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Omega 3 fatty acids, gestation and pregnancy outcomes

  • Elvira Larqué (a1), Alfonso Gil-Sánchez (a2), María Teresa Prieto-Sánchez (a2) and Berthold Koletzko (a3)
Abstract

Pregnancy is associated with a reduction in maternal serum docosahexaenoic acid (DHA, 22:6 n-3) percentage and its possible depletion in the maternal store. Since the synthesis of long chain polyunsaturated fatty acids (LCPUFA) in the fetus and placenta is low, both the maternal LCPUFA status and placental function are critical for their supply to the fetus. Maternal supplementation with DHA up to 1 g/d or 2·7 g n-3 LCPUFA did not have any harmful effect. DHA supplementation in large studies slightly the enhanced length of gestation (by about 2 days), which may increase the birth weight by about 50 g at delivery. However no advice can be given on their general using to avoid preterm deliveries in low or high risk pregnancies. Several studies, but not all, reported improvements of the offspring in some neurodevelopmental tests as a result of DHA supplementation during gestation, or, at least, positive relationships between maternal or cord serum DHA percentages and cognitive skills in young children. The effect seems more evident in children with low DHA proportions, which raises the question of how to identify those mothers who might have a poor DHA status and who could benefit from such supplementation. Most studies on the effects of n-3 LCPUFA supplementation during pregnancy on maternal depression were judged to be of low-to-moderate quality, mainly due to small sample sizes and failure to adhere to Consolidated Standards of Reporting Trials guidelines. In contrast, the effects of n-3 LCPUFA supplementation on reducing allergic diseases in offspring are promising.

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Corresponding author
*Corresponding author: Elvira Larqué, fax 0034-868883963, email elvirada@um.es
References
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1 Boyd, EM (1934) The lipemia of pregnancy. J Clin Invest 13, 347363.
2 Peters, JP, Heinemann, M & Man, EB (1951) The lipids of serum in pregnancy. J Clin Invest 30, 388394.
3 Al, MD, van Houwelingen, AC, Kester, AD, Hasaart, TH, de Jong, AE & Hornstra, G (1995) Maternal essential fatty acid patterns during normal pregnancy and their relationship to the neonatal essential fatty acid status. Br J Nutr 74, 5568.
4 Al, MD, van Houwelingen, AC & Hornstra, G (2000) Long-chain polyunsaturated fatty acids, pregnancy, and pregnancy outcome. Am J Clin Nutr 71, 285S291S.
5 Stewart, F, Rodie, VA, Ramsay, JE, Greer, IA, Freeman, DJ & Meyer, BJ (2007) Longitudinal assessment of erythrocyte fatty acid composition throughout pregnancy and post partum. Lipids 42, 335344.
6 Haggarty, P (2004) Effect of placental function on fatty acid requirements during pregnancy. Eur J Clin Nutr 58, 15591570.
7 Matorras, R, Ruiz, JI, Perteagudo, L, Barbazan, MJ, Diaz, A, Valladolid, A & Sanjurjo, P (2001) Longitudinal study of fatty acids in plasma and erythrocyte phospholipids during pregnancy. J Perinat Med 29, 293297.
8 Montgomery, C, Speake, BK, Cameron, A, Sattar, N & Weaver, LT (2003) Maternal docosahexaenoic acid supplementation and fetal accretion. Br J Nutr 90, 135145.
9 Otto, SJ, Houwelingen, AC, Antal, M, Manninen, A, Godfrey, K, Lopez-Jaramillo, P & Hornstra, G (1997) Maternal and neonatal essential fatty acid status in phospholipids: an international comparative study. Eur J Clin Nutr 51, 232242.
10 Clandinin, MT, Chappell, JE, Leong, S, Heim, T, Swyer, PR & Chance, GW (1980) Intrauterine fatty acid accretion rates in human brain: implications for fatty acid requirements. Early Hum Dev 4, 121129.
11 Clandinin, MT, Chappell, JE, Heim, T, Swyer, PR & Chance, GW (1981) Fatty acid utilization in perinatal de novo synthesis of tissues. Early Hum Dev 5, 355366.
12 Campbell, FM, Gordon, MJ & Dutta-Roy, AK (1996) Preferential uptake of long chain polyunsaturated fatty acids by isolated human placental membranes. Mol Cell Biochem 155, 7783.
13 Campbell, FM, Clohessy, AM, Gordon, MJ, Page, KR & Dutta-Roy, AK (1997) Uptake of long chain fatty acids by human placental choriocarcinoma (BeWo) cells: role of plasma membrane fatty acid-binding protein. J Lipid Res 38, 25582568.
14 Campbell, FM, Gordon, MJ & Dutta-Roy, AK (1998) Placental membrane fatty acid-binding protein preferentially binds arachidonic and docosahexaenoic acids. Life Sci 63, 235240.
15 Crawford, M (2000) Placental delivery of arachidonic and docosahexaenoic acids: implications for the lipid nutrition of preterm infants. Am J Clin Nutr 71, 275S284S.
16 Gil-Sanchez, A, Larque, E, Demmelmair, H, Acien, MI, Faber, FL, Parrilla, JJ & Koletzko, B (2010) Maternal-fetal in vivo transfer of [13C]docosahexaenoic and other fatty acids across the human placenta 12 h after maternal oral intake. Am J Clin Nutr 92, 115122.
17 Haggarty, P, Page, K, Abramovich, DR, Ashton, J & Brown, D (1997) Long-chain polyunsaturated fatty acid transport across the perfused human placenta. Placenta 18, 635642.
18 Larque, E, Demmelmair, H, Berger, B, Hasbargen, U & Koletzko, B (2003) In vivo investigation of the placental transfer of (13)C-labeled fatty acids in humans. J Lipid Res 44, 4955.
19 Chambaz, J, Ravel, D, Manier, MC, Pepin, D, Mulliez, N & Bereziat, G (1985) Essential fatty acids interconversion in the human fetal liver. Biol Neonate 47, 136140.
20 Szitanyi, P, Koletzko, B, Mydlilova, A & Demmelmair, H (1999) Metabolism of 13C-labeled linoleic acid in newborn infants during the first week of life. Pediatr Res 45, 669673.
21 Innis, SM & Friesen, RW (2008) Essential n-3 fatty acids in pregnant women and early visual acuity maturation in term infants. Am J Clin Nutr 87, 548557.
22 Bergmann, RL, Haschke-Becher, E, Klassen-Wigger, P, Bergmann, KE, Richter, R, Dudenhausen, JW, Grathwohl, D & Haschke, F (2008) Supplementation with 200 mg/day docosahexaenoic acid from mid-pregnancy through lactation improves the docosahexaenoic acid status of mothers with a habitually low fish intake and of their infants. Ann Nutr Metab 52, 157166.
23 De V, Sr, Matthys, C, De, HS, De, BG, Dhont, M & Christophe, AB (2002) Maternal and umbilical fatty acid status in relation to maternal diet. Prostaglandins Leukot Essent Fatty Acids 67, 389396.
24 Decsi, T & Koletzko, B (2005) N-3 fatty acids and pregnancy outcomes. Curr Opin Clin Nutr Metab Care 8, 161166.
25 Dunstan, JA, Mori, TA, Barden, A, Beilin, LJ, Holt, PG, Calder, PC, Taylor, AL & Prescott, SL (2004) Effects of n-3 polyunsaturated fatty acid supplementation in pregnancy on maternal and fetal erythrocyte fatty acid composition. Eur J Clin Nutr 58, 429437.
26 Helland, IB, Saugstad, OD, Saarem, K, van Houwelingen, AC, Nylander, G & Drevon, CA (2006) Supplementation of n-3 fatty acids during pregnancy and lactation reduces maternal plasma lipid levels and provides DHA to the infants. J Matern Fetal Neonatal Med 19, 397406.
27 Krauss-Etschmann, S, Shadid, R, Campoy, C, et al. (2007) Effects of fish-oil and folate supplementation of pregnant women on maternal and fetal plasma concentrations of docosahexaenoic acid and eicosapentaenoic acid: a European randomized multicenter trial. Am J Clin Nutr 85, 13921400.
28 Matorras, R, Perteagudo, L & Sanjurjo, P (1998) Biochemical markers of n-3 long chain polyunsaturated fatty acid intake during pregnancy. Clin Exp Obstet Gynecol 25, 135138.
29 Parra, MS, Schnaas, L, Meydani, M, Perroni, E, Martinez, S & Romieu, I (2002) Erythrocyte cell membrane phospholipid levels compared against reported dietary intakes of polyunsaturated fatty acids in pregnant Mexican women. Public Health Nutr 5, 931937.
30 Malcolm, CA, McCulloch, DL, Montgomery, C, Shepherd, A & Weaver, LT (2003) Maternal docosahexaenoic acid supplementation during pregnancy and visual evoked potential development in term infants: a double blind, prospective, randomised trial. Arch Dis Child Fetal Neonatal Ed 88, F383F390.
31 Barden, AE, Dunstan, JA, Beilin, LJ, Prescott, SL & Mori, TA (2006) n – 3 fatty acid supplementation during pregnancy in women with allergic disease: effects on blood pressure, and maternal and fetal lipids. Clin Sci (Lond) 111, 289294.
32 Salvig, JD, Olsen, SF & Secher, NJ (1996) Effects of fish oil supplementation in late pregnancy on blood pressure: a randomised controlled trial. Br J Obstet Gynaecol 103, 529533.
33 Koletzko, B, Cetin, I & Brenna, JT (2007) Dietary fat intakes for pregnant and lactating women. Br J Nutr 98, 873877.
34 Makrides, M, Gibson, RA, McPhee, AJ, Yelland, L, Quinlivan, J & Ryan, P (2010) Effect of DHA supplementation during pregnancy on maternal depression and neurodevelopment of young children: a randomized controlled trial. JAMA 304, 16751683.
35 Ramakrishnan, U, Stein, AD, Parra-Cabrera, S, Wang, M, Imhoff-Kunsch, B, Juarez-Marquez, S, Rivera, J & Martorell, R (2010) Effects of docosahexaenoic acid supplementation during pregnancy on gestational age and size at birth: randomized, double-blind, placebo-controlled trial in Mexico. Food Nutr Bull 31, S108S116.
36 Olsen, SF, Sorensen, JD, Secher, NJ, Hedegaard, M, Henriksen, TB, Hansen, HS & Grant, A (1992) Randomised controlled trial of effect of fish-oil supplementation on pregnancy duration. Lancet 339, 10031007.
37 Helland, IB, Saugstad, OD, Smith, L, Saarem, K, Solvoll, K, Ganes, T & Drevon, CA (2001) Similar effects on infants of n-3 and n-6 fatty acids supplementation to pregnant and lactating women. Pediatrics 108, E82.
38 Knudsen, VK, Hansen, HS, Osterdal, ML, Mikkelsen, TB, Mu, H & Olsen, SF (2006) Fish oil in various doses or flax oil in pregnancy and timing of spontaneous delivery: a randomised controlled trial. BJOG 113, 536543.
39 Smuts, CM, Huang, M, Mundy, D, Plasse, T, Major, S & Carlson, SE (2003) A randomized trial of docosahexaenoic acid supplementation during the third trimester of pregnancy. Obstet Gynecol 101, 469479.
40 Makrides, M, Duley, L & Olsen, SF (2006) Marine oil, and other prostaglandin precursor, supplementation for pregnancy uncomplicated by pre-eclampsia or intrauterine growth restriction. Cochrane Database Syst Rev 3, CD003402.
41 Szajewska, H, Horvath, A & Koletzko, B (2006) Effect of n-3 long-chain polyunsaturated fatty acid supplementation of women with low-risk pregnancies on pregnancy outcomes and growth measures at birth: a meta-analysis of randomized controlled trials. Am J Clin Nutr 83, 13371344.
42 Salvig, JD & Lamont, RF (2011) Evidence regarding an effect of marine n-3 fatty acids on preterm birth: a systematic review and meta-analysis. Acta Obstet Gynecol Scand 90, 825838·44.
43 Olsen, SF, Secher, NJ, Tabor, A, Weber, T, Walker, JJ & Gluud, C (2000) Randomised clinical trials of fish oil supplementation in high risk pregnancies. Fish Oil Trials In Pregnancy (FOTIP) Team. BJOG 107, 382395.
44 Olsen, SF & Secher, NJ (2002) Low consumption of seafood in early pregnancy as a risk factor for preterm delivery: prospective cohort study. BMJ 324, 447.
45 Harper, M, Thom, E, Klebanoff, MA, et al. (2010) Omega-3 fatty acid supplementation to prevent recurrent preterm birth: a randomized controlled trial. Obstet Gynecol 115, 234242.
46 Horvath, A, Koletzko, B & Szajewska, H (2007) Effect of supplementation of women in high-risk pregnancies with long-chain polyunsaturated fatty acids on pregnancy outcomes and growth measures at birth: a meta-analysis of randomized controlled trials. Br J Nutr 98, 253259.
47 Simmer, K, Patole, SK & Rao, SC (2008) Longchain polyunsaturated fatty acid supplementation in infants born at term. Cochrane Database Syst Rev 23, 1, CD000376.
48 Schulzke, SM, Patole, SK & Simmer, K (2011) Longchain polyunsaturated fatty acid supplementation in preterm infants. Cochrane Database Syst Rev 16, 2, CD000375.
49 Fagan, JF & Shephard, A (1991) The Fagan Test of Intelligence manual. Cleveland: OH: Infantest Corporation.
50 Helland, IB, Smith, L, Saarem, K, Saugstad, OD & Drevon, CA (2003) Maternal supplementation with very-long-chain n-3 fatty acids during pregnancy and lactation augments children's IQ at 4 years of age. Pediatrics 111, e39e44.
51 Helland, IB, Smith, L, Blomen, B, Saarem, K, Saugstad, OD & Drevon, CA (2008) Effect of supplementing pregnant and lactating mothers with n-3 very-long-chain fatty acids on children's IQ and body mass index at 7 years of age. Pediatrics 122, e472e479.
52 Colombo, J (2001) The development of visual attention in infancy. Annu Rev Psychol 52, 337367.
53 Malcolm, CA, Hamilton, R, McCulloch, DL, Montgomery, C & Weaver, LT (2003) Scotopic electroretinogram in term infants born of mothers supplemented with docosahexaenoic acid during pregnancy. Invest Ophthalmol Vis Sci 44, 36853691.
54 Judge, MP, Harel, O & Lammi-Keefe, CJ (2007) A docosahexaenoic acid-functional food during pregnancy benefits infant visual acuity at four but not six months of age. Lipids 42, 117122.
55 Dunstan, JA, Simmer, K, Dixon, G & Prescott, SL (2008) Cognitive assessment of children at age 2(1/2) years after maternal fish oil supplementation in pregnancy: a randomised controlled trial. Arch Dis Child Fetal Neonatal Ed 93, F45F50.
56 Judge, MP, Harel, O & Lammi-Keefe, CJ (2007) Maternal consumption of a docosahexaenoic acid-containing functional food during pregnancy: benefit for infant performance on problem-solving but not on recognition memory tasks at age 9 mo. Am J Clin Nutr 85, 15721577.
57 Colombo, J, Kannass, KN, Shaddy, DJ, Kundurthi, S, Maikranz, JM, Anderson, CJ, Blaga, OM & Carlson, SE (2004) Maternal DHA and the development of attention in infancy and toddlerhood. Child Dev 75, 12541267.
58 Tofail, F, Kabir, I, Hamadani, JD, Chowdhury, F, Yesmin, S, Mehreen, F & Huda, SN (2006) Supplementation of fish-oil and soy-oil during pregnancy and psychomotor development of infants. J Health Popul Nutr 24, 4856.
59 Jacobson, JL, Jacobson, SW, Muckle, G, Kaplan-Estrin, M, Ayotte, P & Dewailly, E (2008) Beneficial effects of a polyunsaturated fatty acid on infant development: evidence from the inuit of arctic Quebec. J Pediatr 152, 356364.
60 Jacques, C, Levy, E, Muckle, G, Jacobson, SW, Bastien, C, Dewailly, E, Ayotte, P, Jacobson, JL & Saint-Amour, D (2011) Long-term effects of prenatal omega-3 fatty acid intake on visual function in school-age children. J Pediatr 158, 8390, 90.
61 Hibbeln, JR, Davis, JM, Steer, C, Emmett, P, Rogers, I, Williams, C & Golding, J (2007) Maternal seafood consumption in pregnancy and neurodevelopmental outcomes in childhood (ALSPAC study): an observational cohort study. Lancet 369, 578585.
62 Oken, E, Wright, RO, Kleinman, KP, Bellinger, D, Amarasiriwardena, CJ, Hu, H, Rich-Edwards, JW & Gillman, MW (2005) Maternal fish consumption, hair mercury, and infant cognition in a U.S. Cohort. Environ Health Perspect 113, 13761380.
63 Oken, E, Osterdal, ML, Gillman, MW, Knudsen, VK, Halldorsson, TI, Strom, M, Bellinger, DC, Hadders-Algra, M, Michaelsen, KF & Olsen, SF (2008) Associations of maternal fish intake during pregnancy and breastfeeding duration with attainment of developmental milestones in early childhood: a study from the Danish National Birth Cohort. Am J Clin Nutr 88, 789796.
64 Freeman, MP, Hibbeln, JR, Wisner, KL, Brumbach, BH, Watchman, M & Gelenberg, AJ (2006) Randomized dose-ranging pilot trial of omega-3 fatty acids for postpartum depression. Acta Psychiatr Scand 113, 3135.
65 Freeman, MP, Davis, M, Sinha, P, Wisner, KL, Hibbeln, JR & Gelenberg, AJ (2008) Omega-3 fatty acids and supportive psychotherapy for perinatal depression: a randomized placebo-controlled study. J Affect Disord 110, 142148.
66 Freeman, MP & Davis, MF (2010) Supportive psychotherapy for perinatal depression: preliminary data for adherence and response. Depress Anxiety 27, 3945.
67 Rees, AM, Austin, MP & Parker, GB (2008) Omega-3 fatty acids as a treatment for perinatal depression: randomized double-blind placebo-controlled trial. Aust N Z J Psychiatry 42, 199205.
68 Su, KP, Huang, SY, Chiu, TH, Huang, KC, Huang, CL, Chang, HC & Pariante, CM (2008) Omega-3 fatty acids for major depressive disorder during pregnancy: results from a randomized, double-blind, placebo-controlled trial. J Clin Psychiatry 69, 644651.
69 Doornbos, B, van Goor, SA, jck-Brouwer, DA, Schaafsma, A, Korf, J & Muskiet, FA (2009) Supplementation of a low dose of DHA or DHA+AA does not prevent peripartum depressive symptoms in a small population based sample. Prog Neuropsychopharmacol Biol Psychiatry 33, 4952.
70 Jans, LA, Giltay, EJ & Van der Does, AJ (2010) The efficacy of n-3 fatty acids DHA and EPA (fish oil) for perinatal depression. Br J Nutr 104, 15771585.
71 Furuhjelm, C, Warstedt, K, Larsson, J, Fredriksson, M, Bottcher, MF, Falth-Magnusson, K & Duchen, K (2009) Fish oil supplementation in pregnancy and lactation may decrease the risk of infant allergy. Acta Paediatr 98, 14611467.
72 Warstedt, K, Furuhjelm, C, Duchen, K, Falth-Magnusson, K & Fageras, M (2009) The effects of omega-3 fatty acid supplementation in pregnancy on maternal eicosanoid, cytokine, and chemokine secretion. Pediatr Res 66, 212217.
73 Krauss-Etschmann, S, Hartl, D, Rzehak, P, et al. (2008) Decreased cord blood IL-4, IL-13, and CCR4 and increased TGF-beta levels after fish oil supplementation of pregnant women. J Allergy Clin Immunol 121, 464470.
74 Olsen, SF, Osterdal, ML, Salvig, JD, Mortensen, LM, Rytter, D, Secher, NJ & Henriksen, TB (2008) Fish oil intake compared with olive oil intake in late pregnancy and asthma in the offspring: 16 y of registry-based follow-up from a randomized controlled trial. Am J Clin Nutr 88, 167175.
75 Furuhjelm, C, Warstedt, K, Fageras, M, Falth-Magnusson, K, Larsson, J, Fredriksson, M & Duchen, K (2011) Allergic disease in infants up to 2 yr of age in relation to plasma omega-3 fatty acids and maternal fish oil supplementation in pregnancy and lactation. Pediatr Allergy Immunol.
76 Dunstan, JA, Mori, TA, Barden, A, Beilin, LJ, Taylor, AL, Holt, PG & Prescott, SL (2003) Fish oil supplementation in pregnancy modifies neonatal allergen-specific immune responses and clinical outcomes in infants at high risk of atopy: a randomized, controlled trial. J Allergy Clin Immunol 112, 11781184.
77 Dunstan, JA, Mori, TA, Barden, A, Beilin, LJ, Taylor, AL, Holt, PG & Prescott, SL (2003) Maternal fish oil supplementation in pregnancy reduces interleukin-13 levels in cord blood of infants at high risk of atopy. Clin Exp Allergy 33, 442448.
78 Stein, AD, Wang, M, Martorell, R, Neufeld, LM, Flores-Ayala, R, Rivera, JA & Ramakrishnan, U (2011) Growth to age 18 months following prenatal supplementation with docosahexaenoic acid differs by maternal gravidity in Mexico. J Nutr 141, 316320.
79 Lucia, BR, Bergmann, KE, Haschke-Becher, E, Richter, R, Dudenhausen, JW, Barclay, D & Haschke, F (2007) Does maternal docosahexaenoic acid supplementation during pregnancy and lactation lower BMI in late infancy? J Perinat Med 35, 295300.
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