Title

Pregnancy complicated with GDM: Long-chain polyunsaturated fatty acids and infant neurodevelopment

Date of Completion

January 2004

Keywords

Health Sciences, Nutrition|Health Sciences, Human Development

Degree

Ph.D.

Abstract

This research focused on pregnant women who developed GDM as compared to those who did not. Maternal nutrient consumption, plasma phospholipid (PL) fatty acids (FA), and infant sleep states, as a determinant of maturity of the central nervous system (CNS), were assessed. Maternal plasma insulin and glucose levels, measures of short- and long-term glucose control, and infant glucose levels were examined. ^ In Study 1 the relationship of plasma PL LC-PUFA with infant sleep patterns was determined. Women with and without GDM were recruited at approximately 26 weeks of gestation and followed through delivery. Infant sleep-wake patterns were recorded in the first 48 postnatal hours. Sleep-wake patterns of infants born to women with GDM were typical of a less well developed CNS, while those infants born to women with uncomplicated pregnancies exhibited patterns typical of a more well developed CNS. ^ Study 2 addressed the efficacy of MNT in the treatment of GDM by assessing the dietary intake of women with GDM as compared with that of control subjects using repeated 24-hour recalls. Women with GDM received dietary education and guidance from Registered Dietitians. Women with GDM had more appropriate energy intake, lower fat intake and a higher percent of calories from polyunsaturated fats than did controls, suggesting MNT was effective. ^ Study 3 was an assessment of dietary intake of EFA and LC-PUFA in pregnant women with and without GDM to determine whether diets have changed in the last decade with respect to dietary FA. Dietary intake was assessed using repeated 24-hour recalls. Results were consistent with those reported by Wijendren et al. (1) a decade ago, indicating a need to educate pregnant women about the importance and sources of LC-PUFA, especially DHA. ^ Clearly, maternal dietary LC-PUFA, especially DHA, is important to fetal development. Additionally, nutrition education provided by Registered Dietitians positively impacts dietary intake of macronutrients. It appears that limited progress has been made vis-à-vis increasing intake of n-3 as compared to n-6 fatty acids. Finally, it is clear nutrition education should be expanded to all pregnant women to assure the most favorable outcome for all infants. ^