Maternal docosahexaenoic acid supplementation and fetal accretion

Abstract
Docosahexaenoic acid (DHA) (22:6n−3) is a polyunsaturated fatty acid that is an essential constituent of membranes, particularly of the nervous system. Infants acquire DHA from their mothers, either prenatally via the placenta or postnatally in milk. The present study aimed to test the hypothesis that maternal supplementation during the second and third trimesters of pregnancy enriches maternal and/or fetal DHA status. In a randomised, prospective, double-blind study 100 mothers received either fish-oil capsules containing 400mg DHA/g (200mg/d) (n 50), or placebo containing 810mg oleic acid/g (400mg/d) (n 50) from 15 weeks gestation until term. Venous blood samples were obtained from mothers at 15, 28 and 40 weeks, and from the umbilical cord at birth. Total fatty acids in plasma and erythrocytes were analysed by GC–MS. There were no significant differences between maternal groups in baseline DHA, as a proportion of total fatty acids (g/100g total fatty acids) or concentration (nmol/ml), in plasma and erythrocytes. DHA concentrations in plasma at 28 weeks (P=0·02) and erythrocytes at both 28 weeks (P=0·03) and term (P=0·02) were 20% higher in supplemented mothers than the placebo group. DHA accounted for a higher proportion of total fatty acids in erythrocytes of supplemented mothers at 28 weeks (P=0·003) and term (P=0·01). There were no significant differences between groups in DHA (g/100g total fatty acids or nmol/l) in cord blood. Maternal DHA status was maximal in mid-trimester and declined to term, at a lower rate in supplemented compared with unsupplemented mothers. Maternal DHA supplementation significantly increases maternal DHA status and limits the last trimester decline in maternal status, aiding preferential transfer of DHA from mother to fetus.