Maternal Midpregnancy Plasma trans 18:1 Fatty Acid Concentrations Are Positively Associated with Risk of Maternal Vascular Complications and Child Low Birth Weight

Abstract

Evidence is plentiful that fatty acids (TFAs) induce vascular inflammation with adverse metabolic consequences. However, it is not clear whether TFAs increase the risk of vascular pregnancy complications such as preeclampsia. We investigated associations between midpregnancy maternal plasma 18:1 fatty acid (t18:1) concentrations and pregnancy course and outcomes. Participants were 6695 pregnant women and newborns from the Generation R Study, Rotterdam, Netherlands (enrollment in 2001-2005). Maternal midpregnancy (mean ± SD gestational age: 20.7 ± 1.2 wk) t18:1 plasma concentrations were determined and related to gestational age and sex-adjusted birth weight SD scores, placental weight, and the risk of preeclampsia. In addition, we explored potential time trends by testing the association of maternal plasma t18:1 concentrations with birth weight in birth cohorts given the Dutch industry-initiative to lower food TFA contents during the inclusion period. Multiple logistic and linear regression analyses were performed, taking various socioeconomic and biological covariates into account. A higher midpregnancy maternal plasma t18:1 concentration was associated with lower birth weight (SD score, adjusted β: -0.10; 95% CI: -0.15, -0.04; < 0.001) and placental weight (kilograms, adjusted β: -10,65; 95% CI: -20.23, -1.07; = 0.03) and with a higher risk of preeclampsia (adjusted OR: 1.65; 95% CI: 1.10, 2.49; = 0.02). We observed a 31% decrease in the median plasma t18:1 concentration in our population over time, but the association between the plasma t18:1 concentration standardized per birth year and birth weight was comparable between birth-year cohorts (years 2001-2005). A higher maternal midpregnancy plasma t18:1 concentration was associated with lower birth weight and placental weight and with a higher risk of preeclampsia. Although the intake of TFAs in our population decreased during the inclusion period, the association with adverse pregnancy outcomes was unchanged even at lower maternal plasma t18:1 concentrations.

Systematic Literature Review and Meta-Analysis of the Relationship Between Polyunsaturated and Trans Fatty Acids During Pregnancy and Offspring Weight Development

“…DHA levels ranged from 3.34 to 5.76% and EPA levels ranged from 0.50 to 0.77%. Four studies investigated TFAs and birth weight (32,33,77,79). Three studies found that high levels of TFAs during pregnancy were related to a lower weight at birth (33,77,79), while one study found no association between TFAs and birth weight (32) Two studies calculated regression coefficients and showed the relation between maternal levels of different fatty acids and birth weight (76,78).…”

“…In our protocol, we included children up to 18 years of age, but only one observational study investigated the effect of PUFAs on BMI up to 23 years of age (72). In total, 14 eligible observational studies investigated the relationship between blood levels of TFAs or n-3 LCPUFA during pregnancy or from cord blood or placental tissues, in relation to birth weight or weight in childhood (32,33,(72)(73)(74)(75)(76)(77)(78)(79)(80)(81)(82). All the included observational studies are summarized in Table 4.…”

“…Only one study included more multiparous women than nulliparous (83). Most of the studies included slightly more boys than girls ranging from 50 to 54% (32,(72)(73)(74)(75)(76)(77)(78)(79)(80)(81)(82), and one study included slightly more girls than boys (48.8%) (33).…”

“…All the observational studies included in this systematic review investigated different kinds of fatty acids (DHA, EPA, and TFAs) and outcomes (weight and BMI). Four of the studies reported fatty acid levels in mg/L or µg/ml (33,77,80,83), other studies presented in relative percentage (%, w/w) to total fatty acid levels (32,72,73,76,78,79,81,82), one reported fatty acid levels in both ways (74,75). Overall, four studies were from the Generation ⊕ ⊕ ⊕• MODERATE a n-3 LCPUFA probably results in an increase in BMI compared to controls groups *The risk in the intervention group (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).…”

“…Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect. R Study from the Netherlands (74)(75)(76)(77), three other studies also involved participants from the Netherlands (33,72,79), one study was from the UK (80), one study was from Italy (81), three studies were from Asia (73,78,82), one was from Canada (32), and, lastly, one study was from the USA [(83); Table 4].…”