Reduced DHA transfer in diabetic pregnancies: mechanistic basis and long-term neurodevelopmental implications

Michelle P Judge; Sharon G Casavant; Juliana A M Dias; Jacqueline M McGrath

doi:10.1093/nutrit/nuw006

Reduced DHA transfer in diabetic pregnancies: mechanistic basis and long-term neurodevelopmental implications

Nutr Rev. 2016 Jun;74(6):411-20. doi: 10.1093/nutrit/nuw006. Epub 2016 May 3.

Authors

Michelle P Judge¹, Sharon G Casavant², Juliana A M Dias², Jacqueline M McGrath²

Affiliations

¹ M.P Judge, S.G. Casavant, J.A.M. Dias, and J.M. McGrath are with the University of Connecticut, School of Nursing, Storrs, Connecticut, USA. J.M. McGrath and S.G. Casavant are with the Connecticut Children's Medical Center, Hartford, Connecticut, USA.J.A.M. Dias is with the Nursing Department, Federal University of Ceará, Fortaleza Ceará, Brazil. [email protected].
² M.P Judge, S.G. Casavant, J.A.M. Dias, and J.M. McGrath are with the University of Connecticut, School of Nursing, Storrs, Connecticut, USA. J.M. McGrath and S.G. Casavant are with the Connecticut Children's Medical Center, Hartford, Connecticut, USA.J.A.M. Dias is with the Nursing Department, Federal University of Ceará, Fortaleza Ceará, Brazil.

Abstract

Infants born to diabetic mothers have a higher frequency of impaired neurodevelopment. The omega-3 or n-3 fatty acid docosahexaenoic acid (DHA) is an important structural component of neural tissue and is critical for fetal brain development. Maternal DHA supplementation during pregnancy is linked to better infant neurodevelopment; however, maternal-fetal transfer of DHA is reduced in women with diabetes. Evidence of mechanisms explaining altered maternal-fetal DHA transfer in this population is limited. This review explores existing evidence underpinning reduced maternal-fetal DHA transfer in maternal fuel metabolism in this population. Further research is necessary to evaluate the role of peroxisome proliferator-activated receptors in modulating placental fatty acid binding and maternal-fetal DHA transfer. Considerations for clinical practice include a diet high in DHA and/or provision of supplemental DHA to obstetric diabetic patients within minimum guidelines.

Keywords: PPAR; altered omega-3 transfer; diabetes; infant developmental outcomes; omega-3 fatty acids; pregestational type 2 diabetes..

Publication types

Review

MeSH terms

Brain / growth & development*
Diabetes Mellitus / metabolism*
Docosahexaenoic Acids / metabolism*
Female
Fetal Development*
Humans
Maternal-Fetal Exchange*
Neuroprotective Agents / metabolism*
Placenta / metabolism
Pregnancy
Pregnancy in Diabetics / metabolism*

Substances

Neuroprotective Agents
Docosahexaenoic Acids