Docosahexaenoic Acid Supplementation Early in Pregnancy May Prevent Deep Placentation Disorders

Abstract

Uteroplacental ischemia may cause preterm birth, either due to preterm labor, preterm premature rupture of membranes, or medical indication (in the presence of preeclampsia or fetal growth restriction). Uteroplacental ischemia is the product of defective deep placentation, a failure of invasion, and transformation of the spiral arteries by the trophoblast. The failure of normal placentation generates a series of clinical abnormalities nowadays called “deep placentation disorders”; they include preeclampsia, fetal growth restriction, preterm labor, preterm premature rupture of membranes, in utero fetal death, and placental abruption. Early reports suggested that a LC-PUFAs (long chain polyunsaturated fatty acids) rich diet reduces the incidence of deep placentation disorders. Recent randomized controlled trials are inconsistent to show the benefit of docosahexaenoic acid (DHA) supplementation during pregnancy to prevent deep placentation disorders, but most of them showed that DHA supplementation was associated with lower risk of early preterm birth. We postulate that DHA supplementation, early in pregnancy, may reduce the incidence of deep placentation disorders. If our hypothesis is correct, DHA supplementation, early in pregnancy, will become a safe and effective strategy for primary prevention of highly relevant pregnancy diseases, such as preterm birth, preeclampsia, and fetal growth restriction.

Role and Progress of DHA Dietary Supply in Brain Development of Maternal and Golden Periods

“…The majority of studies have considered both neurocognitive function and growth and development have used infant formulas for maternal and infant term that contain DHA obtained from DHA from fish oil 72,74 , eggs 75,76 and micro algae have been considered. This is noteworthy for both maternal [77][78][79][80] and infant term 81,82 .…”

Maternal and fetal benefits of DHA supplementation during pregnancy

“…Some papers report an improved outcome for preventing placentation disorders [18]. But 3 Cochrane database systematic reviews and recent meta-analysis are not conclusive and do not recommend a DHA supplementation for the prevention of preeclampsia, gestational diabetes and postpartum depression [26,30,31,41].…”

“…The failure of a normal placentation may generate uteroplacental ischemia responsible for several complications including preeclampsia, fetal growth restriction, preterm labor, PROM, ... In a paper reviewing the effects of DHA supplementation on the placentation disorders prevention, an early first trimester supplementation was associated with a significantly better outcome [18].…”

“…They found lower levels of DHA in maternal plasma, cord plasma and placenta in the group with PE. They suggested that supplementation of omega-3 fatty acids during the [16][17][18][19][20] th week of gestation could improve fatty acid status in infants born to mothers with PE [23].…”

Suplementación con Omega-3 para prevención de parto prematuro recurrente: revisión sistemática y metaanálisis (1) Saccone G, Berghella V.

“…En este contexto, se ha propuesto la suplementación de ácidos grasos Omega 3 como una alternativa preventiva del parto prematuro, puesto que estos disminuirían la síntesis de prostaglandinas (8). Otros grupos han postulado que la suplementación con ácidos grasos Omega 3 podría mejorar la tasa de parto prematuro al mejorar la placentación (9). Sin embargo, estudios clínicos randomizados muestran resultados contradictorios sobre la utilidad de la suplementación materna con ácidos grasos Omega 3 para reducir la tasa de parto prematuro.…”