OMEGA-3 FATTY ACIDS AND NEUROPROTECTION IN
PREGNANCY
Edina Berberović, Marina Ivanišević, Marina Hovratiček, Ivančica Delaš, Josip
Đelmiš
University Clinic for women's diseases and delivery, University Clinical Hospital
Centre Zagreb, School of Medicine University of Zagreb
Petrova 13, Zagreb, Croatia
Objective. Perinatal and neonatal hypoxic/ischemic (H/I) brain injury is a leading
cause of perinatal mortality and morbidity [1]. Prolonged neuronal apoptosis plays an
important role in the processes contributing to neuronal degeneration. The essential
long-chain polyunsaturated fatty acid (LCPUFA) docosahexaenoic acid (DHA), a
major component of brain membrane phospholipids, prevents neuronal cell apoptosis
and plays an important role as an anti-oxidant agent [2]. Some research has shown
that omega-3 FAs protect against ischemic brain damage in adult stroke models [3].
One recent study has suggested the beneficial effect of DHA pretreatment on brain
damage and functional outcomes at 7 days after H/I in neonatal rats [4]. In this study,
it was found that dietary supplementation of omega-3 FAs to pregnant female rats
resulted in robust and prolonged neuroprotection in the neonatal brain after H/I. Fetal
concentration of DHA depends on the mother’s concentration, i.e. on their ingestion
by food. During the pregnancy the maternal EFA status declines steadily. Therefore, it
is recommended that this fatty acid must be added in food [5]. Previous studies
showed that type 1 diabetes is associated with low DHA level of pregnant women [6,
7].
The aims of the study were:
1. To determine total FAs concentration (mg/L) in the maternal vein serum and in the
serum of the umbilical vein in pregnant women suffering from Type 1 diabetes
(T1DM) and in healthy pregnant women (Control group) and;
2. To determine and analyze omega-3 FAs (ALA, EPA, DHA) concentrations (mg/L)
in relation to the total FAs concentration in the mother’s vein serum and the serum of
the umbilical vein in pregnant women suffering from T1DM compared to the Control
group.
Methods. The study included 63 pregnant women, 32 suffering from T1DM and 31
from Control group who gave birth to eutrophic children. Samples of a mother’s vein
blood and the umbilical vein blood were taken immediately after the birth. The total
lipid extraction was carried out by the mixture of chloroform: methanol solvent: a
method of increasing polarity according to Folch [8]. Heptadecanoic acid (C17) was
used as internal standard in order to determine the exact proportion of total lipids.
Fatty acids from lipid extracts were converted to methyl esters by transesterification
with methanolic HCl (ref: ISO standard) and their composition analyzed by GC-MS
on Varian 3400 (Varian, USA) equipped with Saturn II ion trap mass spectrometer
operating in the electron impact (EI) mode.
Results. There was statistically significant difference in the total FAs concentration in
the maternal vein serum and the umbilical vein serum between the two groups
(p<0.001). There was a statistically significant higher concentration of total FAs in
the maternal and umbilical vein serum of the diabetic group. Statistically significant
difference of ALA, EPA and DHA concentrations in the maternal vein serum were
found between two groups (ALA: p>0.001; EPA: p>0.001; DHA: p<0.001).
Significantly higher concentrations of EPA and DHA were found in the umbilical
vein serum in T1DM (EPA: p<0.001; DHA: p<0.05). Higher ALA, EPA and DHA
concentrations were found in the maternal vein serum compared to an umbilical vein
serum of the diabetic group.
Conclusion. Our study found the significant difference in DHA concentration in the
maternal and in the umbilical vein serum of diabetic pregnant women compared to the
control group. A good metabolic control leads to insignificant changes in the omega-3
fatty acids (ALA, EPA and DHA) levels in diabetic pregnancy. Omega 3-fatty acids
supplementation, especially DHA may have an influence and may improve neuronal
and cognitive development during the pregnancy, especially diabetic pregnancy.
REFERENCES
[1] Graham EM, Ruis KA, Hartman AL, Northington FJ, Fox HE. A systematic
review of the role of intrapartum hypoxia–ischemia in the causation of neonatal
encephalopathy. Am J Obstet Gynecol. 2008;199: 587–595
[2] Suganuma H, Arai Y, Kitamura Y, Hayashi M, Okumura A, Shimizu T. Maternal
docosahexaenoic acid-enriched diet prevents neonatal brain injury. Neuropathology.
2010;30(6):597-605.
[3] Belayev L, Khoutorova L, Atkins KD, Bazan NG. Robust docosahexaenoic acidmediated neuroprotection in a rat model of transient, focal cerebral ischemia. Stroke.
2009;40:3121–3126.
[4] Berman DR, Mozurkewich E, Liu Y, Barks J. Docosahexaenoic acid pretreatment
confers neuroprotection in a rat model of perinatal cerebral hypoxia–ischemia. Am J
Obstet Gynecol. 2009;200:305.e301– e306.
[5] Al MDM, van Houwelingen AC, Kester ADM, Hasaart THM, de Jong AEP,
Hornstra G. Maternal essential fatty acid patterns during normal pregnancy and its
relationship with the neonatal essential fatty acid status. Br J Nutr 1995;74:55–68
[6] Tilvis RS, Miettinen TA. Fatty acid compositions of serum lipids, erythrocytes,
and platelets in insulin-dependent diabetic women. J Clin Endocrinol Metab
1985;61:741–5.
[7] Lakin V, Haggarty P, Abramovich DR, Ashton J, Moffat CF, McNeill G,
Danielian PJ, Grubb D.. Dietary intake and tissue concentration of fatty acids in
omnivore, vegetarian and diabetic pregnancy. Prostaglandins Leukot Essent Fatty
Acids 1998;59:209 –20
[8] Folch J, Lees M, Sloane-Stanley GH. A simple method for the isolation and
purification of total lipids from animal tissues. J Biol Chem 1957; 226(1): 497-509