The Role of Docosahexaenoic Acid in the Development of Preeclampsia and Perinatal Outcomes

Background/Objectives: Preeclampsia is a leading cause of maternal and perinatal morbidity worldwide, yet its underlying mechanisms remain unclear. Polyunsaturated fatty acids, particularly docosahexaenoic acid (DHA), are essential for placental development and vascular function, but evidence on their role in preeclampsia is inconsistent. This study aimed to compare serum DHA levels between women with preeclampsia and normotensive pregnant women and to examine their association with disease severity and maternal and perinatal outcomes. Methods: A total of 145 pregnant women aged 18-40 years were enrolled, including 47 with newly diagnosed preeclampsia (PE) and 98 normotensive controls. PE was defined according to the ACOG 2019 criteria. Serum DHA levels were measured using ELISA in fasting blood samples collected at the first visit. Results: Maternal serum DHA levels did not differ significantly between preeclampsia and control groups (p = 0.571); they were similar across control, mild PE, and severe PE groups. DHA showed a negative correlation with neutrophil-to-lymphocyte ratio (r = -0.305) and maternal hospitalization duration (r = -0.334). Independent predictors of PE included nulliparity (OR: 4.43), advanced age (OR: 1.14), elevated BMI (OR: 1.29), and low albumin (OR: 0.77). After adjusting for age and BMI, DHA was an independent negative predictor of IUGR (OR: 0.65). Conclusions: DHA levels: Placental and/or fetal DHA metabolism may be impaired in patients with preeclampsia. Although DHA was not associated with the development of PE, it was a negative predictor of IUGR. DHA reduces the length of maternal hospital stay through its anti-inflammatory effect.