Long-chain polyunsaturated fatty acid status in first-trimester pregnant women
AbstractBackground: The beneficial effects of long-chain polyunsaturated fatty acid (LCPUFA) on maternal health have been widely investigated in pregnant women. First-trimester supplementation of LCPUFA has been reported to play a role in the inflammatory response, thus reducing a preterm birth and preeclampsia. However, there is a lack of studies investigating the blood concentration of LCPUFA in pregnant women in Indonesia. This study was conducted to evaluate the status of LCPUFA in first-trimester pregnant women in Jakarta, Indonesia.
Methods: A descriptive study was conducted using the secondary data of 197 pregnant women in their first trimester who received antenatal care in Budi Kemuliaan Hospital during February 2012 to April 2015. Nutrient intake data were collected through interviews conducted using a semi-quantitative frequency food questionnaire (SQ-FFQ). Total concentrations of linoleic acid (LA), arachidonic acid (AA), alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) were measured using gas-chromatography/mass spectrometry (GC-MS). Statistical analysis of the data was conducted using SPSS 20.0.
Results: Most subjects had deficient blood concentrations of LA (74.1%), AA (85.3%), ALA (76.6%), and DHA (73.1%). The median total concentrations of LA, AA, ALA, EPA, and DHA were as follows: 76.08%, 14.97%, 2.64%, 6.36%, and 1.18%, respectively. The median EPA+DHA level was 7.98%. A total of 38 women (19.3%) were classified as high-risk subjects based on the omega-3 index. No correlation was observed between total DHA+EPA concentration and birth weight (r=0.027, p=0.709). However, a significant difference was detected between the concentrations of LA, AA, and ALA and the maternal body mass index (p<0.05).
Conclusion: Most subjects had low intake and blood concentrations of LA, AA, ALA, EPA, and DHA in the first trimester of pregnancy.
Giuseppe RD, Roggi C, Cena H. n-3 LC-PUFA supplementation: effects on infant and maternal outcomes. Eur J Nutr. 2014;53(5):1147â54. https://doi.org/10.1007/s00394-014-0660-9
Burchakov DI, Kuznetsova IV, Uspenskaya YB. Omega-3 Long-Chain Polyunsaturated Fatty Acids and Preeclampsia: Trials Say "No," but Is It the Final Word? Nutrients. 2017;9(12):1364â77. https://doi.org/10.3390/nu9121364
Mackay VA, Huda SS, Stewart FM, Tham K, McKenna LA, Martin I, et al. Preeclampsia is associated with compromised maternal synthesis of long chain polyunsaturated fatty acids leading to offspring deficiency. Hypertension. 2012;60(4):1078â85. https://doi.org/10.1161/HYPERTENSIONAHA.112.197897
Carvajal JA. Docosahexaenoic acid supplementation early in pregnancy may prevent deep placentation disorders. Biomed Res Int. 2014;2014:526895. https://doi.org/10.1155/2014/526895
Hadders-Algra M. Prenatal long-chain polyunsaturated fatty acid status: the importance of a balanced intake of docosahexaenoic acid and arachidonic acid. J Perinat Med. 2008;36(2):101â9. https://doi.org/10.1515/JPM.2008.029
Hanson MA, Bardsley A, De-Regil LM, Moore SE, Oken E, Poston L, et al. The International Federation of Gynecology and Obstetrics (FIGO) Recommendations on Adolescent, Preconception, and Maternal Nutrition: Think Nutrition First. Int J Gynaecol Obstet. 2015;131 suppl 4:S213â53. https://doi.org/10.1016/S0020-7292(15)30023-0
Brenna JT, Varamini B, Jensen RG, Diersen-Schade DA, Boettcher JA, Arterburn LM. Docosahexainoic and arachidonic acid concentrations in human breast milk worldwide. Am J Clin Nutr. 2007;85(6):1457â64. https://doi.org/10.1093/ajcn/85.6.1457
Smits LJ, Elzenga HM, Gemke RJ, Hornstra G, van Eijsden M. The association between interpregnancy interval and birth weight: what is the role of maternal polyunsaturated fatty acid status? BMC Pregnancy Childbirth. 2013;13:23. https://doi.org/10.1186/1471-2393-13-23
Eijsden M, Hornstra G, Wal MF, Vrijkotte TGM, Bonsel GJ. Maternal n-3, n-6, and trans fatty acid profile early in pregnancy and term birth weight: a prospective cohort study. Am J Clin Nutr 2008;87(4):887â95. https://doi.org/10.1093/ajcn/87.4.887
Dwarkanath P, Muthayya S, Thomas T, Vaz M, Parikh P, Mehra R, Kurpad AV. Polyunsaturated fatty acid consumption and concentration among south indian women during pregnancy. Asia Pac J Clin Nutr 2009;18(3):389â94.
Stark KD, Van Elswyk ME, Higgins MR, Weatherford CA, Salem N, Jr. Global survey of the omega-3 fatty acids, docosahexaenoic acid and eicosapentaenoic acid in the blood stream of healthy adults. Prog Lipid Res. 2016;63:132â52. https://doi.org/10.1016/j.plipres.2016.05.001
Peraturan Menteri Kesehatan Republik Indonesia No 75 Tahun 2013 tentang Angka Kecukupan Gizi yang Dianjurkan bagi Bangsa Indonesia: Depkes. 2013. Indonesian.
Angkasa D, Tambunan V, Khusun H, Witjaksono F, Agustina R. Inadequate dietary Î±-linolenic acid intake among Indonesian pregnant women is associated with lower newborn weights in urban Jakarta. Asia Pac J Clin Nutr. 2017;26(Suppl 1):S9â18.
Hatma RD, Lukito W, Rumawas YSP. Fatty acids intake among diverse ethnic groups in Indonesia. Med J Indones. 2005;14(4):242â8. https://doi.org/10.13181/mji.v14i4.203
Harika RK, Eilander A, Alssema M, Osendarp SJM, Zock PL. Intake of fatty acids in general populations worldwide does not meet dietary recommendations to prevent coronary heart disease: a systematic review of data from 40 countries. Ann Nutr Metab. 2013;63(3):229â38. https://doi.org/10.1159/000355437
Akrele OA, Cheema SK. A balance of omega-3 and omega-6 polyunsaturated fatty acids is important in pregnancy. J Nutr Intermed Metab. 2016;5:23â33. https://doi.org/10.1016/j.jnim.2016.04.008
Simopoulos AP. An increase in the omega-6/omega-3 fatty acid ratio increases the risk for obesity. Nutrients. 2016;8(3):128. https://doi.org/10.3390/nu8030128
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