Abstract

Long-Chain Polyunsaturated Fatty Acid (LCPUFA) is essential throughout pregnancy, since deficiency of LPUFA may linked to obstetrical complications. This study aimed to investigate LCPUFA status in severe preeclampsia and preterm birth. A cross sectional study was conducted in 104 pregnant women, which divided into normal pregnancy, severe preeclampsia and preterm birth groups. Serum percentage and concentration of total LCPUFA, omega-3, alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), omega-6, linoleic acid (LA), and arachidonic acid (AA) were measured using gas chromatography/mass spectrometry. Receiver operating characteristic (ROC), bivariate and multivariate analysis were performed. Severe preeclampsia showed the highest concentration of total PUFA and the lowest DHA percentage, with significantly higher Omega-6/Omega-3 ratio (p = 0.004) and lower omega-3 index (p < 0.002) compared to control. Preterm birth showed the least omega-3 concentrations, with significantly low omega-6 derivates (LA (p = 0.014) and AA (p = 0.025)) compared to control. LCPUFA parameters have shown to increase the risk in both conditions, particularly ALA ≤ 53 µmol/L in preeclampsia with OR 5.44, 95%CI 1.16–25.42 and preterm birth with OR 4.68, 95%CI 1.52–14.38. These findings suggest that severe preeclampsia and preterm birth have an imbalance in LCPUFA status.

Highlights

  • Long-Chain Polyunsaturated Fatty Acid (LCPUFA) is essential throughout pregnancy, since deficiency of LPUFA may linked to obstetrical complications

  • We found that mean ± SD for eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA) percentage in preterm birth was 1.41 ± 0.8115 and in preeclampsia was 2.69 ± 2.5616, which results in calculated effect size (Cohen’s D) 0.67 and minimum sample requirement was 25

  • Even though studies have shown that there is an increasing trend of LCPUFA level in serum, erythrocyte and plasma throughout p­ regnancy[24,25,26], studies have suggested that low total omega-3 had increased the risk of preterm birth < 34 weeks, which can be reduced through LCPUFA s­ upplementation[27,28]

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Summary

Introduction

Long-Chain Polyunsaturated Fatty Acid (LCPUFA) is essential throughout pregnancy, since deficiency of LPUFA may linked to obstetrical complications. Serum percentage and concentration of total LCPUFA, omega-3, alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), omega-6, linoleic acid (LA), and arachidonic acid (AA) were measured using gas chromatography/mass spectrometry. LCPUFA parameters have shown to increase the risk in both conditions, ALA ≤ 53 μmol/L in preeclampsia with OR 5.44, 95%CI 1.16–25.42 and preterm birth with OR 4.68, 95%CI 1.52–14.38. Abbreviations LCPUFA Long-chain polyunsaturated fatty acid PUFA Polyunsaturated fatty acid ALA Alpha-linolenic acid EPA Eicosapentaenoic acid DHA Docosahexaenoic acid LA Linoleic acid AA Arachidonic acid GC-MS Gas chromatography/mass spectrometry LXA4 Lipoxin A4. LCPUFA has a role in maternal health as dietary omega-3 has been correlated with reduced risk in poor maternal outcome associated with inflammation p­ rocess[4] Obstetrical complication such as preeclampsia and preterm birth have been reported to associated with inflammation process. Contractility, cervical ripening, and membrane ruptures by releasing proinflammatory cytokines which normally initiated in term ­labor[7,8]

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