Meta-Analysis of 196 Articles: Plasma Phospholipid Fatty Acid Supply of Expecting Women during Pregnancy and at Delivery

Background: As long-chain polyunsaturated fatty acids play an important role in the maturation of the developing nervous system, maternal fatty acid supply is essential for the fetus as well as the newborn baby.

Objective: Our aim was to systematically review available data on fatty acid composition of plasma and erythrocyte membrane lipids in expecting women during pregnancy and at delivery.

Methods: Electronic literature search was performed in July 2017, on Embase, Cochrane Library, and Ovid Medline with a search strategy including the following search expressions: (pregnant* OR gestation* OR deliver*) AND (arachidonic OR docosahexaenoic) NOT animal. We analysed data from clinical trials investigating fatty acid composition of plasma or erythrocyte membrane lipids in healthy expecting women without any fatty acid supplementation during pregnancy. Statistical analysis of fatty acid data was performed by Comprehensive Meta-Analysis v3.0 Software.

Results: After excluding duplicates there were 3351 potentially relevant articles. We excluded 3155 articles because they didn’t meet our inclusion criteria, so 196 relevant articles remained publishing fatty acid data of plasma or erythrocyte membrane lipids, while 39 articles published data of plasma phospholipids (PLs). During the first trimester the studies investigated fatty acid status of a great number of mothers (n = 8337-8555), while in the three other timepoints the studies investigated somewhat smaller (n = 802-2757) populations. Values of arachidonic acid decreased significantly by the 3^rd trimester, while its values became significantly higher at delivery. On the other hand, values of docosahexaenoic acid remained quite stable during pregnancy, but decreased by delivery (Table).

Conclusion: 1. Our results indicate that on a population level, docosahexaenoic acid status remains remarkable stable during pregnancy 2. However, in plasma phospholipids values of arachidonic acid decreased significantly in the course of pregnancy.