Gestational age and maternal status of DHA and other polyunsaturated fatty acids in pregnancy: A systematic review

Wilson, Nina A; Mantzioris, Evangeline; Middleton, Philippa; Mühlhäusler, Beverly S.

doi:10.1016/j.plefa.2019.04.006

Cited by 26 publications

(31 citation statements)

References 52 publications

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“…Of the 48 articles that reported associations between omega-3 fatty acid status in pregnancy and one or more maternal factors, 15 studies reported only clinical characteristic(s) and 11 students reported gestational age as a determinant of maternal omega-3 status. Since the association between gestational age and maternal omega-3 status has already been the subject of a published meta-analysis [14], and the studies assessing only clinical characteristics have been allocated to their own paper, these studies were not included in the final analyses, leaving 22 studies included in the current review.…”

Section: Resultsmentioning

confidence: 99%

“…The methods for this systematic review have been published previously [14]. Briefly, a search was designed and implemented using the Medline, Embase, Amed and CINAHL databases.…”

Section: Search Strategymentioning

confidence: 99%

“…In addition, blood samples were only taken in the third trimester of pregnancy (at 28 weeks and at the time of birth) in this study. Thus, the relationship between higher maternal fish (and hence omega-3 LCPUFA) intakes and increased maternal DHA status may have been offset by the preferential transfer of DHA from the maternal circulation to the fetus that occurs during this time, and account for the lack of a positive correlation [14,37].…”

Section: Diet and Lifestylementioning

confidence: 99%

“…The results of a recent meta-analysis indicated that absolute concentrations of DHA increase across gestation, while DHA as a proportion of total lipids decreases across this same period [14]. Fewer studies have attempted to assess the potential influence of other factors on maternal fatty acid status during pregnancy, and the quality and scope of those studies that have explored such relationships has been highly variable.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Influence of sociodemographic, lifestyle and genetic characteristics on maternal DHA and other polyunsaturated fatty acid status in pregnancy: A systematic review

Wilson

Mantzioris

Middleton

et al. 2020

Prostaglandins, Leukotrienes and Essential Fatty Acids

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is important for the prevention of preterm birth, however there is limited knowledge of the determinants of omega-3 status during pregnancy. The primary objective of this systematic review was to synthesise data from existing studies assessing relationships between sociodemographic, diet, lifestyle and genetic factors and maternal DHA status. Materials and methods: The Medline, Embase, Amed, and CINAHL databases were searched for studies reporting measures of maternal omega-3 status and a sociodemographic/lifestyle/genetic characteristic. Results: Twenty-two studies were included in the final analyses. Higher dietary fish consumption/PUFA intake, higher education level and an older maternal age were associated with higher maternal omega-3 status. Higher alcohol intake, smoking and FADS genotype were each associated with lower maternal omega-3 status. Discussion: Differences in findings between studies make it difficult to draw clear conclusions about the relationship between these factors and maternal omega-3 DHA status, although socioeconomic status may play a role.

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Section: Resultsmentioning

confidence: 99%

“…The methods for this systematic review have been published previously [14]. Briefly, a search was designed and implemented using the Medline, Embase, Amed and CINAHL databases.…”

Section: Search Strategymentioning

confidence: 99%

Section: Diet and Lifestylementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Influence of sociodemographic, lifestyle and genetic characteristics on maternal DHA and other polyunsaturated fatty acid status in pregnancy: A systematic review

Wilson

Mantzioris

Middleton

et al. 2020

Prostaglandins, Leukotrienes and Essential Fatty Acids

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“…This transport aims to achieve 8-9% DHA in total fatty acids in the membranes of the erythrocytes of the fetus [27][28][29][30]. Without substitution, a pregnant woman's DHA levels will fall in proportion to the amounts transported to the fetus, despite mobilization of DHA with advancing gestation [28,29,31]. Longer pregnancies result in higher DHA levels in erythrocytes in the child [32,33].…”

Section: Target Omega-3 Index In Pregnancymentioning

confidence: 99%

Omega-3 Fatty Acids in Pregnancy—The Case for a Target Omega-3 Index

Schacky

2020

Nutrients

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Scientific societies recommend increasing intake of docosahexaenoic acid (DHA) by 200 mg/day during pregnancy. However, individually, clinical events correlate quite strongly with levels of eicosapentaenoic acid (EPA) and DHA in blood, but these levels poorly correlate with amounts ingested. EPA and DHA in erythrocytes (Omega-3 Index) have a low biologic variability. If analyzed with a standardized analytical procedure (HS-Omega-3 Index®), analytical variability is low. Thus, the largest database of any fatty acid analytical method was provided. Pregnant women in Germany had a mean Omega-3 Index below the target range suggested for cardiovascular disease of 8–11%, with large interindividual variation, and quite independent of supplementation with EPA and DHA. In Germany, premature birth is a major health issue. Premature birth and other health issues of pregnant women and their offspring correlate with levels of EPA and DHA in blood and can be reduced by increasing intake of EPA and DHA, according to individual trials and pertinent meta-analyses. Very high intake or levels of EPA and DHA may also produce health issues, like bleeding, prolonged gestation, or even premature birth. While direct evidence remains to be generated, evidence from various scientific approaches supports that the target range for the Omega-3 Index of 8–11% might also pertain to pregnancy and lactation.

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Maternal supplementation with docosahexaenoic acid does not cause constriction of fetal ductus arteriosus: randomized controlled trial

Zielinsky,

Alves,

Foresti

et al. 2024

Ultrasound in Obstet & Gyne

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ObjectivesDocosahexaenoic acid (DHA) is routinely recommended to adequate fetal development during gestation. Since it is a substance with intense anti‐inflammatory action, its effects upon the fetal heart and circulation are unknown and safety of its administration during gestation is not yet established. This randomized clinical trial was designed to investigate if maternal supplementation of DHA is followed by alterations of maternal prostaglandin levels and fetal ductus arteriosus flow dynamics, at the final trimester of pregnancy.MethodsA double blind, placebo‐controlled, randomized clinical trial by parallel groups was designed. The study was developed in the period of 2018 to 2021. Pregnant women above 18 years of age, at 27 or 28 weeks without cardiac alterations at fetal echocardiography were enlisted to the trial, with exclusion of those taking substances with known prostaglandin inhibition effect, such as nonsteroidal anti‐inflammatory drugs and polyphenol‐rich foods. The intervention group received oral supplementation of omega‐3 with 450 mg/day of DHA, and the placebo group received capsules of soy lecithin. Both groups were supplemented for eight weeks. The following data were obtained at the beginning and at the end of the follow‐up: anthropometric, assessment of polyphenol and omega‐3 consumption, fetal morphological ultrasound, fetal Doppler echocardiographic examination and blood draw to assess prostaglandin levels. Participants were considered eligible, without cardiac or extracardiac abnormalities, when the diagnosis of ductal constriction was excluded by two observers. Intergroup and intragroup data were evaluated.ResultsThe study ended up with 24 participants in each group. After 8 weeks, Doppler echocardiographic parameters of ductal flow and serum prostaglandin levels in both groups did not show significant intergroup differences. The expected intragroup differences as a result in increase in gestational ages were present.ConclusionsEven though complete safety of DHA has not been tested, this randomized clinical trial shows that third trimester maternal supplementation of DHA, at the doses and period used, does not result in inhibition of PGE2 and does not cause ductus arteriosus constriction, providing the basis for post‐market surveillance studies with larger numbers, to allow the best clinical reassurance.This article is protected by copyright. All rights reserved.

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Gestational age and maternal status of DHA and other polyunsaturated fatty acids in pregnancy: A systematic review

Cited by 26 publications

References 52 publications

Influence of sociodemographic, lifestyle and genetic characteristics on maternal DHA and other polyunsaturated fatty acid status in pregnancy: A systematic review

Influence of sociodemographic, lifestyle and genetic characteristics on maternal DHA and other polyunsaturated fatty acid status in pregnancy: A systematic review

Omega-3 Fatty Acids in Pregnancy—The Case for a Target Omega-3 Index

Maternal supplementation with docosahexaenoic acid does not cause constriction of fetal ductus arteriosus: randomized controlled trial

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