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Omega-3 and omega-6 polyunsaturated fatty acids in neurodevelopment and prematurity: Correcting imbalances and
Simon C Dyall1, J Thomas Brenna2, Susan E Carlson3
1School of Life and Health Sciences, University of Roehampton, London, UK.
Insights
Preterm infants experience a significant drop in essential fatty acids like arachidonic acid (ARA) and docosahexaenoic acid (DHA) after birth, termed the Preterm PUFA Gap. This gap may contribute to long-term health issues in survivors.
Area of Science:
- Neonatal nutrition
- Developmental neuroscience
- Perinatal health
Background:
- Preterm birth affects 11% globally, with survivors facing increased chronic disorder risks.
- Arachidonic acid (ARA) and docosahexaenoic acid (DHA) are vital for infant development, particularly brain and visual systems.
- Fetal demand for ARA and DHA is high, met by placental transfer before birth.
Purpose of the Study:
- To review the role of docosahexaenoic acid (DHA) in preventing early preterm birth.
- To define and explore the "Preterm PUFA Gap"—decreased tissue ARA and DHA in preterm infants post-birth.
- To discuss intervention trial outcomes and potential strategies to address this nutritional gap.
Main Methods:
- Literature review focusing on DHA's role in preterm birth prevention.
- Conceptual development of the Preterm PUFA Gap.
- Analysis of intervention studies involving ARA and DHA supplementation.
- Exploration of methods to close the Preterm PUFA Gap.
Main Results:
- Evidence supports DHA's importance in reducing early preterm birth risk.
- Postnatal feeding in preterm infants leads to reduced tissue ARA and DHA levels, alongside increased linoleic acid (LA).
- Intervention trials with ARA and DHA have yielded conflicting results.
Conclusions:
- The Preterm PUFA Gap is a critical factor potentially linking preterm birth to adverse long-term health outcomes.
- Addressing this gap through nutritional strategies is crucial for improving preterm infant health.
- Further research is needed to optimize interventions for closing the Preterm PUFA Gap.
Abstract:
Preterm birth has a worldwide prevalence of around 11 %, and > 95 % of preterm infants now survive into adulthood. However, improved survival is accompanied by increased risks of later life chronic disorders. The brain is enriched in arachidonic acid (ARA) and docosahexaenoic acid (DHA), which are essential for optimum brain and visual system development, and cardiovascular and immune system function. Fetal demand for ARA and DHA is high, especially in the last trimester. Prior to birth they are provided by placental transfer, enriched by placental biomagnification, which occurs in parallel with placental bioreduction of linoleic acid (LA). However, after birth preterm infant feeding results in marked decreases in tissue levels of ARA and DHA, and concomitant increases in LA. This phenomenon we term the Preterm PUFA Gap, which may be a key factor in adverse health consequences of preterm birth. The review begins with a summary of the evidence highlighting the importance of DHA in reducing the risk of early preterm birth. We then develop the concept of the Preterm PUFA Gap, including discussion of the conflicting results of intervention trials with ARA and DHA. This is followed by a review of potential approaches to close the Preterm PUFA Gap.
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