Efficacy of docosahexaenoic acid-enriched formula to enhance maternal and fetal blood docosahexaenoic acid levels: Randomized double-blinded placebo-controlled trial of pregnant women with gestational diabetes mellitus

Min, Yoeju; Djahanbakhch, O.; Hutchinson, Joanne; Eram, Sofia; Bhullar, Amritpal S.; Namugere, Irene; Ghebremeskel, Kebreab

doi:10.1016/j.clnu.2015.05.020

Cited by 32 publications

(24 citation statements)

References 32 publications

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“…Given the importance of DHA in the correct neurodevelopment of fetuses, it is essential to understand the mechanisms that regulate this carrier in detail before specific drugs can be designed to improve its expression. In this context, the efficiency of DHA supplementation in GDM pregnancies could be poor, since DHA cannot cross the placenta properly [80]. …”

Section: Discussionmentioning

confidence: 99%

Role of Insulin in Placental Transport of Nutrients in Gestational Diabetes Mellitus

Ruiz-Palacios

Ruiz–Alcaraz²,

Sánchez-Campillo³

et al. 2017

Ann Nutr Metab

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Background: Gestational diabetes mellitus (GDM) is associated with increased fetal adiposity, which may increase the risk of obesity in adulthood. The placenta has insulin receptors and maternal insulin can activate its signaling pathways, affecting the transport of nutrients to the fetus. However, the effects of diet or insulin treatment on the placental pathophysiology of GDM are unknown. Summary: There are very few studies on possible defects in the insulin signaling pathway in the GDM placenta. Such defects could influence the placental transport of nutrients to the fetus. In this review we discuss the state of insulin signaling pathways in placentas of women with GDM, as well as the role of exogenous insulin in placental nutrient transport to the fetus, and fetal adiposity. Key Messages: Maternal insulin in the third trimester is correlated with fetal abdominal circumference at that time, suggesting the important role of insulin in this process. Since treatment with insulin at the end of pregnancy may activate placental nutrient transport to the fetus and promote placental fatty acid transfer, it would be interesting to improve maternal hyperlipidemia control in GDM subjects treated with this hormone. More research in this area with high number of subjects is necessary.

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Section: Discussionmentioning

confidence: 99%

Role of Insulin in Placental Transport of Nutrients in Gestational Diabetes Mellitus

Ruiz-Palacios

Ruiz–Alcaraz²,

Sánchez-Campillo³

et al. 2017

Ann Nutr Metab

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“…Finally, substantial evidence exists in the literature for an association between blood fatty acids and cognitive impairment, particularly in Alzheimer's disease [ 35 , 36 ]. An increasing number of studies suggest that the omega-3 polyunsaturated fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are protective against cognitive impairment and dementia [ 37 – 41 ]; however, young Australian women have been shown to have inadequate intake of omega-3 fatty acids [ 42 , 43 ], and low blood omega-3 levels have been commonly observed in young women with depression [ 44 ] and during pregnancy [ 45 ].…”

Section: Introductionmentioning

confidence: 99%

Relationship between Obesity and Cognitive Function in Young Women: The Food, Mood and Mind Study

et al. 2017

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Limited research addresses links between obesity and cognitive function in young adults. Objective. To investigate the relationship between obesity and cognitive function in young women. Methods. This cross-sectional study recruited healthy, young (18–35 y) women of normal (NW: BMI = 18.5–24.9 kg·m−2) or obese (OB: BMI ≥ 30.0 kg·m−2) weight. Participants completed a validated, computer-based cognitive testing battery evaluating impulsivity, attention, information processing, memory, and executive function. Questionnaires on depression and physical activity and a fasting blood sample for C-reactive protein and the Omega-3 Index were also collected. Cognition data are presented as z-scores (mean ± SD), and group comparisons were assessed via ANOVA. Potential confounding from questionnaire and blood variables were evaluated using ANCOVA. Results. 299 women (NW: n = 157; OB: n = 142) aged 25.8 ± 5.1 y were enrolled. Cognition scores were within normal range (±1 z-score), but OB had lower attention (NW: 0.31 ± 1.38; OB: −0.25 ± 1.39; ES: 0.41, CI: 0.17–0.64; p < 0.001) and higher impulsivity (NW: 0.36 ± 1.14; OB: −0.07 ± 1.07; ES: 0.39, CI: 0.15–0.62; p=0.033). Confounder adjustment had minimal impact on results. Conclusion. The OB group had normal but significantly lower performance on attention and were more impulsive compared to NW participants. This may indicate early cognitive decline, but longitudinal research confirming these findings is warranted.

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“…However, there was a significant effect on perinatal mortality and neonatal convulsions in the DHA treated group [31]. Another RCT using a supplementation of 600 mg reported increased maternal but not fetal DHA levels in pregnant patients with GDM [33]. This finding could be explained by an impaired DHA transfer across the placenta due to GDM as reported by Pagan et al using stable isotope tracers for dynamic studies in vivo [34].…”

Section: Dha and Gestational Diabetesmentioning

confidence: 57%

Maternal and fetal benefits of DHA supplementation during pregnancy

Hubinont¹,

Savoye²

2017

J Pregnancy Reprod

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During pregnancy, the benefits of long-chain n-3 fatty acids, mainly DHA supplementation has been reported with controversial results. The aim of this review paper is to clarify the role of DHA on maternal and fetal outcomes and to discuss supplementation.Low maternal concentrations of DHA are associated with an increased incidence of preeclampsia, gestational diabetes, postpartum depression, preterm labour and intrauterine fetal growth restriction (IUGR).The effect of a preventive supplementation on these complications is not clearly demonstrated . Some authors report an improved outcome but recent Cochrane database systematic reviews and meta-analysis are not conclusive.DHA supplementation reduces significantly the effects of prenatal stress and the perinatal mortality rate. In patients with previous history of preterm birth, supplementation is also controversial.In conclusion, even if the DHA requirements are increased in pregnancy and if positive correlations are reported between low maternal concentrations and an adverse pregnancy outcome, there are conflicting results on the efficacy of a DHA supplementation. Further studies using different DHA regimens of administration are needed. In the meantime, as it is a safe supplementation with few side effects, DHA should be prescribed in patients with a low dietary intake and risks factors.

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Efficacy of docosahexaenoic acid-enriched formula to enhance maternal and fetal blood docosahexaenoic acid levels: Randomized double-blinded placebo-controlled trial of pregnant women with gestational diabetes mellitus

Cited by 32 publications

References 32 publications

Role of Insulin in Placental Transport of Nutrients in Gestational Diabetes Mellitus

Role of Insulin in Placental Transport of Nutrients in Gestational Diabetes Mellitus

Relationship between Obesity and Cognitive Function in Young Women: The Food, Mood and Mind Study

Maternal and fetal benefits of DHA supplementation during pregnancy

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