title: Efficacy of docosahexaenoic acid-enriched formula to enhance maternal and fetal blood docosahexaenoic acid levels: Randomized double-blinded placebo-controlled trial of pregnant women with gestational diabetes mellitus.
abstract: Gestational diabetes mellitus (GDM) compromises the level of docosahexaenoic acid (DHA) in phospholipids of maternal and fetal red blood cells and fetal plasma. This is of some concern because of the importance of DHA for fetal neuro-visual development. We have investigated whether this abnormality could be rectified by supplementation with DHA-enriched formula.
  
  
  
  Women with GDM (n = 138) recruited from Newham University Hospital, London received two capsules of DHA-enriched formula (active-group) or high oleic acid sunflower seed oil (placebo-group) from diagnosis until delivery. Maternal (baseline and delivery) and fetal (cord blood) red blood cell and plasma phospholipid fatty acid composition, and neonatal anthropometry were assessed.
  
  
  
  One hundred and fourteen women (58 active, 56 placebo) completed the trial. The active-group compared with the placebo-group had significantly enhanced level of DHA in plasma phosphatidylcholine (4.5% vs 3.8%, P = 0.011), red blood cell phosphatidylcholine (2.7% vs 2.2%, P = 0.022) and phosphatidylethoanolamine (9.5% vs 7.6%, P = 0.002). There was no difference in cord plasma and red blood cell phospholipid DHA between the two groups. The neonates of the two groups of women had comparable anthropometric measurements at birth.
  
  
  
  Daily supplementation of 600 mg DHA enhances maternal but not fetal DHA status in pregnancy complicated by GDM. The inefficacy of the supplement to improve fetal status suggests that the transfer of DHA across the placenta maybe impaired in women with the condition. Regardless of the mechanisms responsible for the impairment of the transfer, the finding has implications for the management of neonates of women with GDM because they are born with a reduced level of DHA and the condition is thought to be associated with a risk of neuro-developmental deficits. We suggest that babies of women with GDM, particularly those not suckling, similar to the babies born prematurely require formula milk fortified with a higher level of DHA.
authors.affiliation: Lipidomics and Nutrition Research Centre, Faculty of Life Sciences and Computing, London Metropolitan University, London, UK. Electronic address: y.min@londonmet.ac.uk.
authors.forename: Yoeju
authors.initials: Y
authors.lastname: Min
authors.affiliation: Newham University Hospital National Health Service Trust, London, UK; Academic Department of Women's Health, Queen Mary's School of Medicine, University of London, London, UK.
authors.forename: Ovrang
authors.initials: O
authors.lastname: Djahanbakhch
authors.affiliation: Newham University Hospital National Health Service Trust, London, UK; Lipidomics and Nutrition Research Centre, Faculty of Life Sciences and Computing, London Metropolitan University, London, UK.
authors.forename: Joanne
authors.initials: J
authors.lastname: Hutchinson
authors.affiliation: Lipidomics and Nutrition Research Centre, Faculty of Life Sciences and Computing, London Metropolitan University, London, UK.
authors.forename: Sofia
authors.initials: S
authors.lastname: Eram
authors.affiliation: Lipidomics and Nutrition Research Centre, Faculty of Life Sciences and Computing, London Metropolitan University, London, UK.
authors.forename: Amritpal S
authors.initials: AS
authors.lastname: Bhullar
authors.affiliation: Newham University Hospital National Health Service Trust, London, UK.
authors.forename: Irene
authors.initials: I
authors.lastname: Namugere
authors.affiliation: Lipidomics and Nutrition Research Centre, Faculty of Life Sciences and Computing, London Metropolitan University, London, UK.
authors.forename: Kebreab
authors.initials: K
authors.lastname: Ghebremeskel
mesh_terms: D000328:Adult; D016640:Diabetes, Gestational / Q000097:blood / Q000178:diet therapy*; D019587:Dietary Supplements / Q000032:analysis; D004281:Docosahexaenoic Acids / Q000097:blood / Q000378:metabolism / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D047109:Fetal Development; D006801:Humans; D007004:Hypoglycemic Agents / Q000097:blood / Q000378:metabolism / Q000627:therapeutic use*; D007231:Infant, Newborn; D007408:Intestinal Absorption; D008131:London; D059012:Lost to Follow-Up; D008297:Male; D039382:Maternal Nutritional Physiological Phenomena; D008431:Maternal-Fetal Exchange; D009752:Nutritional Status; D010352:Patient Dropouts; D011247:Pregnancy; D000074242:Sunflower Oil / Q000032:analysis / Q000378:metabolism / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D007004:Hypoglycemic Agents; D000074242:Sunflower Oil; D004281:Docosahexaenoic Acids
keywords: Docosahexaenoic acid; Gestational diabetes mellitus; Pregnancy