Introduction

Maternal–infant equilibrium occurs when cord blood docosahexaenoic acid (DHA) is less than or equal to maternal DHA at delivery. Equilibrium may be an indicator of sufficient DHA for optimal fetal and infant neurodevelopment. The purpose of this study was to test the effect of maternal DHA supplementation on equilibrium status and fetal neurodevelopment.

Methods

Women enrolled between 12 and 20 weeks gestation and were randomized to 200 or 800 mg DHA/day until delivery. Maternal red blood cell (RBC) phospholipids were measured at enrollment, 32 weeks, delivery, and in cord blood at delivery. Fetal neurodevelopment was measured at 32 and 36 weeks gestation. Intent-to-treat analyses were conducted to test differences in equilibrium status by group. Fetal outcomes were assessed by equilibrium status and group.

Results

Three hundred women enrolled and 262 maternal–infant dyads provided blood samples at delivery. No maternal–infant dyads with maternal RBC-DHA ≤ 6.96% at delivery achieved equilibrium. The incidence of equilibrium was significantly higher in the 800 mg group. There was no effect of maternal group or equilibrium status on fetal neurodevelopment.

Conclusion

The significance of maternal–infant DHA equilibrium remains unknown. Ongoing research will test the effect of treatment group, equilibrium, and nutrient status on infant behavior and brain function.

Impact

• Pregnant women who received a higher dose of docosahexaenoic acid (DHA) were more likely to achieve maternal–infant DHA equilibrium at delivery.

• Equilibrium status had no effect on fetal neurodevelopment in this sample.

• While DHA is crucial for early life neurodevelopment, the significance of achieving maternal–infant equilibrium above the lower threshold is uncertain.

• There is a lower threshold of maternal DHA status where maternal–infant DHA equilibrium never occurs.

• The lack of equilibrium associated with low maternal DHA status may indicate insufficient maternal status for optimal placental transfer.

中文翻译：

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产前二十二碳六烯酸对母婴 DHA 平衡和胎儿神经发育的影响：一项随机临床试验

介绍

当脐带血二十二碳六烯酸 (DHA) 在分娩时小于或等于母体 DHA 时，就会出现母婴平衡。平衡可能是 DHA 充足的指标，可实现最佳的胎儿和婴儿神经发育。本研究的目的是测试母体 DHA 补充剂对平衡状态和胎儿神经发育的影响。

方法

女性在妊娠 12 至 20 周之间入组，并被随机分配至 200 或 800 毫克 DHA/天直至分娩。在入组、32 周、分娩和分娩时的脐带血中测量母体红细胞 (RBC) 磷脂。在妊娠 32 周和 36 周时测量胎儿神经发育。进行意向治疗分析以测试各组平衡状态的差异。胎儿结局通过平衡状态和组进行评估。

结果

300 名妇女和 262 名母婴在分娩时提供了血液样本。分娩时母体 RBC-DHA ≤ 6.96% 的母婴没有达到平衡。800 mg组的平衡发生率显着更高。母体组或平衡状态对胎儿神经发育没有影响。

结论

母婴 DHA 平衡的重要性仍然未知。正在进行的研究将测试治疗组、平衡和营养状况对婴儿行为和大脑功能的影响。

影响

• 接受较高剂量二十二碳六烯酸 (DHA) 的孕妇更有可能在分娩时达到母婴 DHA 平衡。

• 平衡状态对该样本中的胎儿神经发育没有影响。

• 虽然 DHA 对生命早期神经发育至关重要，但在下限以上实现母婴平衡的意义尚不确定。

• 母婴 DHA 平衡从未发生的母婴 DHA 状态阈值较低。

• 缺乏与母体 DHA 状态低相关的平衡可能表明母体状态不足以进行最佳胎盘移植。