First-Trimester Serum n-3/n-6 Fatty Acids Predict Large-for-Gestational-Age Risk: A Nested Case-Control Study

Area of Science:

• Obstetrics and Gynecology
• Nutritional Science
• Perinatal Development

Background:

• Polyunsaturated fatty acids (PUFAs) are essential for fetal growth and development.
• Maternal PUFA status during pregnancy may influence fetal growth trajectories.
• Large-for-gestational-age (LGA) infants are associated with increased risks of adverse perinatal and long-term health outcomes.

Purpose of the Study:

• To investigate the association between maternal serum concentrations of n-3 and n-6 PUFAs in early pregnancy and the risk of delivering LGA infants.
• To identify specific PUFAs that may predict or be associated with LGA.
• To explore the potential role of PUFA profiles in guiding prenatal nutritional strategies.

Main Methods:

• A nested case-control study design was employed, including 45 matched pairs of LGA and appropriate-for-gestational-age (AGA) infants.
• Maternal serum samples were collected in early pregnancy from a cohort of 2839 women.
• Lipid profiles, including various PUFAs, were analyzed using gas chromatography-mass spectrometry (GC-MS).
• Statistical analyses, including Spearman correlation, chi-square tests, and logistic regression, were used to assess associations.

Main Results:

• Higher serum levels of arachidonic acid (ARA) and docosahexaenoic acid (DHA) were positively correlated with an increased risk of LGA.
• Elevated quartiles of ARA and DHA were associated with significantly increased odds of LGA.
• Conversely, higher levels of linoleic acid (LA), alpha-linolenic acid (ALA), and the n-6/n-3 PUFA ratio were negatively correlated with LGA risk.
• Higher overall n-6 PUFA levels were found to be protective against LGA.

Conclusions:

• Maternal serum n-3 and n-6 PUFA levels in early pregnancy are significantly associated with the risk of delivering LGA infants.
• Specific PUFAs, namely ARA and DHA, may contribute to an increased risk of LGA, while higher n-6 PUFA intake might be protective.
• These findings highlight the potential of monitoring PUFA levels as early indicators for personalized nutritional interventions during pregnancy to optimize fetal growth.