Role of LCPUFA in Maternal and Infant Health

Brandy Frost, MD Neonatologist, Assistant Clinical Professor, Northshore University Health System

 Dr. Brandy L. Frost is a neonatologist in Evanston, Illinois and is affiliated with NorthShore University Health System-Metro Chicago. She received her medical degree from University of Kansas School of Medicine.

Brandy_Frost

Role of LCPUFA in Maternal and Infant Health

Long-chain polyunsaturated fatty acids (LCPUFA) are critical dietary components of maternal and infant health. Maternal diet influences her LCPUFA stores and thus the fetus’s availability of these fatty acids. Significantly, LCPUFA status has also been associated with increased length of gestation and reduced risk of preterm birth.¹ˑ² Pregnant and lactating women are encouraged to consume LCPUFA in their diet. One international working group recommends at least 200 mg daily of one particular LCPUFA, docosahexaenoic acid (DHA).³

Importance of LCPUFA in Premature Infants 

The preterm infant population is at inherent risk of LCPUFA deficiency. The third trimester of pregnancy is the time of maximal trans-placental LCPUFA accretion. This correlates with the time of maximal brain growth in utero.¹⁹,²⁰ Therefore, with preterm delivery, placental transfer of LCPUFA is abruptly halted at a critical time of development. Additionally, one-week blood LCPUFA levels correlate with gestational age, indicating that the lowest levels are found in most premature infants, and preterm levels are significantly lower than those of term infants.²¹ Furthermore, extremely low birth weight (ELBW) infants have a significant drop in LCPUFA as soon as two weeks of life, rendering them deficient in these critical fatty acids.²²

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References

1. Olsen SF, Secher NJ, Tabor A, Weber T, Walker JJ, Gluud C. Randomised clinical trials of fish oil supplementation in high risk pregnancies. Fish Oil Trials In Pregnancy (FOTIP) Team. BJOG. 2000;107(3):382-95.

2. Horvath A, Koletzko B, Szajewska H. Effect of supplementation of women in high-risk pregnancies with long-chain polyunsaturated fatty acids on pregnancy outcomes and growth measures at birth: a meta-analysis of randomized controlled trials. Br J Nutr. 2007;98(2):253-9.

3. Koletzko B, Cetin I, Brenna JT, Perinatal Lipid Intake Working G, Child Health F, Diabetic Pregnancy Study G, et al. Dietary fat intakes for pregnant and lactating women. Br J Nutr. 2007;98(5):873-7.

19. Lapillonne A, Jensen CL. Reevaluation of the DHA requirement for the premature infant. Prostaglandins Leukot Essent Fatty Acids. 2009;81(2-3):143-50. 

20. Lauritzen L, Hansen HS, Jorgensen MH, Michaelsen KF. The essentiality of long chain n-3 fatty acids in relation to development and function of the brain and retina. Prog Lipid Res. 2001;40(1-2):1-94. 

21. Baack ML, Puumala SE, Messier SE, Pritchett DK, Harris WS. What is the relationship between gestational age and docosahexaenoic acid (DHA) and arachidonic acid (ARA) levels? Prostaglandins Leukot Essent Fatty Acids. 2015;100:5-11. 

22. Robinson DT, Carlson SE, Murthy K, Frost B, Li S, Caplan M. Docosahexaenoic and arachidonic acid levels in extremely low birth weight infants with prolonged exposure to intravenous lipids. J Pediatr. 2013;162(1):56-61. 

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