Overweight and Pre-Pregnancy Obesity (OWOB) are associated with higher birth obesity, abnormal fetal growth (large and small in gestational infants), and medically indicated and spontaneous premature births.
Polyunsaturated fatty acids (PUFA) have been found to modulate inflammation, insulin sensitivity, and lipid metabolism. A recently published Cochrane study showed that omega-3 supplementation was associated with a reduced risk of premature birth and low birth weight (BW).
Animal studies and post-hoc analysis from previous RCTs suggest that women with higher baseline metabolic dysregulation and low n-3 status may benefit most from supplementation. However, there are no studies that assess the role of supplementation specifically in these cohorts with higher risk.
The authors of the current study previously reported that in women with OWOB, a higher n-6 / n-3 PUFA ratio was associated with a shorter gestation period and impaired fetal growth. However, the effects of n-3 PUFA supplementation on length of pregnancy and outcomes in newborns, especially women with OWOB, are not yet known.
The current double-blind pilot RCT included 48 healthy women (24 placebo and 24 supplements) with a body mass index (BMI)> 25 kg / m2 and was carried out to assess the effects of n-3 supplementation from early pregnancy ( <16 weeks).
The study was unique in that it specifically included women with OWOB who have an increased risk of premature birth and a unique metabolism characterized by chronic low-level inflammation, oxidative stress, and an imbalance between pro-inflammatory n-6 and anti-inflammatory drugs. flammable n-3 PUFA.
Blister packs were dispensed monthly during routine obstetric visits that were checked for compliance and side effects. For each study participant, there were two visits to the MetroHealth Medical Center’s clinical research unit (CRU): one between 8 and 16 weeks and two between 34 and 36 weeks
The researchers in this study previously reported the primary results of this study that n-3 PUFA supplementation reduced systemic and placental inflammation, and in a secondary analysis of the study they reported that n-3 PUFA supplementation reduced the placenta – Reduced lipid storage.
The aim of this report was to examine the results to examine the preliminary efficacy of n-3 PUFA supplementation on neonatal obesity, fetal growth, and length of gestation.
The results suggest that supplementation with n-3 PUFA resulted in increased muscle mass at birth, improved fetal growth and a longer pregnancy. However, the effects of dietary supplementation were only noticeable in women with a high n-6 / n-3 ratio in the diet, suggesting that dietary supplementation with n-3 is particularly beneficial in mothers with overall poor nutritional quality and high metabolic dysfunction can be.
The authors also point out that supplementing women who are already high in omega-3 PUFAs may increase the risk of premature delivery.
They also found that, unlike previous studies, n-3 supplementation was more effective in male babies compared to females.
The report concludes, “This pilot study provides preliminary evidence that supplementation with n-3 PUFA during pregnancy in women with OWOB for ~ 25 weeks can increase fetal lean mass accumulation, improve fetal growth, and extend pregnancy.
“Improving n-3 status in pregnancy may be useful as a prophylactic intervention in some women, especially women with high-risk pregnancies, such as women with obesity. Larger studies with adequate performance on n-3 supplementation or Dietary Intervention Specific to Women with OWOB onset before conception or early in pregnancy should be done to confirm these results and to study the long-term effects on offspring obesity and cardiometabolic health. ”
Maternal obesity-related inflammation has been found to be associated with altered placenta lipid metabolism and insulin signals, which are believed to result in excessive nutrient transport resulting in increased fetal fat accretion. Placental inflammation can also lead to abnormal placentation and vasculature, which can lead to placental insufficiency, resulting in restriction of intrauterine growth and premature birth. This adverse metabolic environment is linked to metabolic programming of the offspring and has lifelong consequences.
Prospective cohort studies have shown associations of higher n-6 PUFA with lower birth weight (BW), higher fat mass (FM), and higher body fat, as well as associations of higher n-3 with higher lean mass (LM) and lower childhood obesity. Animal studies have shown that interventions to increase the ratio of anti-inflammatory omega-3 (n-3) to pro-inflammatory n-6 can reduce obesity-related inflammation and insulin resistance and prevent adverse metabolic programming in the offspring.
Prior to the current study, several n-3 randomized controlled trials (RCTs) reported mixed results, and systematic reviews were inconclusive regarding the effects of n-3 supplementation on outcomes in newborns, particularly offspring body composition.
Catalan. PM et al
“Effect of Omega-3 Supplementation in Obese Pregnant Women on Newborn Composition, Growth, and Length of Gestation: A Randomized Controlled Pilot Study”
https://doi.org/10.3390/nu13020578 (registration of DOI)