Fatty acids in obese pregnancies: maternal and child outcomes
- Autores: Andrea de la Garza Puentes
- Directores de la Tesis: María del Carmen López Sabater (dir. tes.), Ana Isabel Castellote Bargalló (codir. tes.)
- Lectura: En la Universitat de Barcelona ( España ) en 2017
- Idioma: español
- Tribunal Calificador de la Tesis: Rosa María Lamuela Raventós (presid.), Maria Rodriguez Palmero Seuma (secret.), Montserrat Fitó Colomer (voc.)
- Materias:
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- Resumen
Fatty Acids in Obese Pregnancies: Maternal and Child Outcomes Abstract Maternal obesity has implications on the health of future generations by early life programming. The mother is usually the main source of nutrients for the fetus and neonate, hence her nutritional status is crucial for child development. Fatty acids (FAs), especially long chain polyunsaturated fatty acids (LC-PUFAs), are key nutrients in fetal growth and development. Since these nutrients are known to be altered by conditions such as obesity, maternal obesity could impair fetal/neonatal FA supply, and consequently child outcomes.
This thesis presents 4 manuscripts about the influence of maternal pre-pregnancy weight on FA quality and concentrations, along with the implications on maternal and child outcomes. We studied mother-child pairs selected from the total participants in the observational PREOBE cohort study and divided them into 4 groups according to maternal pre-pregnancy body mass index (BMI) and gestational diabetes status; 1) normal-weight, overweight, obese and gestational diabetic. We investigated if FADS and ELOVL genetic variants were associated with pre-pregnancy BMI or affected PUFA levels in plasma of pregnant women. We found that minor allele carriers of FADS1 and FADS2 SNPs had an increased risk for obesity and that the effects of genotype on plasma FA concentrations differed by maternal pre-pregnancy weight status. Enzymatic activity and FA levels were reduced in normal-weight women who were minor allele carriers of FADS SNPs; these reductions were not significant in overweight/obese participants. This suggests that women with a BMI>25 are less affected by FADS genetic variants in this regard. In the presence of FADS2 and ELOVL2 SNPs, overweight/obese women showed higher n-3 LC-PUFA production indexes in plasma than those women in the normal-weight group, but this was not enough to obtain a higher n3 LC-PUFA concentration. We also analyzed the differences in colostrum PUFA composition according to maternal pre-gestational BMI and FADS genotype. A high maternal pre-pregnancy BMI was associated with altered FA levels in colostrum, nevertheless FADS genotypes modulated these results. Minor allele carriers resulted with decreased enzymatic activity and PUFA levels only in normal-weight individuals, making their FA levels similar to those of overweight/obese women. Therefore, FADS genetic variation in overweight/obese women had a different impact, possibly improving their FA status. We also found that dietary intake of DHA in late pregnancy influenced colostrum levels of DHA, thus a high intake of this FA could be a recommendation to improve breast milk composition.
Prior to FA analysis in the infants, we validated cheek cells and capillary blood as less invasive alternatives to traditional plasma sampling for FA analysis. We determined the impact of maternal BMI and/or infant feeding practice in infant FA concentrations, and analyzed if these FAs associated with cognitive performance. Maternal pre-pregnancy BMI altered the infant FA behavior in evolution, feeding practice and cognition. In general, FA concentrations decreased towards the 3 years of life, except for the SFAs, n6:n3 and LC-n6:n3 ratios which were increased. Exclusive breastfeeding seemed to rise crucial FAs (e.g. DHA) in infants at 6 months of age, and cognitive performance was found improved in infants with high levels of PUFAs (e.g. DHA, AA) until 1.5 years of age (e.g. n3 PUFAs).
These results are a contribution to the scientific evidence of the importance of a healthy pre-pregnancy weight, and identify groups of women who could benefit from an adequate FA intake to pursue better infant outcomes. We therefore should promote a healthy weight and diet in women before, during and after pregnancy to have beneficial effect in children, and consequently prevent some nutrition-related issues through their life.
