A Randomized Trial of Docosahexaenoic Acid Supplementation During the Third Trimester of Pregnancy

Smuts, Cornelius M.; Huang, Min-Zhao; Mundy, David; Plasse, Terry F.; Major, Stacey; Carlson, Susan E.

doi:10.1097/00006250-200303000-00011

Cited by 72 publications

(117 citation statements)

References 37 publications

Supporting

Mentioning

106

Contrasting

Unclassified

Order By: Relevance

“…The fatty acid composition of the maternal diet during pregnancy is thought to affect a number of pregnancy outcomes including the rate of growth in utero (Carlson et al, 1992;Smuts et al, 2003) and the length of gestation (Olsen et al, 2000;Olsen & Secher, 2002), but the outcomes most often studied in relation to LCPUFA in early life are visual and intellectual development, largely as a result of the observation that tissues such as the brain and retina require a high concentration of DHA to function properly (Innis, 1991). Although the brain of the newborn has a relatively high concentration of DHA, the absolute accretion during in utero life is small.…”

Section: Importance Of Fatty Acids To the Fetusmentioning

confidence: 99%

“…It is likely, however, that buffering by the maternal adipose tissue and the ability of the placenta to transport AA to and from the fetus will protect it against large variations in maternal dietary intake. More recently, it has been reported that supplementation of mothers with modest levels of DHA resulted in a slight but nonsignificant increase in birth weight and length of gestation (Smuts et al, 2003), but this supplement did not include EPA. Another concern relates to the other fat-soluble components of foods and supplements of marine origin.…”

Section: Potentially Adverse Affects Of High Lcpufa Intakesmentioning

confidence: 99%

See 1 more Smart Citation

Effect of placental function on fatty acid requirements during pregnancy

Haggarty¹

2004

Eur J Clin Nutr

187

156

View full text Add to dashboard Cite

The fetus has an absolute requirement for the n-3/n-6 fatty acids and docosahexaenoic acid (22:6 n-3; DHA) in particular is essential for the development of the brain and retina. Most of the fat deposition in the fetus occurs in the last 10 weeks of pregnancy. The likely rate of DHA utilisation during late pregnancy cannot be met from dietary sources alone in a significant proportion of mothers. De novo synthesis makes up some of the shortfall but the available evidence suggests that the maternal adipose tissue makes a significant contribution to placental transport to the fetus. The placenta plays a crucial role in mobilising the maternal adipose tissue and actively concentrating and channelling the important n-3/n-6 fatty acids to the fetus via multiple mechanisms including selective uptake by the syncytiotrophoblast, intracellular metabolic channelling, and selective export to the fetal circulation. These mechanisms protect the fetus against low long-chain polyunsaturated fatty acid (LCPUFA) intakes in the last trimester of pregnancy and have the effect of reducing the maternal dietary requirement for preformed DHA at this time. As a result of these adaptations, small changes in the composition of the habitual maternal diet before pregnancy are likely to be more effective in improving LCPUFA delivery to the fetus than large dietary changes in late pregnancy. There is little evidence that DHA intake/status in the second half of pregnancy affects visual and cognitive function in the offspring, but more studies are needed, particularly in children born to vegetarian and vegan and mothers who may have very low intakes of DHA.

show abstract

Section: Importance Of Fatty Acids To the Fetusmentioning

confidence: 99%

Section: Potentially Adverse Affects Of High Lcpufa Intakesmentioning

confidence: 99%

Effect of placental function on fatty acid requirements during pregnancy

Haggarty¹

2004

Eur J Clin Nutr

187

156

View full text Add to dashboard Cite

show abstract

“…The hypothesis has been supported by some (Olsen et al, 1992;Olsen et al, 2000;Smuts et al, 2003) but not all (Bulstra-Ramakers et al, 1995;Onwude et al, 1995;Helland et al, 2001;Knudsen et al, 2006) randomised controlled trials (Olsen 2004;Makrides et al, 2006;Szajewska et al, 2006), and by some (Olsen et al, 1991;Olsen and Secher 2002) but, again, far from all (Olsen 1994;Olsen et al, 1995;Bjerregaard and Hansen 1996;Oken et al, 2004;Rogers et al, 2004;Thorsdottir et al, 2004) observational studies. Two recent meta-analyses of controlled trials concluded that fish oil probably prolongs pregnancy, but that the size of this effect, estimated from the pooled analyses, is most probably too small to be of any clinical significance (Makrides et al, 2006;Szajewska et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Duration of pregnancy in relation to fish oil supplementation and habitual fish intake: a randomised clinical trial with fish oil

et al. 2007

View full text Add to dashboard Cite

Objective: To examine the effect of fish oil supplementation on duration of pregnancy, conditional on the woman's habitual fish intake. Design: Multicentre 1:1 randomised clinical trial of effect of fish oil in a high-risk population of pregnant women in whom habitual fish intake was assessed at randomisation. Setting: Nineteen university delivery wards in seven European countries. Subjects: Pregnant women with preterm delivery, intrauterine growth retardation (IUGR), or pregnancy-induced hypertension (PIH) in a previous pregnancy (group 1, n ¼ 495); with twin pregnancies (group 2, n ¼ 367); or with suspicion of IUGR or threatening preeclampsia in the current pregnancy (group 3, n ¼ 106). Women were stratified into low, middle, or high fish consumers. Methods: The intervention group received fish oil capsules providing 2.7 g long-chain n-3 fatty acids per day (n-3 poly unsaturated fatty acids (PUFA)) from around week 20 (groups 1 and 2) or 6.3 g n-3 PUFA from week 33 (group 3). The control regimen was capsules with olive oil. Effect on timing of spontaneous delivery was examined by Cox regression, assuming elective delivery (occurring in 40%) as a censoring event. Analyses of effect of fish oil were intention to treat, and all analyses were adjusted for maternal smoking, age, and parity. Results: In group 1, fish oil reduced the hazard rate of spontaneous delivery (HR) by 44% (95% confidence interval 14-64%) and 39% (16-56%) in low and middle fish consumers, respectively, with no detectable effect (À56 to 33%) in high fish consumers. In groups 2 and 3, no significant effect of fish oil was detected in any of the sub-strata defined by baseline fish consumption. Conclusions: In pregnant women with previous pregnancy complications, fish oil supplementation delayed onset of delivery in low and middle, but not in high, fish consumers.

show abstract

“…DHA modulates a number of cell functions and exerts a wide range of biological effects including alterations in endothelial function, vascular reactivity, leukocyte and macrophage function, cytokine production and reactive oxygen species (ROS) production (Gorjao et al 2009). In pregnancy, dietary supplementation with n-3 fatty acids confers significant clinical benefits, reducing the incidence of spontaneous preterm birth (Olsen et al 2000, Smuts et al 2003, Makrides et al 2010.…”

Section: Introductionmentioning

confidence: 99%

Differential effects of docosahexaenoic acid on preterm and term placental pro-oxidant/antioxidant balance

2013

View full text Add to dashboard Cite

Docosahexaenoic acid (DHA) supplementation in pregnancy may confer some clinical benefits; however, this compound can exert pro-oxidant effects. In this study, we investigated the effects of DHA on pro-oxidant/antioxidant balance in term and preterm placental explants, assessing oxidative stress marker concentrations, antioxidant capacity and pro-inflammatory cytokine production. Term (nZ8) and preterm (nZ9) placental explants were exposed to lipopolysaccharide (LPS, 1 ng/ml), DHA (1, 10 and 100 mM), and DHA and LPS simultaneously or pre-treated with DHA for 24 h prior to LPS treatment. The production of malondialdehyde (MDA, lipid peroxidation), 8-hydroxy-2-deoxy guanosine (8-OHdG, oxidative DNA damage) and pro-inflammatory cytokines (tumour necrosis factor a (TNFa), interleukin 6 and interferon-g) and total antioxidant capacity were measured. DHA at a concentration of 100 mM induced oxidative stress in term placentas, while at all the three concentrations, it induced oxidative stress in preterm placentas. DHA and LPS resulted in reduced MDA levels in term (P!0.005) and preterm (PZ0.004) placentas and reduced 8-OHdG levels in preterm placentas (PZ0.035). DHA pre-treatment, but not co-treatment with LPS, reduced 8-OHdG levels (P!0.001) in term placentas. DHA increased antioxidant capacity only in term placentas (P!0.001), with lower antioxidant capacity being observed overall in preterm placentas compared with term placentas (P%0.001). In term placentas, but not in preterm ones, DHA co-treatment and pre-treatment reduced LPS-induced TNFa levels. The ability of DHA to alter placental pro-oxidant/antioxidant balance is dependent on the DHA concentration used and the gestational age of the placental tissue. DHA has a greater capacity to increase oxidative stress in preterm placentas, but it offers greater protection against inflammation-induced oxidative stress in term placentas. This appears to be a result of DHA altering placental antioxidant capacity. These data have implications for the timing and concentration of DHA supplementation in pregnancy.

show abstract

A Randomized Trial of Docosahexaenoic Acid Supplementation During the Third Trimester of Pregnancy

Cited by 72 publications

References 37 publications

Effect of placental function on fatty acid requirements during pregnancy

Effect of placental function on fatty acid requirements during pregnancy

Duration of pregnancy in relation to fish oil supplementation and habitual fish intake: a randomised clinical trial with fish oil

Differential effects of docosahexaenoic acid on preterm and term placental pro-oxidant/antioxidant balance

Contact Info

Product

Resources

About