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Background: Black American children are at higher risk for developing asthma than White children. Identifying potential scalable preventive interventions that can reduce the racial disparities in asthma prevalence and associated morbidity and mortality are needed. We leveraged data from an RCT of prenatal supplementation with docosahexaenoic acid (DHA) in Black American women, to explore whether prenatal fatty acid supplementation is associated with offspring wheeze and asthma. Methods: Data were from the Nutrition and Pregnancy Study (NAPS), a double-blind RCT of prenatal DHA supplementation in Black women targeting stress regulation during pregnancy. A subset of mothers (n = 83) completed a standardized questionnaire on offspring wheeze and asthma when children were between 0.5 and 5.5 years of age. DHA levels were measured from venous blood and reported as percent of total fatty acids. Results: Of the 83 mothers providing data on child wheeze and asthma, 57 (68.7%) had been randomized to active DHA and 26 (31.3%) to placebo. Mothers and research staff were blind to group assignment. Comparison at the group assignment level yielded a relative reduction of 32% in the rate of wheeze or asthma among offspring of mothers assigned to active DHA compared to offspring of mothers assigned to placebo (OR = 1.6 [95% CI = 0.50– 5.09], p = 0.426). DHA levels measured at 25– 29 and 33– 37 weeks of gestation differed as a function of offspring wheeze or asthma (t = 2.21, p = 0.015 and t = 2.54, p = 0.007, respectively). Conclusion: These preliminary data suggest that increasing prenatal levels of DHA could be considered as a potential prevention for asthma in Black American children. [ABSTRACT FROM AUTHOR]