Self-Reported DHA Supplementation during Pregnancy and Its Association with Obesity or Gestational Diabetes in Relation to DHA Concentration in Cord and Maternal Plasma: Results from NELA, a Prospective Mother-Offspring Cohort.

Antonio Gázquez,Luís García-Marcos,María Giménez-Bañón,Eva Morales,Miriam Martínez-Villanueva,Carmen Ballesteros-Meseguer,Carmen Martínez-Graciá,Francisco Avilés-Plaza,Marina Santaella-Pascual,Clara Suárez,José Noguera-Velasco,Jesús Vioque,Elvira Larqué,María Prieto-Sánchez,Lina Galdo-Castiñeira

doi:10.3390/nu13030843

Abstract

Maternal supplementation of docosahexaenoic acid (DHA) during pregnancy has been recommended due to its role in infant development, but its effect on materno-fetal DHA status is not well established. We evaluated the associations between DHA supplementation in pregnant women with obesity or gestational diabetes mellitus (GDM) and maternal and neonatal DHA status. Serum fatty acids (FA) were analyzed in 641 pregnant women (24 weeks of gestation) and in 345 venous and 166 arterial cord blood samples of participants of the NELA cohort. Obese women (n = 47) presented lower DHA in serum than those lean (n = 397) or overweight (n = 116) before pregnancy. Linoleic acid in arterial cord was elevated in obese women, which indicates lower fetal retention. Maternal DHA supplementation (200 mg/d) during pregnancy was associated with enhanced maternal and fetal DHA levels regardless of pre-pregnancy body mass index (BMI), although higher arterial DHA in overweight women indicated an attenuated response. Maternal DHA supplementation was not associated with cord venous DHA in neonates of mothers with GDM. The cord arteriovenous difference was similar for DHA between GDM and controls. In conclusion, maternal DHA supplementation during pregnancy enhanced fetal DHA status regardless of the pre-pregnancy BMI while GDM may reduce the effect of DHA supplementation in newborns.

Highlights

The aim of the present study is to evaluate the associations between docosahexaenoic acid (DHA) supplementation in obese pregnant women with obesity or gestational diabetes mellitus (GDM) and fetal DHA status in a prospective mother–child cohort study in Spain
We found that maternal DHA supplementation in special conditions such as pre-pregnancy obesity and GDM is associated with increased maternal DHA
body mass index (BMI) of the mother, supplementation with DHA at third trimester in overweight women was associated with higher levels of arterial DHA cord serum and less DHA

Summary

Introduction

Docosahexaenoic acid (DHA) is an omega-3 long-chain polyunsaturated fatty acid (LC-PUFA) that rapidly accumulates on human brain during the last trimester of pregnancy creativecommons.org/licenses/by/ 4.0/). Dietary DHA intake is inadequate in many pregnant women (less than 1–2 portions of oily fish per week) and maternal dietary supplementation of at least 200 mg DHA/d during pregnancy and lactation is recommended [6,7]. Some recent studies reported that pre-pregnancy body mass index (BMI) was inversely associated with polyunsaturated fatty acids (PUFA), DHA, and omega-6 fatty acids (FA) in venous cord blood while the results were contradictory in the mothers [8,9]. Gestational diabetes mellitus (GDM) has been associated with lower proportion of AA (arachidonic acid, 20:4 omega-6) and DHA in umbilical vein plasma but not in maternal plasma [10,11]. Disturbances on placental FA transport using labeled FA with stable isotopes [12,13] and altered

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