Prenatal DHA Supplementation and Pregnancy Outcomes in Women With Diabetes [39J

Abstract

INTRODUCTION: Docosahexaenoic acid (DHA) supplementation may improve pregnancy outcomes, but its role in patients with diabetes is unclear. The object of this study was to determine the association between DHA and pregnancy outcomes in women with diabetes. METHODS: We performed a retrospective cohort study of pregnant women with type 1, type 2 and gestational diabetes who delivered at Barnes-Jewish Hospital from 2012 to 2016. Women prescribed prenatal vitamins (PNV) with DHA were compared to those prescribed PNV without DHA. The primary outcome was hypertensive disorders of pregnancy. Secondary outcomes included preterm birth (PTB), neonatal hyperbilirubinemia and postpartum depression. Outcomes were compared between women who used PNV with and without DHA. Logistic regression was used to control for potential confounders. RESULTS: Of 298 women in the cohort, 30 (10.1%) took a PNV with DHA. DHA use was significantly lower among women who were obese, African American, Latina, and had medical co-morbidities and was higher in those with a history of PTB. Women taking a PNV with DHA were less likely to develop hypertensive disorders of pregnancy after adjusting for obesity, race, medical comorbidities, and history of PTB (20.0% versus 50.0%, aOR 0.29; 95% CI 0.10–0.84). There was no significant difference in neonatal hyperbilirubinemia, PTB and postpartum depression. CONCLUSION: PNV supplementation with DHA is associated with a reduced risk of hypertensive disorders of pregnancy in a high-risk cohort of women with diabetes. Larger prospective studies are needed to determine the impact of DHA on maternal and neonatal outcomes in women with diabetes.