Long-chain polyunsaturated fatty acid (LC-PUFA) status in severe preeclampsia and preterm birth: a cross sectional study

Irwinda R., Hiksas R., Siregar A.A., Saroyo Y.B., Wibowo N.

Maternal Fetal Division, Department of Obstetrics and Gynaecology, Faculty of Medicine, Universitas Indonesia/Cipto-Mangunkusumo Hospital, Jakarta, Indonesia; Faculty of Medicine, Universitas Indonesia/Cipto-Mangunkusumo Hospital, Jakarta, Indonesia


Abstract

Long-Chain Polyunsaturated Fatty Acid (LCPUFA) is essential throughout pregnancy, since deficiency of LPUFA may linked to obstetrical complications. This study aimed to investigate LCPUFA status in severe preeclampsia and preterm birth. A cross sectional study was conducted in 104 pregnant women, which divided into normal pregnancy, severe preeclampsia and preterm birth groups. Serum percentage and concentration of total LCPUFA, omega-3, alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), omega-6, linoleic acid (LA), and arachidonic acid (AA) were measured using gas chromatography/mass spectrometry. Receiver operating characteristic (ROC), bivariate and multivariate analysis were performed. Severe preeclampsia showed the highest concentration of total PUFA and the lowest DHA percentage, with significantly higher Omega-6/Omega-3 ratio (p = 0.004) and lower omega-3 index (p < 0.002) compared to control. Preterm birth showed the least omega-3 concentrations, with significantly low omega-6 derivates (LA (p = 0.014) and AA (p = 0.025)) compared to control. LCPUFA parameters have shown to increase the risk in both conditions, particularly ALA ≤ 53 µmol/L in preeclampsia with OR 5.44, 95%CI 1.16–25.42 and preterm birth with OR 4.68, 95%CI 1.52–14.38. These findings suggest that severe preeclampsia and preterm birth have an imbalance in LCPUFA status. © 2021, The Author(s).


Journal

Scientific Reports

Publisher: Nature Research

Volume 11, Issue 1, Art No 14701, Page – , Page Count


Journal Link: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85110662198&doi=10.1038%2fs41598-021-93846-w&partnerID=40&md5=f379da0f3a9e78e16af9cc0ca6bb9968

doi: 10.1038/s41598-021-93846-w

Issn: 20452322

Type: All Open Access, Gold, Green


References

Leghi, G.E., Muhlhausler, B.S., The effect of n-3 LCPUFA supplementation on oxidative stress and inflammation in the placenta and maternal plasma during pregnancy (2016) Prostaglandins Leukot. Essent. Fat. Acids, 113, pp. 33-39. , COI: 1:CAS:528:DC%2BC28XhsVKqsLbE; Ogundipe, E., Johnson, M.R., Wang, Y., Crawford, M.A., Peri-conception maternal lipid profiles predict pregnancy outcomes (2016) Prostaglandins Leukot. Essent. Fat. Acids, 114, pp. 35-43. , COI: 1:CAS:528:DC%2BC28XhslShs7rF; Taylor, R.M., Effects of nutritional interventions during pregnancy on infant and child cognitive outcomes: A systematic review and meta-analysis (2017) Nutrients, 9, p. 1265. , COI: 1:CAS:528:DC%2BC1cXitFegurvO, PID: 5707737; Kofod Vinding, R., Fish oil supplementation in pregnancy increases gestational age, size for gestational age, and birth weight in infants: A randomized controlled trial (2019) J. Nutr., 149, pp. 628-634; Amaral, L.M., Wallace, K., Owens, M., Lamarca, B., Pathophysiology and current clinical management of preeclampsia (2018) Curr. Hypertens. Rep., 19, p. 61. , COI: 1:CAS:528:DC%2BC2sXhtFKhs7zF; Tenório, M.B., Cross-Talk between oxidative stress and inflammation in preeclampsia (2019) Oxid. Med. Cell. Longev., p. 2019; Boyle, A.K., Rinaldi, S.F., Norman, J.E., Stock, S.J., Preterm birth: Inflammation, fetal injury and treatment strategies (2017) J. Reprod. Immunol., 119, pp. 62-66. , PID: 28122664; Aung, M.T., Prediction and associations of preterm birth and its subtypes with eicosanoid enzymatic pathways and inflammatory markers (2019) Sci. Rep., 9, pp. 1-17; Braunthal, S., Brateanu, A., Hypertension in pregnancy: Pathophysiology and treatment (2019) SAGE Open Med., 7, pp. 1-15; Depatemen Kesehatan Indonesia (2018) Riset Kesehatan Dasar, , http://www.yankes.kemkes.go.id/assets/downloads/PMKNo.57Tahun2013tentangPTRM.pdf(; Chawanpaiboon, S., Global, regional, and national estimates of levels of preterm birth in 2014: A systematic review and modelling analysis (2019) Lancet Glob. Heal., 7, pp. e37-e46; Wibowo, N., Assessment of the nutrient intake and micronutrient status in the first trimester of pregnant women in Jakarta (2017) Med. J. Indones., 26, pp. 109-115; Wibowo, N., Long-chain polyunsaturated fatty acid status in first-trimester pregnant women (2018) Med. J. Indones., 27, pp. 155-160; Karadaǧ, Ö., Aktaş, S., Optimal sample size determination for the ANOVA designs (2012) Int. J. Appl. Math. Stat., 25, pp. 127-134; Olsen, S.F., Plasma concentrations of long chain N-3 fatty acids in early and mid-pregnancy and risk of early preterm birth (2018) EBioMedicine, 35, pp. 325-333. , COI: 1:STN:280:DC%2BB3c7lsFKltA%3D%3D, PID: 30082226; Mahomed, K., Williams, M.A., King, I.B., Mudzamiri, S., Woelk, G.B., Erythrocyte omega-3, omega-6 and trans fatty acids in relation to risk of preeclampsia among women delivering at Harare Maternity Hospital Zimbabwe (2007) Physiol. Res., 56, pp. 37-50. , COI: 1:CAS:528:DC%2BD2sXksVSisbk%3D, PID: 16497090; The American Collge of Obstetricians and Gynecologists (2013) Hypertension in Pregnancy, 122, pp. 1122-1131; Ren, J., Total serum fatty acid analysis by GC-MS: Assay validation and serum sample stability (2013) Curr. Pharm. Anal., 9, pp. 331-339. , COI: 1:CAS:528:DC%2BC3sXhslSqs7zM, PID: 25110470; (2014) C6A-2: Liquid Chromatography-Mass Spectrometry Methods, , Clinical and Laboratory Standards Institute; Lagerstedt, S.A., Quantitative determination of plasma C8–C26 total fatty acids for the biochemical diagnosis of nutritional and metabolic disorders (2001) Mol. Genet. Metab., 45, pp. 38-45. , COI: 1:CAS:528:DC%2BD3MXjtlOqt7g%3D; Abdelmagid, S.A., Comprehensive profiling of plasma fatty acid concentrations in young healthy canadian adults (2015) PLoS ONE, 10, pp. 1-16. , COI: 1:CAS:528:DC%2BC2MXhs1Whur3O; Stark, K.D., Van Elswyk, M.E., Higgins, M.R., Weatherford, C.A., Salem, N., Global survey of the omega-3 fatty acids, docosahexaenoic acid and eicosapentaenoic acid in the blood stream of healthy adults (2016) Prog. Lipid Res., 63, pp. 132-152. , COI: 1:CAS:528:DC%2BC28Xpslyitr0%3D, PID: 27216485; Liu, L., Maternal body mass index and risk of neonatal adverse outcomes in China: A systematic review and meta-analysis (2019) BMC Pregnancy Childbirth, 19, pp. 1-12; Otto, S.J., Van Houwelingen, A.C., Badart-Smook, A., Hornstra, G., Changes in the maternal essential fatty acid profile during early pregnancy and the relation of the profile to diet (2001) Am. J. Clin. Nutr., 73, pp. 302-307. , COI: 1:CAS:528:DC%2BD3MXpsFejtA%3D%3D, PID: 11157328; Zhang, T., Xia, Y., Han, T.L., Zhang, H., Baker, P.N., Five serum fatty acids are associated with subclinical hypothyroidism in a Chinese pregnant population (2020) Sci. Rep., 10, pp. 1-9. , COI: 1:CAS:528:DC%2BB3cXitlWjtrbJ; Stewart, F., Longitudinal assessment of erythrocyte fatty acid composition throughout pregnancy and post partum (2007) Lipids, 42, pp. 335-344. , COI: 1:CAS:528:DC%2BD2sXkvFCmtL0%3D, PID: 17406928; von Schacky, C., Omega-3 fatty acids in pregnancy—The case for a target omega-3 index (2020) Nutrients, 12, pp. 1-12; Simmonds, L.A., Omega-3 fatty acid supplementation in pregnancy—Baseline omega-3 status and early preterm birth: Exploratory analysis of a randomised controlled trial (2020) BJOG An Int. J. Obstet. Gynaecol., 127, pp. 975-981. , COI: 1:CAS:528:DC%2BB3cXhtF2jsLbO; Qiu, C., Erythrocyte omega-3 and omega-6 polyunsaturated fatty acids and preeclampsia risk in Peruvian women (2006) Arch. Gynecol. Obstet., 274, pp. 97-103. , COI: 1:CAS:528:DC%2BD28XjslGjtbs%3D, PID: 16520922; Carvajal, J.A., Docosahexaenoic acid supplementation early in pregnancy may prevent deep placentation disorders (2014) Biomed. Res. Int., 2014; Salvig, J.D., Lamont, R.F., Evidence regarding an effect of marine n-3 fatty acids on preterm birth: A systematic review and meta-analysis (2011) Acta Obstet. Gynecol. Scand., 90, pp. 825-838. , COI: 1:CAS:528:DC%2BC3MXpsV2iuro%3D, PID: 21535434; Mehendale, S., Fatty acids, antioxidants, and oxidative stress in pre-eclampsia (2008) Int. J. Gynecol. Obstet., 100, pp. 234-238. , COI: 1:CAS:528:DC%2BD1cXitlemur4%3D; Samuel, T.M., Preterm birth: A narrative review of the current evidence on nutritional and bioactive solutions for risk reduction (2019) Nutrients, 11, pp. 1-26; Swanson, D., Block, R., Mousa, S.A., Omega-3 fatty acids EPA and DHA: Health benefits throughout life (2012) Adv. Nutr., 3, pp. 1-7. , COI: 1:CAS:528:DC%2BC38XjtFGmtLw%3D, PID: 22332096; Bobiński, R., Mikulska, M., The ins and outs of maternal-fetal fatty acid metabolism (2015) Acta Biochim. Pol., 62, pp. 499-507. , PID: 26345097, COI: 1:CAS:528:DC%2BC28XntFSntA%3D%3D; Rajaram, S., Health benefits of plant-derived a-linolenic acid 1–3 (2014) Am. J. Clin. Nutr., 3, pp. 443-449. , COI: 1:CAS:528:DC%2BC2cXhtFWhtL%2FO; Coletta, J.M., Bell, S.J., Roman, A.S., Fish, omega-3 fatty acids, and pregnancy (2011) Harv. Ment. Health Lett., 27, p. 7; Arvizu, M., Afeiche, M.C., Hansen, S., Halldorsson, T.F., Chavarro, J.E., Fat intake during pregnancy and risk of preeclampsia: a prospective cohort study in Denmark (2020) Eur. J. Clin. Nutr., 73, pp. 1040-1048. , COI: 1:CAS:528:DC%2BC1cXhs12it7bE; De Giuseppe, R., Roggi, C., Cena, H., n-3 LC-PUFA supplementation: Effects on infant and maternal outcomes (2014) Eur. J. Nutr., 53, pp. 1147-1154. , PID: 24448975, COI: 1:CAS:528:DC%2BC2cXhtlWmtrjK; Carlson, S.E., DHA supplementation and pregnancy outcomes (2013) Am. J. Clin. Nutr., 97, pp. 808-815. , COI: 1:CAS:528:DC%2BC3sXlt1Sqtro%3D, PID: 23426033; Ciesielski, T.H., Bartlett, J., Williams, S.M., Omega-3 polyunsaturated fatty acid intake norms and preterm birth rate: A cross-sectional analysis of 184 countries (2019) BMJ Open, 9, pp. 1-9. , COI: 1:CAS:528:DC%2BC1MXhtl2rtbrO; Wadhwani, N., Altered maternal proportions of long chain polyunsaturated fatty acids and their transport leads to disturbed fetal stores in preeclampsia (2014) Prostaglandins Leukot. Essent. Fat. Acids, 91, pp. 21-30. , COI: 1:CAS:528:DC%2BC2cXpslKksbo%3D; Mackay, V.A., Huda, S.S., Stewart, F.M., Tham, K., Louise, A., Preeclampsia is associated with compromised maternal synthesis of long chain polysaturated fatty acids lading to offspirng deficiency (2013) Hypertension, 60, pp. 1078-1085. , COI: 1:CAS:528:DC%2BC38XhtlemsbbL; Kulkarni, A.V., Mehendale, S.S., Yadav, H.R., Joshi, S.R., Reduced placental docosahexaenoic acid levels associated with increased levels of sFlt-1 in preeclampsia (2011) Prostaglandins Leukot. Essent. Fat. Acids, 84, pp. 51-55. , COI: 1:CAS:528:DC%2BC3MXjvF2jug%3D%3D; Robinson, N.J., Minchell, L.J., Myers, J.E., Hubel, C.A., Crocker, I.P., A potential role for free fatty acids in the pathogenesis of preeclampsia (2009) J. Hypertens., 27, pp. 1293-1302. , COI: 1:CAS:528:DC%2BD1MXmtVKgs70%3D, PID: 19462499; Wadhwani, N., Patil, V., Joshi, S., Prostaglandins, leukotrienes and essential fatty acids maternal long chain polyunsaturated fatty acid status and pregnancy complications (2018) Prostaglandins Leukot. Essent. Fat. Acids, 136, pp. 143-152. , COI: 1:CAS:528:DC%2BC2sXhsVKgu73L; Nelson, J.R., Raskin, S., The eicosapentaenoic acid:arachidonic acid ratio and its clinical utility in cardiovascular disease (2019) Postgrad. Med., 131, pp. 268-277. , COI: 1:STN:280:DC%2BB3M7jt1Ckuw%3D%3D, PID: 31063407; Tutino, V., Elevated AA/EPA ratio represents an inflammatory biomarker in tumor tissue of metastatic colorectal cancer patients (2019) Int. J. Mol. Sci., 20, p. 2050. , COI: 1:CAS:528:DC%2BB3cXpvVentA%3D%3D, PID: 6515168; Marion-Letellier, R., Savoye, G., Ghosh, S., Polyunsaturated fatty acids and inflammation (2015) IUBMB Life, 67, pp. 659-667. , COI: 1:CAS:528:DC%2BC2MXhsFCisb7P, PID: 26397837; Xu, Z., Preeclampsia is associated with a deficiency of lipoxin A4, an endogenous anti-inflammatory mediator (2014) Fertil. Steril., 102, pp. 282-290. , COI: 1:CAS:528:DC%2BC2cXnsFCjtrY%3D, PID: 24796762; Szczuko, M., Palma, J., Kikut, J., Komorniak, N., Ziętek, M., Changes of lipoxin levels during pregnancy and the monthly—cycle, condition the normal course of pregnancy or pathology (2020) Inflamm. Res., 69, pp. 869-881. , COI: 1:CAS:528:DC%2BB3cXhtVOjt73E, PID: 32488315

Indexed by Scopus

Leave a Comment