005 , and January 11 , 2008 . Follow-up of children ( n = 726 ) was completed December 16 , 2009 . INTERVENTION Docosahexaenoic acid-rich fish oil capsules ( providing 800 mg/d of DHA ) or matched vegetable oil capsules without DHA from study entry to birth . MAIN OUTCOME MEASURES High levels of depressive symptoms in mothers as indicated by a score of more than 12 on the Edinburgh Postnatal Depression Scale at 6 weeks or 6 months postpartum . Cognitive and language development in children as assessed by the Bayley Scales of Infant and Toddler Development , Third Edition , at 18 months . RESULTS Of 2399 women enrolled , 96.7 % completed the trial . The percentage of women with high levels of depressive symptoms during the first 6 months postpartum did not differ between the DHA and control groups ( 9.67 % vs 11.19 % ; adjusted relative risk , 0.85 ; 95 % confidence interval [ CI ] , 0.70 - 1.02 ; P = .09 ) . Mean cognitive composite scores ( adjusted mean difference , 0.01 ; 95 % CI , -1.36 to 1.37 ; P = .99 ) and mean language composite scores ( adjusted mean difference , -1.42 ; 95 % CI , -3.07 to 0.22 ; P = .09 ) of children in the DHA group did not differ from children in the control group . CONCLUSION The use of DHA-rich fish oil capsules compared with vegetable oil capsules during pregnancy did not result in lower levels of postpartum depression in mothers or improved cognitive and language development in their offspring during early childhood . TRIAL REGISTRATION anzctr.org.au Identifier : ACTRN12605000569606 A preventive effect of dietary marine n-3 fatty acids on  early delivery  and toxaemia has recently been hypothesized . In only one published controlled trial fish oil has been given to pregnant women , namely in that conducted during 1938 - 9 in London by the People 's League of Health with a dietary supplement containing vitamins , minerals , and halibut liver oil . Although it was of high quality and its findings are hitherto unexplained , neglect and misinterpretation of the trial seem to occur commonly in review s. Of the 5644 women who were enrolled the 622 withdrawals were independent of treatment . Alternate allocation to treatment was used , producing two groups that were well balanced as to age and parity . The supplement was given from about week 20 . The control group did not receive any supplement . Reductions of 20.4 % ( 95 % confidence interval 9 - 30 % , P = 0.00083 ) and 31.5 % ( 95 % confidence interval 11 - 47 % , P = 0.0047 ) were seen in odds of delivering before 40 weeks of gestation and pre-eclampsia respectively . No significant effects were seen on perinatal mortality , average birth weight , deliveries after 40 weeks , hypertension in the absence of oedema and proteinuria , duration of labour , sepsis or breast-feeding occurrence . Later controlled trials with vitamins or minerals given in the same amounts as in this trial have largely failed to show convincing effects as seen here . A controlled trial assessing the isolated effects of fish oil in pregnancy is warranted Dietary DHA enhances infant  attention and visual development . Because the DHA content of red blood cells and plasma lipids varies approximately threefold in pregnancy , maternal DHA status may influence subsequent infant function . It would be feasible to study the effects of higher maternal  DHA intake on infant development if dietary intake of DHA could be increased by a reliable means . This study was design ed to determine whether women provided with one dozen high-DHA hen eggs ( 135 mg DHA/egg ) would consume the eggs and have higher blood DHA levels than women consuming ordinary eggs  ( 18 mg DHA/egg ) . The study was a r and omized , double-masked comparison of the effect of eggs with different concentrations of DHA on intake and blood lipid DHA content of women and their infants . A third nonr and omized group ate few eggs . In this study , DHA intake reported from eggs was eightfold higher in the high-DHA egg group compared to the ordinary egg group . Including all groups , DHA intake ranged from 0 to 284 mg/d . In this intake range , maternal blood lipid DHA content at enrollment best predicted DHA content at delivery , accounting for 36.5 and 51.7 % of the variance in ordinary and high-DHA egg intake groups , respectively . The high-DHA vs. ordinary egg groups had similar maternal and cord blood lipid DHA , but there was a positive relationship between maternal plasma phospholipid DHA and daily DHA intake from eggs controlled for study duration ( r=0.278 , P=0.048 ) . DHA intake and birth weight were also correlated ( r=0.299 , P=0.041 ) . High-DHA eggs were well accepted and increased DHA intake . Other benefits of DHA intake during pregnancy were also suggested Summary High-DHA eggs appear to be a practical way to increase maternal DHA status . The data suggest that high-DHA eggs could decrease the incidence of preterm and low-birth-weight births , and this could be tested in a study with more statistical power . The neurodevelopment of infants from women fed low- and high-DHA eggs  could also provide helpful information Background DHA is accumulated in the central nervous system ( CNS ) before birth and is involved in early developmental processes , such as neurite outgrowth and gene expression . Objective To determine whether fetal DHA insufficiency occurs and constrains CNS development in term gestation infants . Design A risk reduction model using a r and omized prospect i ve study of term gestation single birth healthy infants born to women ( n = 270 ) given a placebo or 400 mg/day DHA from 16 wk gestation to delivery . Fetal DHA deficiency sufficient to constrain CNS development was assessed based on increased risk that infants in the placebo group would not achieve neurodevelopment scores in the top quartile of all infants in the study . Results Infants in the placebo group were at increased risk of lower language development assessed as words understood ( OR 3.22 , CL 1.49–6.94 , P = 0.002 ) and produced ( OR 2.61 , CL 1.22–5.58 , P = 0.01 ) at 14 mo , and words understood ( OR 2.77 , CL 1.23–6.28 , P = 0.03 ) and sentences produced ( OR 2.60 , CL 1.15–5.89 , P = 0.02 ) at 18 mo using the McArthur Communicative Developmental Inventory ; receptive ( OR 2.23 , CL 1.08–4.60 , P = 0.02 ) and expressive language ( OR 1.89 , CL 0.94–3.83 , P = 0.05 ) at 18 mo using the Bayley Scales of Infant Development III ; and visual acuity ( OR 2.69 , CL 1.10–6.54 , P = 0.03 ) at 2 mo . Trial Registration Clinical Trials.gov OBJECTIVE There have been indications that high intake of n-3 long-chain polyunsaturated fatty acids ( PUFAs ) during pregnancy may increase birth weight and gestational length . In addition , n-3 long-chain PUFAs may be important for the neurobiological development of the infants . High levels of docosahexaenoic acid ( DHA , 22:6 n-3 ) are found in the gray matter of the cerebral cortex and in the retina , and it seems as if the availability of long-chain PUFAs may be limiting cerebral development . The fetus and the newborn are dependent on a high supply from their mothers , either via the placenta or via breast milk . We supplemented pregnant and lactating women with n-3 or n-6 long-chain PUFAs to evaluate the effect on birth weight , gestational length , and infant development . DESIGN We performed a double-blind , r and omized study recruiting 590 pregnant , healthy , nulli- or primiparous women ( 19 - 35 years old ) in weeks 17 to 19 of pregnancy . The women were provided 10 mL of either cod liver oil or corn oil daily until 3 months after delivery . MAIN OUTCOME MEASURES Primary outcomes were gestational length and birth weight . Electroencephalography ( EEG ) was done on the second day of life and at 3 months of age . Novelty preference ( Fagan test ) was used as an indicator of cognitive function at 6 and 9 months of age . The fatty acid pattern in umbilical plasma phospholipids and in breast milk was measured , and dietary assessment s were performed , both on the mothers during pregnancy and on the infants at 3 months of age . The growth of the infants was followed up to 1 year of age . RESULTS Three hundred forty-one mothers took part in the study until delivery . There were no significant differences in maternal body mass index before pregnancy and at birth , or parity between the 2 groups . Smoking habits and parental education were also similar in the 2 groups . The mean age of the mothers receiving cod liver oil was , by chance , 1 year higher than the age of the mothers receiving corn oil ( 28.6 [ 3.4 ] vs 27.6 [ 3.2 ] years ) . The maternal dietary intake in the 2 groups receiving cod liver oil or corn oil was similar , except for the supplementation . There were no differences in gestational length or birth weight between the cod liver oil group and the corn oil group ( 279.6 [ 9.2 ] vs 279.2 [ 9.3 ] days ; 3609 [ 493 ] vs 3618 [ 527 ] g , respectively ) . Birth length , head circumference , and placental weight were also similar in the 2 groups . The concentrations of the n-3 fatty acids eicosapentaenoic acid ( 20:5 n-3 ) , docosapentaenoic acid ( 22:5 n-3 ) , and DHA in umbilical plasma phospholipids were higher in the cod liver oil group compared with the corn oil group ( 10.8 [ 7.6 ] vs 2.5 [ 1.8 ] microg/mL , 5.0 [ 2.6 ] vs 2.9 [ 1.3 ] microg/mL , 55.8 [ 20.6 ] vs 45.3 [ 12.8 ] microg/mL , respectively ) . Neonates with high concentration of DHA in umbilical plasma phospholipids ( upper quartile ) had longer gestational length than neonates with low concentration ( lower quartile ; 282.5 [ 8.5 ] vs 275.4 [ 9.3 ] days ) . No differences in EEG scores or Fagan scores were found , but neonates with mature EEG ( N = 70 ) had a higher concentration of DHA in umbilical plasma phospholipids than neonates with immature EEG ( N = 51 ) on the second day of life . Dietary information from 251 infants at 3 months of age was collected and 85 % of these infants were exclusively breastfed , in addition to 12 % who were partly breastfed . The breast milk of mothers supplemented with cod liver oil contained more n-3 long-chain PUFAs and less n-6 long-chain PUFAs than breast milk of mothers supplemented with corn oil . There were no significant differences in infant growth during the first year of life between the 2 groups . CONCLUSIONS This study shows neither harmful nor beneficial effects of maternal supplementation of long-chain n-3 PUFAs regarding pregnancy outcome , cognitive development , or growth , as compared with supplementation with n-6 fatty acids . However , it confirms that DHA concentration may be related to gestational length and cerebral maturation of the newborn OBJECTIVE To hypothesize that higher intake of docosahexaenoic acid , an n-3 long chain polyunsaturated fatty acid , would increase duration of gestation and birth weight in US women . METHODS This was a r and omized , double-blind , controlled , clinical trial . Subjects were enrolled in an ambulatory clinic where they received prenatal care . This was a population -based sample . Most subjects received government assistance for  medical care and most were black ( 73 % ) . Subjects were enrolled between the 24th and 28th week of pregnancy and consumed docosahexaenoic acid ( 33 or 133 mg ) from eggs until parturition . Gestational age and birth weight were the main study outcomes . Infant length and head circumference , preterm birth , and low birth weight were secondary outcomes . RESULT 
    Output:
    