DHA supplementation: Current implications in pregnancy and childhood

Abstract

Dietary supplementation with (ω)-3 long chain fatty acids including docosahexaenoic acid (DHA) has increased in popularity in recent years and adequate DHA supplementation during pregnancy and early childhood is of clinical importance. Some evidence has been built for the neuro-cognitive benefits of supplementation with long chain polyunsaturated fatty acids (LCPUFA) such as DHA during pregnancy; however, recent data indicate that the anti-inflammatory properties may be of at least equal significance. Adequate DHA availability in the fetus/infant optimizes brain and retinal maturation in part by influencing neurotransmitter pathways. The anti-inflammatory properties of LCPUFA are largely mediated through modulation of signaling either directly through binding to receptors or through changes in lipid raft formation and receptor presentation. Our goal is to review the current findings on DHA supplementation, specifically in pregnancy and infant neurodevelopment, as a pharmacologic agent with both preventative and therapeutic value. Given the overall benefits of DHA, maternal and infant supplementation may improve neurological outcomes especially in vulernable populations. However, optimal composition of the supplement and dosing and treatment strategies still need to be determined to lend support for routine supplementation.

Maternal dietary omega-3 fatty acids and placental function

“…In particular, fetal accretion of DHA is essential for early development of the brain and the visual system (Rogers et al 2013), and overall demand peaks during the final trimester of human pregnancy to accommodate rapid growth of the fetal brain (Duttaroy 2009). The placenta normally mediates adequate delivery of physiologically important PUFAs to the fetus by extracting and transporting fatty acids in a directional, preferential, and timely manner (Haggarty 2010).…”

“…The n-3 PUFA, DHA, appears to be of particular importance to human health, with this fatty acid considered essential to the cerebral expansion in human evolution (Crawford & Broadhurst 2012). Accordingly, DHA is particularly crucial to fetal and infant neural development (see review, Rogers et al (2013)). …”

Effects of maternal n-3 fatty acid supplementation on placental cytokines, pro-resolving lipid mediators and their precursors

“…Maternal n-3 PUFA supplementation has also been shown in some studies to benefit the fetus/neonate by improving neurodevelopment and behavioural outcomes (Campoy et al 2012, Larque et al 2012, Rogers et al 2013 and reducing the risk of developing allergic diseases in childhood (Dunstan & Prescott 2005, Klemens et al 2011, Palmer et al 2012. Many of the potential benefits ascribed to n-3 PUFA can be attributed to their well-documented immunomodulatory/ anti-inflammatory actions (Calder 2013a).…”

Associations of maternal immune response with MeHg exposure at 28 weeks’ gestation in the Seychelles Child Development Study

“…21–23 Long chain n-3 PUFA, together with long chain n-6 PUFA (e.g. arachidonic acid (AA)), have important roles in inflammation by acting as precursors for eicosanoid and docosanoid signalling molecules.…”