Effect of n-3 long-chain polyunsaturated fatty acids supplementation in healthy mothers on DHA and EPA profiles in maternal and umbilical blood: a randomized controlled trial
-
Dragan Soldo
,
Matija Mikulić-Kajić
Abstract
Background
The objective of the study was to compare the effect of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) dietary supplementation on their concentration in total lipids (TL) and lipid fractions of maternal and umbilical vein (UV) blood. The specific objective was to analyze the impact of EPA and DHA supplementation on pregnancy outcome and neonatal birth weight.
Methods
Women were randomly single-blinded (randomized controlled trial; ISRCTN36705743) allocated to the group receiving EPA and DHA supplementation (supplemented group) or the group receiving placebo-corn oil (control group) in the time period from January 1st, 2016 until March 1st, 2017. Women in the supplemented group (n=45) took 360 mg EPA and 240 mg DHA daily while controls (n=42) were given a placebo. Maternal and UV bloods were obtained at delivery. After lipid extraction, phospholipids (PL), cholesterol esters (CE), triacylglycerols (TG) and non-esterified fatty acids were separated by thin layer chromatography and analyzed by gas chromatography.
Results
Higher DHA concentrations in TL (37.24±21.87 mg/L), PL (13.14±8.07 mg/L) and triacylglycerols (2.24±2.21 mg/L) were recorded in mothers from the supplemented group when compared to the study group (TL 21.89±14.53 mg/L; P<0.001; PL 9.33±5.70 mg/L; P=0.013; TG 0.56±0.43 mg/L; P<0.001). Higher DHA concentrations in UV samples were found in TL (11.51±7.34 mg/L), PL (5.29±3.31 mg/L) and triacylglycerols (0.62±0.46 mg/L) from the supplemented groups compared with controls (TL 7.37±3.60 mg/L; P=0.002; PL 3.52±2.19 mg/L; P=0.005; TG 0.40±0.46 mg/L; P=0.035). The ratio of AA:DHA was lower in maternal (2.43) and UV serum (4.0) of the supplemented group than in the control group (maternal 3.85 P<0.001; UV 4.91 P<0.001).
Conclusion
The study demonstrated the higher ratio of AA/DHA in the control group indicating that pregnant women on the traditional Herzegovina diet need supplementation with DHA and EPA.
Correction Note
Correction added after online publication. December 19, 2018: The first name and last name of each of the authors (except for Dragan Soldo) were mistakenly printed in the wrong order.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. Witte AV, Kerti L, Hermannstadter HM, Fiebach JB, Schreiber SJ, Schuchardt JP, et al. Long-chain omega-3 fatty acids improve brain function and structure in older adults. Cereb Cortex 2014;24:3059–68.10.1093/cercor/bht163Suche in Google Scholar
2. Lee LK, Shahar S, Chin AV, Yusoff NA. Docosahexaenoic acid-concentrated fish oil supplementation in subjects with mild cognitive impairment (MCI): a 12-month randomised, double-blind, placebo-controlled trial. Psychopharmacology 2013;225:605–12.10.1007/s00213-012-2848-0Suche in Google Scholar
3. Carlson SE, Colombo J, Gajewski BJ, Gustafson KM, Mundy D, Yeast J, et al. DHA supplementation and pregnancy outcomes. Am J Clin Nutr 2013;97:808–15.10.3945/ajcn.112.050021Suche in Google Scholar
4. Olsen SF, Secher NJ. Low consumption of seafood in early pregnancy as a risk factor for preterm delivery: prospective cohort study. Br Med J 2002;324:447.10.1136/bmj.324.7335.447Suche in Google Scholar
5. Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet 2013;382:427–51.10.1016/S0140-6736(13)60937-XSuche in Google Scholar
6. Anne S, Menon A, Parikh S. Role of omega 3 fatty acids on pregnancy outcome. Int J Reprod Contracept Obstet Gynecol 2017;6:5396–400.10.18203/2320-1770.ijrcog20175249Suche in Google Scholar
7. FDA. Fish: What Pregnant Women and Parents Should Know, June 2014 ed., U.S. Food and Drug Administration, 2017. Available online: https://www.epa.gov/fish-tech/2017-epa- fda-advice-about-eating-fish-and-shellfish. Accessed 22 Jun 2018.Suche in Google Scholar
8. Analysis of the Fishery and Aquaculture Sector in Bosnia and Herzegovina EU funded project: “Preparation of IPARD Forest and Fisheries Sector Reviews in Bosnia and Herzegovina”, 2015. Available online: http://www.fao.org/3/a-au016e.pdf. Accessed 30 Jun 2018.Suche in Google Scholar
9. Kang JX. The importance of omega-6/omega-3 fatty acid ratio in cell function. The gene transfer of omega-3 fatty acid desaturase. In: Simopoulos AP, Cleland LG, editors. Omega-6/Omega-3 Essential Fatty Acid Ratio: The Scientific Evidence. Volume 92. Basel, Switzerland: Karger; 2003. p. 23–36.10.1159/000073790Suche in Google Scholar
10. Dunstan JA, Simmer K, Dixon G, Prescott SL. 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 2008;93:F45–50.10.1136/adc.2006.099085Suche in Google Scholar
11. Clandinin MT, Chappell JE, Heim T, Swyer PR, Chance GW. Fatty acid utilization in perinatal de novo synthesis of tissues. Early Hum Dev 1981;5:355–66.10.1016/0378-3782(81)90016-5Suche in Google Scholar
12. Innis SM. Essential fatty acid transfer and fetal development. Placenta 2005;26:70–5.10.1016/j.placenta.2005.01.005Suche in Google Scholar PubMed
13. Herrera E. Lipid metabolism in pregnancy and its consequences in the fetus and newborn. Endocrin 2002;19:43–55.10.1385/ENDO:19:1:43Suche in Google Scholar
14. Coleman RA. Placental metabolism and transport of lipid. Fed Proc 1986;45:2519–23.Suche in Google Scholar
15. Salma BMA, Takruri HR, Kazaleh FAA, Thekrallah FM, Elmoumani FI, Afram KM. Docosahexaenoic acid and eicosapentaenoic acid supplementation improves plasma lipid profile in late pregnancy. J Clin Nutr Metab 2018;2:2.Suche in Google Scholar
16. Sample Size Calculators [Internet]. Available from: http://www.sample-size.net/sample-size-proportions/ (Accessed 20 May 2017).Suche in Google Scholar
17. Folch J, Lees M, Sloane Stanley GH. A simple method for the isolation and purification of total lipids from animal tissues. J Biol Chem 1957;226:497–509.10.1016/S0021-9258(18)64849-5Suche in Google Scholar
18. Zahir HA, Christopher KB, Jacquelyn MW, Youping Z, Malcolm JM, Peter JM. An efficient single phase method for the extraction of plasma lipids. Metabolites 2015;5:389–403.10.3390/metabo5020389Suche in Google Scholar
19. Berberovic E, Ivanisevic M, Juras J, Horvaticek M, Delas I, Djelmis J. Arachidonic and docosahexaenoic acid in the blood of mother and umbilical vein in diabetic women. J Matern Fetal Neonatal Med 2013;26:1287–91.10.3109/14767058.2013.783800Suche in Google Scholar
20. Burdge GC, Wright P, Jones AE, Wootton SA. A method for separation of phosphatidyl choline, triacylglycerol, non-esterified fatty acids and cholesterol esters from plasma by solid-phase extraction. Br J Nutr 2000;84:781–7.10.1017/S0007114500002154Suche in Google Scholar
21. Stefanie VW, Kelsey R, Lieve MLL. Determination of total lipids as fatty acid methyl esters (FAME) by in situ transesterification laboratory analytical procedure (LAP), 2013. Available online: https://www.nrel.gov/docs/fy16osti/60958.pdf (accessed on 30 Julay 2018).Suche in Google Scholar
22. Kar S, Wong M, Rogozinska E, Thangaratinam S. Effects of omega-3 fatty acids in prevention of early preterm delivery: a systematic review and meta-analysis of randomized studies. Eur J Obstet Gynecol Reprod Biol 2016;198:40–6.10.1097/01.ogx.0000488678.45806.beSuche in Google Scholar
23. Salvig JD, Lamont RF. Evidence regarding an effect of marine n-3 fatty acids on preterm birth: a systematic review and meta-analysis. Acta Obstet Gynecol Scand 2011;90:825–38.10.1111/j.1600-0412.2011.01171.xSuche in Google Scholar
24. Brantsaeter AL, Englund OL, Haugen M, Birgisdottir BE, Knutsen HK, Sengpiel V, et al. Maternal intake of seafood and supplementary long chain n-3 poly-unsaturated fatty acids and preterm delivery. BMC Pregnancy Childbirth 2017;17:41.10.1186/s12884-017-1225-8Suche in Google Scholar
25. Ramakrishnan U, Stein AD, Parra-Cabrera S, Wang M, Imhoff-Kunsch B, Juárez-Márquez S, et al. 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 2010;31:108–16.10.1177/15648265100312S203Suche in Google Scholar
26. Zhao JP, Levy E, Fraser WD, Julien P, Delvin E, Montoudis A, et al. Circulating docosahexaenoic acid levels are associated with fetal insulin sensitivity. PLoS One 2014;9:85054.10.1371/journal.pone.0085054Suche in Google Scholar
27. Korotkova M, Gabrielsson BG, Holmang A, Larsson BM, Hanson LA, Strandvik B. Gender-related long-term effects in adult rats by perinatal dietary ratio of n-6/n-3 fatty acids. Am J Physiol Regul Integr Comp Physiol 2005; 288:575–9.10.1152/ajpregu.00342.2004Suche in Google Scholar PubMed
28. Simopoulos AP. Evolutionary aspects of diet, the omega-6/omega-3 ratio and genetic variation: nutritional implications for chronic diseases. Biomed Pharmacother 2006; 60:502–7.10.1016/j.biopha.2006.07.080Suche in Google Scholar PubMed
29. Van EK, Bruining H, Birtoli B, Terreaux C, Buitelaar JK, Kas MJ. Food for thought: dietary changes in essential fatty acid ratios and the increase in autism spectrum disorders. Neurosci Biobehav Rev 2014;45:369–78.10.1016/j.neubiorev.2014.07.004Suche in Google Scholar PubMed
30. RCI project paper. Triple Helix Partnerships for Innovation in Bosnia and Herzegovina, 2013. Available online: http://mcp.gov.ba/images/RCI%20Project%20Paper%20Bosnia%20and%20Herzegovina.pdf (accessed on 27 June 2018).Suche in Google Scholar
31. Koletzko B, Lien A, Agostoni C, Böhles H, Campoy C, Cetin I, et al. The roles of long-chain polyunsaturated fatty acids in pregnancy, lactation and infancy: review of current knowledge and consensus recommendations. J Perinat Med 2008;36:5–14.10.1515/JPM.2008.001Suche in Google Scholar PubMed
©2019 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Editorial
- Ultrasound Doppler waveform assessment: the story continues
- Review
- Association between increased antenatal vaginal pH and preterm birth rate: a systematic review
- Mini Review
- Update on uterine tachysystole
- Research Articles – Obstetrics
- First trimester prediction of gestational diabetes mellitus using plasma biomarkers: a case-control study
- Emergency peripartal hysterectomy – a single-center analysis of the last 13 years at a tertiary perinatal care unit
- Efficacy and safety of misoprostol vaginal insert vs. oral misoprostol for induction of labor
- Vitamin A and β-carotene in pregnant and breastfeeding post-bariatric women in an urban population
- Effect of dual tocolysis with fenoterol and atosiban in human myometrium
- Antecedents of red cell transfusion in a large contemporary obstetric cohort
- Effect of n-3 long-chain polyunsaturated fatty acids supplementation in healthy mothers on DHA and EPA profiles in maternal and umbilical blood: a randomized controlled trial
- Research Articles – Fetus
- Effect of psychotropic drugs on fetal behavior in the third trimester of pregnancy
- Prognostic value of the aortic isthmus Doppler assessment on late onset fetal growth restriction
- Doppler evaluation of the fetal pulmonary artery pressure
- Mechanisms of death in structurally normal stillbirths
- The diagnostic value of a detailed first trimester anomaly scan in fetuses with increased nuchal translucency thickness
- Research Articles – Newborn
- Small for gestational age and extremely low birth weight infant outcomes
- Does heart rate variability improve prediction of failed extubation in preterm infants?
Artikel in diesem Heft
- Frontmatter
- Editorial
- Ultrasound Doppler waveform assessment: the story continues
- Review
- Association between increased antenatal vaginal pH and preterm birth rate: a systematic review
- Mini Review
- Update on uterine tachysystole
- Research Articles – Obstetrics
- First trimester prediction of gestational diabetes mellitus using plasma biomarkers: a case-control study
- Emergency peripartal hysterectomy – a single-center analysis of the last 13 years at a tertiary perinatal care unit
- Efficacy and safety of misoprostol vaginal insert vs. oral misoprostol for induction of labor
- Vitamin A and β-carotene in pregnant and breastfeeding post-bariatric women in an urban population
- Effect of dual tocolysis with fenoterol and atosiban in human myometrium
- Antecedents of red cell transfusion in a large contemporary obstetric cohort
- Effect of n-3 long-chain polyunsaturated fatty acids supplementation in healthy mothers on DHA and EPA profiles in maternal and umbilical blood: a randomized controlled trial
- Research Articles – Fetus
- Effect of psychotropic drugs on fetal behavior in the third trimester of pregnancy
- Prognostic value of the aortic isthmus Doppler assessment on late onset fetal growth restriction
- Doppler evaluation of the fetal pulmonary artery pressure
- Mechanisms of death in structurally normal stillbirths
- The diagnostic value of a detailed first trimester anomaly scan in fetuses with increased nuchal translucency thickness
- Research Articles – Newborn
- Small for gestational age and extremely low birth weight infant outcomes
- Does heart rate variability improve prediction of failed extubation in preterm infants?
