Effect of docosahexaenoic acid enriched fish oil supplementation in pregnant women with type 2 diabetes on membrane fatty acids and foetal body composition – Double-blinded randomised placebo-controlled trial

Min, Yoeju, Djahanbakhch, Ovrang, Hutchinson, Joanne, Bhullar, Amritpal S., Raveendran, Manickam, Hallot, Amanda, Eram, Sofia, Namugere, Irene, Nateghian, Shahrzad and Ghebremeskel, Kebreab (2014) Effect of docosahexaenoic acid enriched fish oil supplementation in pregnant women with type 2 diabetes on membrane fatty acids and foetal body composition – Double-blinded randomised placebo-controlled trial. Diabetic Medicine, 31 (11). pp. 1331-1340. ISSN 1464-5491

Abstract

Aims
To test if DHA-enriched fish oil supplementation rectifies red cell membrane lipid anomaly in pregnant women with type 2 diabetes and their neonates, and alters foetal body composition.

Methods
Women with type 2 diabetes (n=88; 41 fish oil, 47 placebo) and healthy women (n=85; 45 fish oil, 40 placebo) were supplemented from the first trimester until delivery. Blood fatty acid composition, foetal biometric and neonatal anthropometric measurements were assessed.

Results
A total of 117 women completed the trial. The women with type 2 diabetes who took fish oil compared with those who received placebo had higher DHA% in red cell phosphatidylethanolamine (PE) in the third trimester (12.0% vs 8.9%, p=0.000) and at delivery (10.7% vs 7.4%, p=0.001). Similarly, the neonates of the fish oil supplemented women with type 2 diabetes had increased DHA in the red cell PE (9.2% vs 7.7%, p=0.027) and plasma PC (6.1% vs 4.7%, p=0.020). DHA-rich fish oil had no effect on the body composition of the foetus and neonates of the women with type 2 diabetes.

Conclusions
A daily dose of 600 mg of DHA was effective in ameliorating red cell membrane DHA anomaly in pregnant women with type 2 diabetes and neonates, and in preventing the decline of maternal DHA during pregnancy. We suggest that the provision of DHA supplement should be integrated in the antenatal care of pregnant women with type 2 diabetes.

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