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Intrauterine growth restriction is associated with changes in polyunsaturated fatty acid fetal-maternal relationships
Irene Cetin1, Niccolò Giovannini, Gioia Alvino
1Department of Obstetrics and Gynecology, DMCO Ospedale San Paolo, University of Milano, 20142 Milano, Italy. irene.cetin@unimi.it
Insights
Intrauterine growth restriction (IUGR) impairs fetal-maternal fatty acid transfer in utero. Specific fatty acid ratios differ in IUGR pregnancies, potentially impacting fetal development and complications.
Area of Science:
- Perinatal Medicine
- Biochemistry
- Fetal Development
Background:
- Intrauterine growth restriction (IUGR) fetuses face increased risks postnatally.
- Postnatal essential fatty acid deficits are linked to neural and vascular issues in neonates.
Purpose of the Study:
- To investigate if fetal-maternal fatty acid relationships are impaired in utero in IUGR pregnancies.
- To compare fatty acid profiles between fetuses appropriate for gestational age (AGA) and those with IUGR.
Main Methods:
- Fetal blood sampling (FBS) was used to determine fetal (F) and maternal (M) plasma fatty acid profiles.
- Profiles were analyzed in 11 AGA and 10 IUGR fetuses between 19 and 39 weeks gestation.
Main Results:
- Total plasma fatty acid concentrations were similar between mothers and fetuses in both AGA and IUGR groups.
- The fetal/maternal ratio for linoleic acid was higher in IUGR fetuses.
- Ratios for docosahexaenoic acid and arachidonic acid were lower in IUGR fetuses compared to AGA fetuses.
Conclusions:
- Altered relative fatty acid amounts, not total concentrations, characterize IUGR pregnancies.
- These differences may stem from inadequate placental transfer or fetal enzyme deficiencies.
- Impaired fatty acid relationships in IUGR could contribute to associated neural and vascular complications.
Abstract:
Fetuses with intrauterine growth restriction (IUGR) are at increased risk of death and disease during neonatal, pediatric, and adult life. Postnatal deficits in essential fatty acids have been associated with the neural and vascular complications of premature neonates. We studied whether fetal-maternal fatty acid relationships are already impaired in utero in IUGR fetuses. Fetal (F) and maternal (M) fatty acid profiles were determined in utero in 11 normal [appropriate for gestational age (AGA)] and in 10 IUGR fetuses by fetal blood sampling (FBS) between 19 and 39 wk. Total plasma fatty acid concentrations were significantly higher in M than in F of both AGA (M: 2.03 +/- 0.53 mg/mL; F: 0.64 +/- 0.29 mg/mL; p < 0.001) and IUGR (M: 2.16 +/- 0.59 mg/mL; F: 0.73 +/- 0.17 mg/mL; p < 0.001). The F/M ratio was significantly higher for linoleic acid (AGA: 0.36 +/- 0.09; IUGR: 0.52 +/- 0.12; p < 0.01) and significantly lower for the long-chain polyunsaturated fatty acid docosahexaenoic acid (AGA: 1.94 +/- 0.32; IUGR: 1.25 +/- 0.19; p < 0.05) and arachidonic acid (AGA: 2.35 +/- 0.35%; IUGR: 2.04 +/- 0.3%; p < 0.05) in IUGR compared with AGA pregnancies. The differences observed in the relative amounts but not in total plasma concentrations of fatty acid fetal-maternal relationships in pregnancies associated with IUGR could be related to inadequate transplacental supply as well as to a fetal lack of the enzymes necessary for elaboration of these metabolically relevant conditionally essential fatty acids. These differences might have a role in determining the biochemical environment leading to the neural and vascular complications associated with IUGR.