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

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• 作者：Yoeju Min^a ; ^{y.min@londonmet.ac.uk" class="auth_mail" title="E-mail the corresponding author} ; ^{minyoeju@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Ovrang Djahanbakhch^b ; ^c ; Joanne Hutchinson^b ; ^a ; Sofia Eram^a ; Amritpal S. Bhullar^a ; Irene Namugere^b ; Kebreab Ghebremeskel^a
• 关键词：Gestational diabetes mellitus ; Pregnancy ; Docosahexaenoic acid
• 刊名：Clinical Nutrition
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：35
• 期：3
• 页码：608-614
• 全文大小：344 K

文摘

Gestational diabetes mellitus (GDM) compromises the level of docosahexaenoic acid (DHA) in phospholipids of maternal and fetal red blood cells and fetal plasma. This is of some concern because of the importance of DHA for fetal neuro-visual development. We have investigated whether this abnormality could be rectified by supplementation with DHA-enriched formula.

ec_2">Methods

Women with GDM (n = 138) recruited from Newham University Hospital, London received two capsules of DHA-enriched formula (active-group) or high oleic acid sunflower seed oil (placebo-group) from diagnosis until delivery. Maternal (baseline and delivery) and fetal (cord blood) red blood cell and plasma phospholipid fatty acid composition, and neonatal anthropometry were assessed.

ec_3">Results

One hundred and fourteen women (58 active, 56 placebo) completed the trial. The active-group compared with the placebo-group had significantly enhanced level of DHA in plasma phosphatidylcholine (4.5% vs 3.8%, <em>Pem> = 0.011), red blood cell phosphatidylcholine (2.7% vs 2.2%, <em>Pem> = 0.022) and phosphatidylethoanolamine (9.5% vs 7.6%, <em>Pem> = 0.002). There was no difference in cord plasma and red blood cell phospholipid DHA between the two groups. The neonates of the two groups of women had comparable anthropometric measurements at birth.

ec_4">Conclusion

Daily supplementation of 600 mg DHA enhances maternal but not fetal DHA status in pregnancy complicated by GDM. The inefficacy of the supplement to improve fetal status suggests that the transfer of DHA across the placenta maybe impaired in women with the condition. Regardless of the mechanisms responsible for the impairment of the transfer, the finding has implications for the management of neonates of women with GDM because they are born with a reduced level of DHA and the condition is thought to be associated with a risk of neuro-developmental deficits. We suggest that babies of women with GDM, particularly those not suckling, similar to the babies born prematurely require formula milk fortified with a higher level of DHA.