title: Polyunsaturated Fatty Acid (PUFA) Status in Pregnant Women: Associations with Sleep Quality, Inflammation, and Length of Gestation.
abstract: Mechanistic pathways linking maternal polyunsaturated fatty acid (PUFA) status with gestational length are poorly delineated. This study examined whether inflammation and sleep quality serve as mediators, focusing on the antiinflammatory ω-3 docosahexaenoic acid (DHA; 22:6n3) and proinflammatory ω-6 arachidonic acid (AA; 20:4n6). Pregnant women (n = 135) provided a blood sample and completed the Pittsburgh Sleep Quality Index (PSQI) at 20-27 weeks gestation. Red blood cell (RBC) fatty acid levels were determined by gas chromatography and serum inflammatory markers [interleukin (IL)-6, IL-8, tumor necrosis factor-α, IL-1β, and C-reactive protein] by electrochemiluminescence using high sensitivity kits. Both higher serum IL-8 (95% CI = 0.10,3.84) and poor sleep (95% CI = 0.03,0.28) served as significant mediators linking lower DHA:AA ratios with shorter gestation. Further, a serial mediation model moving from the DHA:AA ratio → sleep → IL-8 → length of gestation was statistically significant (95% CI = 0.02, 0.79). These relationships remained after adjusting for depressive symptoms, age, BMI, income, race, and smoking. No interactions with race were observed in relation to length of gestation as a continuous variable. However, a significant interaction between race and the DHA:AA ratio in predicting preterm birth was observed (p = 0.049); among African Americans only, odds of preterm birth decreased as DHA:AA increased (p = 0.048). These data support a role for both inflammatory pathways and sleep quality in linking less optimal RBC PUFA status with shorter gestation in African American and European American women and suggest that African-Americans have greater risk for preterm birth in the context of a low DHA:AA ratio.
authors: Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America.|The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America.|Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America.|Department of Psychology, The Ohio State University, Columbus, Ohio, United States of America.
authors: Lisa M
authors: LM
authors: Christian
authors: College of Nursing, The Ohio State University, Columbus, Ohio, United States of America.
authors: Lisa M
authors: LM
authors: Blair
authors: Center for Biostatistics, The Ohio State University, Columbus, Ohio, United States of America.
authors: Kyle
authors: K
authors: Porter
authors: Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America.|The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America.
authors: Mary
authors: M
authors: Lower
authors: Program of Nutrition in the Department of Human Sciences, The Ohio State University, Columbus, Ohio, United States of America.
authors: Rachel M
authors: RM
authors: Cole
authors: Program of Nutrition in the Department of Human Sciences, The Ohio State University, Columbus, Ohio, United States of America.
authors: Martha A
authors: MA
authors: Belury
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D016718:Arachidonic Acid / Q000097:blood; D003430:Cross-Sectional Studies; D004912:Erythrocytes / Q000378:metabolism; D015525:Fatty Acids, Omega-3 / Q000097:blood; D005231:Fatty Acids, Unsaturated / Q000097:blood*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007249:Inflammation / Q000097:blood / Q000150:complications; D018836:Inflammation Mediators / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008137:Longitudinal Studies; D008954:Models, Biological; D011247:Pregnancy / Q000097:blood*; D011248:Pregnancy Complications / Q000097:blood; D047928:Premature Birth / Q000097:blood; D012890:Sleep / Q000502:physiology; D044465:White People; D055815:Young Adult
chemical_list: C508606:CXCL8 protein, human; D015525:Fatty Acids, Omega-3; D005231:Fatty Acids, Unsaturated; D018836:Inflammation Mediators; D016209:Interleukin-8; D016718:Arachidonic Acid