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Omega-3 fatty acids and neuroprotection in pregnancy

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.

omega 3 fatty acid; pregnancy; type 1 diabetes

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