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Past studies were not powered to examine metabolic outcomes and few have specifically targeted metabolically vulnerable populations. We examined the associations of prenatal n-3 LCPUFA status with markers of metabolic health in early and mid-childhood in the full population as well as stratified by maternal glucose tolerance. Our data consisted of 1418 mother\u2013child dyads from Project Viva, a longitudinal, prospective pre-birth cohort enrolled in eastern Massachusetts. We assessed maternal dietary intake of fish and n-3 LCPUFA in mid-pregnancy using a validated food frequency questionnaire. N-3 LCPUFA levels were quantified in maternal second trimester and umbilical cord plasma using liquid-gas chromatography. We assessed offspring anthropometry, adiposity, and blood pressure at early (median age: 3.2 years) and mid-childhood (median age: 7.7 years); and assayed blood samples collected at these visits for metabolic biomarkers. We report here multivariable effect estimates and 95% CI. Early childhood BMI<jats:italic>z<\/jats:italic>-score was on average 0.46 (1.03) units and waist circumference 51.3 (3.7) cm. At mid-childhood these measures were 0.39 (1.00) units and 60.0 (8.3) cm, respectively. Higher cord plasma DHA levels were associated with lower BMI<jats:italic>z<\/jats:italic>-score ((Q)uartile 4 vs. Q1: \u22120.21, 95% CI: \u22120.38, \u22120.03), waist circumference (Q4 vs. Q1: \u22120.63, 95% CI: \u22121.27, 0.00 cm), and leptin levels (Q4 vs. Q1: \u22120.36, 95% CI: \u22120.77, 0.05 ng\/mL) in early childhood. These associations were strongest and reached significance in offspring of women with isolated hyperglycemia vs. better or worse glycemic status. Higher maternal DHA\u2009+\u2009EPA (Q4 vs. Q1: \u22121.59, 95% CI: \u22122.80, \u22120.38\u2009\u03bcg\/mL) and fish (\u22653 vs. 0 portions\/week: \u22122.18, 95% CI: \u22123.90, \u22120.47\u2009\u03bcg\/mL) intake was related to lower adiponectin in early childhood. None of these associations persisted with mid-childhood outcomes. We did not find associations with any of the other outcomes. This study supports early and possibly transient effects of prenatal n-3 LCPUFA status on anthropometric measures and adipokine levels. It also raises the possibility that offspring of women with isolated hyperglycemia derive the most benefits from higher n-3 LCPUFA status.<\/jats:p>","DOI":"10.1038\/s41387-018-0040-2","type":"journal-article","created":{"date-parts":[[2018,5,21]],"date-time":"2018-05-21T15:55:17Z","timestamp":1526918117000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Prenatal n-3 long-chain fatty acid status and offspring metabolic health in early and mid-childhood: results from Project Viva"],"prefix":"10.1038","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5415-8119","authenticated-orcid":false,"given":"Ekaterina","family":"Maslova","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheryl L.","family":"Rifas-Shiman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sjurdur F.","family":"Olsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew W.","family":"Gillman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Oken","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2018,5,25]]},"reference":[{"key":"40_CR1","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1111\/j.1559-4572.2008.00015.x","volume":"3","author":"V Juturu","year":"2008","unstructured":"Juturu, V. 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