Maternal long-chain polyunsaturated fatty acids and pregnancy outcome

Abstract

The mother provides various vital nutrients to the growing fetus during pregnancy. Maternal nutrient levels and fatty acids are critical for normal fetal growth and development. All fatty acids provide energy, but structural and metabolic functions primarily require the long-chain polyunsaturated fatty acids (LCPUFA). The biologically most active LCPUFA are docosahexaenoic acid (22:6, omega-3), eicosapentaenoic acid (20:5, omega-3), and arachidonic acid (AA, 20:4 omega-6) which are synthesized from their essential fatty acid precursors, alpha-linolenic acid (18:3, omega-3), and linoleic acid (18:2, omega-6). LCPUFA and their eicosanoid metabolites such prostaglandins and prostacyclins play a vital role in determining the length of gestation, initiation of labor, and placental growth and development. Storage of LCPUFA in maternal fat depots during early pregnancy serves as a sole source of LCPUFA for the growing fetus as the fetus has a limited capacity to synthesize LCPUFA due to lack of desaturases. Therefore, the amount of LCPUFA transported from the mother to fetus depends on maternal LCPUFA intake, metabolism, and placental uptake/transport of fatty acids. Accretion of maternal LCPUFA during pregnancy may reduce the risk of pregnancy complications such as preterm birth, intrauterine growth restriction, gestational diabetes mellitus, and preeclampsia. Maternal DHA and AA status positively influence fetal growth and brain development and also reduce the risk of developing non-communicable diseases in the offspring in adult life. This chapter describes the role of maternal LCPUFA in reducing the risk of adverse pregnancy outcomes.