1035 DHA transport in the placentas of obese, diabetic, and normal weight patients

Abstract

Docosahexaenoic acid (DHA) is important for fetal neural development. Our objective was to evaluate DHA in maternal and fetal plasma and by placental region in patients with obesity, pregestational diabetes, and normal weight. We performed a pilot study to evaluate DHA transport in patients with pre-pregnancy BMI ≥ 30 kg/m2 (OB), those with Type 1 or Type 2 DM diagnosed prior to pregnancy or in the first trimester (DM), and patients with pre-pregnancy BMI 18.5-24.9 kg/m2 without comorbidities (NL). Placental specimens were collected, rinsed 3 times and flash frozen in liquid nitrogen. Placental specimens were later thawed and total lipids extracted. Gas chromatography mass spectroscopy (GC-MS) was performed on placental extracts and maternal and cord plasma collected at delivery. Percentile of DHA of total fatty acids (DHA) was calculated and compared across groups. Our primary outcome was fetal plasma DHA. Secondary outcomes included maternal DHA and correlations with maternal and fetal DHA by placental region. 3 OB, 3 DM, and 5 NL patients were included. Maternal demographics were similar across groups (Table 1). OB and DM had higher pre-pregnancy BMI (38.7 ± 0.6 kg/m2 and 32.8 ± 2.9 kg/m2, respectively) compared to NL (22.6 ± 2.0 kg/m2, p < 0.001). Fetal plasma DHA was comparable across groups (Table 2). Similarly maternal plasma DHA and placental DHA by regions were similar across groups (Table 2). Maternal plasma DHA was correlated with fetal plasma DHA (0.739, p=0.009). Both maternal and fetal plasma DHA were correlated with chorionic plate (CP) DHA (0.671, p=0.024 and 0.669, p=0.024, respectively) and central villi (CV) DHA (0.676, p=0.022 and 0.858, p=0.001, respectively). Neither maternal nor fetal plasma DHA was correlated with subchorionic villi (SV) DHA (0.281, p=0.402 and 0.405, p=0.217). Similarly, CP DHA was correlated with CV DHA (0.788, p=0.001), but not SV DHA (0.442, p=0.113). In our pilot study, DHA concentrations were not significantly different in OB, DM and NL patients in maternal and fetal plasma or by placental region.View Large Image Figure ViewerDownload Hi-res image Download (PPT)