What is the relationship between gestational age and docosahexaenoic acid (DHA) and arachidonic acid (ARA) levels?

Abstract

Long chain polyunsaturated fatty acids (LCPUFA) including docosahexaenoic acid (DHA) and arachidonic acid (ARA) are increasingly transferred from mother to fetus late in pregnancy. Infants born before this transfer is complete are at risk for deficiency. This study determines the relationship between gestational age (GA) and circulating LCPUFA levels to better understand the unique needs of premature infants born at various GAs. Whole blood was collected within the first 7 days of life from 60 preterm (≤34 weeks GA) and 30 term infants (≥38 weeks GA) and FA levels were analyzed. Since concurrent intravenous lipid emulsion can skew composition data, blood LCPUFA concentrations were also measured. Levels were compared among groups, and linear regression models were used to examine the association between FA composition and GA. Preterm infants had significantly lower DHA and ARA levels than term peers, and whether assessed as concentrations or compositions, both directly correlated with GA (p<0.0001). Moreover, FA comparisons suggest that premature infants have impaired synthesis of LCPUFAs from precursors and may require preformed DHA and ARA. This study confirms that essential FA status is strongly related to GA, and that those babies born the earliest are at the greatest risk of LCPUFA deficiency.

Trial registration: ClinicalTrials.gov NCT01908907.

Keywords: Arachidonic acid; Docosahexaenoic acid; Essential fatty acids; Long chain polyunsaturated acids; Neonatal nutrition; Prematurity.

Conflict of interest statement

Conflict of Interest Statement

Dr. William S. Harris who serves as a senior mentor to Dr. Baack, is the Founder and President of OmegaQuant, LLC, but has no foreseen financial gain from publication of this work. Additional authors declare no conflict of interest.

Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Figures

Figure 1

Relationships between gestational age and blood arachidonic acid (ARA) levels expressed as a composition or percent of total blood fatty acids (top) and as a concentration (bottom).

Figure 2

Relationships between gestational age and blood docosahexaenoic acid (DHA) levels expressed as a composition or percent of total blood fatty acids (top) and as a concentration (bottom).

Figure 3

Apparent point of inhibition of omega-6 LCPUFA synthesis in premature infants (arrows indicate how FA levels in premature infants compare with those in term infants).