Maternal fatty acid intake and human embryonic growth: the Rotterdam Periconception Cohort

• Published in: European journal of epidemiology Vol. 39; no. 12; pp. 1379 - 1389
• Main Authors: Rubini, Eleonora, van Rossem, Lenie, Schoenmakers, Sam, Willemsen, Sten P., Sinclair, Kevin D., Steegers-Theunissen, Régine P. M., Rousian, Melek
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01.12.2024; Springer Nature B.V
• Subjects: Adult; Birth weight; Cardiology; Cohort Studies; Computer applications; Diet; Diet - statistics & numerical data; Dietary intake; Dietary supplements; Docosahexaenoic acid; Docosahexaenoic Acids - administration & dosage; Embryogenesis; Embryonic Development - drug effects; Embryonic Development - physiology; Embryonic growth stage; Epidemiology; Fatty acids; Fatty Acids, Omega-3 - administration & dosage; Fatty Acids, Unsaturated - administration & dosage; Female; Fetal Development - drug effects; Fetal Development - physiology; Fetuses; Fish oils; Food intake; Humans; Infectious Diseases; Maternal Nutritional Physiological Phenomena - physiology; Medicine; Medicine & Public Health; Netherlands; Nutrient deficiency; Omega-3 fatty acids; Oncology; Periconceptional Epidemiology; Polyunsaturated fatty acids; Pregnancy; Pregnancy Trimester, First; Prenatal development; Prospective Studies; Public Health; Risk reduction; Ultrasonic imaging; Virtual reality; Netherlands; Pregnancy; Omega 3; Fetal development; Polyunsaturated fatty acids; Supplements; Virtual reality
• ISSN: 0393-2990; 1573-7284; 1573-7284
• DOI: 10.1007/s10654-024-01184-8

The required intake of macronutrients by women during the periconceptional period for optimal fetal growth is the subject of ongoing investigation. Intake of polyunsaturated fatty acids (PUFA) is positively associated with fetal neural development, growth velocity and birth weight. However, limited evidence indicates that PUFAs play a role in embryogenesis. We aim to investigate the associations between maternal PUFA dietary intake and first trimester embryonic volume (EV) and head volume (HV). In a prospective cohort study (2013–2020), 464 pregnant women at < 8 weeks of gestation were included. Maternal dietary intake of PUFAs, including omega 3 (docosahexaenoic acid, DHA and eicosapentaeonic acid, EPA) and 6, was obtained from food frequency questionnaires, and first trimester three-dimensional ultrasound examinations were performed to measure EV and HV using Virtual Reality techniques. More than 70% of the population had omega 3 intakes below recommendations. A higher intake of PUFAs was associated with a smaller embryonic HV/EV ratio after adjusting for confounders (EPA p  = 0.012, DHA p  = 0.015, omega 3 and 6 p  < 0.001), but no associations were found with EV or HV alone. Omega 3 from fish oil supplements alone was not associated with embryonic growth. Strong adherence to a PUFA-rich dietary pattern was associated with a smaller embryonic HV/EV ratio (DHA and EPA-rich diet p  = 0.054, PUFA-rich diet p  = 0.002). It is important to increase awareness of the high prevalence of omega 3-deficiency among pregnant women, and the opportunity for prevention by increasing PUFA intake, thereby reducing the risks of adverse pregnancy outcomes which originate during the periconceptional period.