Effet des vitamines/oméga chez la femme enceinte sur le bébé

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Higher dose docosahexaenoic acid supplementation during pregnancy and early preterm birth: A randomised, double-blind, adaptive-design superiority trial
Susan E Carlson j.eclinm.2021.100905

Background
Several meta analyses have concluded n-3 fatty acids, including docosahexaenoic acid (DHA), reduce early preterm birth (EPB, < 34 weeks), however, the amount of DHA required is unclear. We hypothesized that 1000 mg DHA per day would be superior to 200 mg, the amount in most prenatal supplements.

Methods
This randomised, multicentre, double-blind, adaptive-design, superiority trial was conducted in three USA medical centres. Women with singleton pregnancies and 12 to 20 weeks gestation were eligible. randomization was generated in SAS® by site in blocks of 4. The planned adaptive design periodically generated allocation ratios favoring the better performing dose. Managing study personnel were blind to treatment until 30 days after the last birth. The primary outcome was EPB by dose and by enrolment DHA status (low/high). Bayesian posterior probabilities (pp) were determined for planned efficacy and safety outcomes using intention-to-treat. The study is registered with ClinicalTrials.gov (NCT02626299) and closed to enrolment.

Findings
Eleven hundred participants (1000 mg, n = 576; 200 mg, n = 524) were enrolled between June 8, 2016 and March 13, 2020 with the last birth September 5, 2020. 1032 (n = 540 and n = 492) were included in the primary analyses. The higher dose had a lower EPB rate [1.7% (9/540) vs 2.4% (12/492), pp=0.81] especially if participants had low DHA status at enrolment [2.0% (5/249) vs 4.1%, (9/219), pp=0.93]. Participants with high enrolment DHA status did not realize a dose effect [1000 mg: 1.4% (4/289); 200 mg: 1.1% (3/271), pp = 0.57]. The higher dose was associated with fewer serious adverse events (maternal: chorioamnionitis, premature rupture of membranes and pyelonephritis; neonatal: feeding, genitourinary and neurologic problems, all pp>0.90).
Interpretation
Clinicians could consider prescribing 1000 mg DHA daily during pregnancy to reduce EPB in women with low DHA status if they are able to screen for DHA.

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Traduction de l'étude

Supplémentation en acide docosahexaénoïque à plus forte dose pendant la grossesse et l'accouchement prématuré précoce : un essai de supériorité randomisé, en double aveugle, de conception adaptative
Susan E Carlson j.eclinm.2021.100905

Contexte
Plusieurs méta-analyses ont conclu que les acides gras n-3, y compris l'acide docosahexaénoïque (DHA), réduisent les naissances prématurées précoces (EPB, < 34 semaines), cependant, la quantité de DHA requise n'est pas claire. Nous avons émis l'hypothèse que 1000 mg de DHA par jour seraient supérieurs à 200 mg, la quantité contenue dans la plupart des suppléments prénataux.

Méthodes
Cet essai de supériorité randomisé, multicentrique, en double aveugle, à conception adaptative, a été mené dans trois centres médicaux américains. Les femmes ayant une grossesse unique et une gestation de 12 à 20 semaines étaient éligibles. la randomisation a été générée dans SAS® par site par blocs de 4. Le design adaptatif prévu générait périodiquement des ratios d'allocation favorisant la dose la plus performante. Le personnel de gestion de l'étude était aveugle au traitement jusqu'à 30 jours après la dernière naissance. Le critère de jugement principal était l'EPB par dose et par statut de DHA d'inscription (faible/élevé). Les probabilités postérieures bayésiennes (pp) ont été déterminées pour les résultats d'efficacité et d'innocuité prévus en utilisant l'intention de traiter. L'étude est enregistrée auprès de ClinicalTrials.gov (NCT02626299) et fermée à l'inscription.

Résultats
Onze cents participants (1 000 mg, n = 576 ; 200 mg, n = 524) ont été inscrits entre le 8 juin 2016 et le 13 mars 2020 avec la dernière naissance le 5 septembre 2020. 1032 (n = 540 et n = 492) ont été inclus dans les analyses primaires. La dose la plus élevée avait un taux d'EPB plus faible [1,7 % (9/540) vs 2,4 % (12/492), pp=0,81] surtout si les participants avaient un faible statut en DHA au moment de l'inscription [2,0 % (5/249) vs 4,1 %, (9/219), pages = 0,93]. Les participants avec un statut DHA élevé n'ont pas réalisé d'effet dose [1000 mg : 1,4 % (4/289) ; 200 mg : 1,1 % (3/271), pp = 0,57]. La dose plus élevée a été associée à moins d'événements indésirables graves (maternels : chorioamnionite, rupture prématurée des membranes et pyélonéphrite ; néonatals : problèmes d'alimentation, génito-urinaires et neurologiques, tous pp> 0,90).
Interprétation
Les cliniciens pourraient envisager de prescrire 1000 mg de DHA par jour pendant la grossesse pour réduire l'EPB chez les femmes ayant un faible statut en DHA si elles sont en mesure de dépister le DHA

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The Role of Magnesium in Pregnancy and in Fetal Programming of Adult Diseases
Daniela Fanni, Biological Trace Element Research volume 199, pages3647–3657 (2021)

Magnesium is an essential trace metal and a necessary factor for multiple biochemical functions in humans. Its role in biology is fundamental in over 600 enzymatic reactions implicated in protein synthesis, mitochondrial functions, neuromuscular activity, bone formation, and immune system competence. Magnesium status is relevant in fetal development during gestation and in the newborn growth during the perinatal period. Moreover, magnesium is able to influence fetal programming and disease presentation in childhood or adulthood. The aim of this review is to focus on this metal homeostasis, analyzing its normal values, the causes of hypomagnesemia, the interaction with drugs and other conditions, and the diseases associated with magnesium value alteration during pregnancy, in order to study its role in fetal programming of adult diseases. The data here reported clearly indicated the existence of a connection between magnesium status and human pathology starting from intrauterine life and extending into childhood and adulthood.

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Hypomagnesemia is the most common disturbance of magnesium homeostasis, with a prevalence of up to 15% in the general population

Chronic primary magnesium deficiency is frequent, about 20% of women are receiving low intakes of magnesium and consuming less than two-thirds of the RDA. Pregnant women are at higher risk of developing magnesium deficiency, with maternal, fetal, and pediatric consequences. A magnesium deficiency status during gestation may interfere with fetal growth and development and may favor premature labor. Preterm delivery is due to uterine hyperexcitability caused by chronic maternal Mg deficiency and is intensified in situations of maternal stress. Gestational magnesium deficiency may induce major maternal, fetal, and pediatric effects which might last throughout life

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Traduction de l'étude

Le rôle du magnésium dans la grossesse et dans la programmation fœtale des maladies de l'adulte
Daniela Fanni, Recherche sur les éléments traces biologiques, volume 199, pages 3647-3657 (2021)

Le magnésium est un métal trace essentiel et un facteur nécessaire pour de multiples fonctions biochimiques chez l'homme. Son rôle en biologie est fondamental dans plus de 600 réactions enzymatiques impliquées dans la synthèse des protéines, les fonctions mitochondriales, l'activité neuromusculaire, la formation osseuse et la compétence du système immunitaire. Le statut en magnésium est important dans le développement fœtal pendant la gestation et dans la croissance du nouveau-né pendant la période périnatale. De plus, le magnésium est capable d'influencer la programmation fœtale et la présentation de la maladie pendant l'enfance ou l'âge adulte. Le but de cette revue est de se concentrer sur cette homéostasie métallique, en analysant ses valeurs normales, les causes de l'hypomagnésémie, l'interaction avec les médicaments et d'autres conditions, et les maladies associées à l'altération de la valeur du magnésium pendant la grossesse, afin d'étudier son rôle dans le fœtus. programmation des maladies de l'adulte. Les données rapportées ici ont clairement indiqué l'existence d'un lien entre le statut en magnésium et la pathologie humaine à partir de la vie intra-utérine et s'étendant jusqu'à l'enfance et l'âge adulte.

L'hypomagnésémie est la perturbation la plus fréquente de l'homéostasie du magnésium, avec une prévalence allant jusqu'à 15 % dans la population générale.

La carence primaire chronique en magnésium est fréquente, environ 20% des femmes reçoivent de faibles apports en magnésium et consomment moins des deux tiers des AJR. Les femmes enceintes sont plus à risque de développer une carence en magnésium, avec des conséquences maternelles, fœtales et pédiatriques. Un statut de carence en magnésium pendant la gestation peut interférer avec la croissance et le développement du fœtus et peut favoriser le travail prématuré. L'accouchement prématuré est dû à une hyperexcitabilité utérine causée par une carence maternelle chronique en Mg et s'intensifie dans les situations de stress maternel. Une carence en magnésium durant la gestation peut induire des effets maternels, fœtaux et pédiatriques majeurs qui peuvent durer toute la vie

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A randomized, double-blind study of iodine supplementation during pregnancy in Sweden: pilot evaluation of maternal iodine status and thyroid function
Sofia Manousou, European Journal of Nutrition volume 60, pages3411–3422 (2021)

Purpose
Pregnant women in Sweden are mildly iodine deficient. We investigated the effect of daily iodine supplementation on the iodine and thyroid status of pregnant women.

Methods
In this pilot, randomized, double-blind trial, 200 thyroid-healthy pregnant women were recruited at mean (standard deviation) pregnancy week 8.85 (1.62) and assigned (1:1) to daily intake of a multivitamin tablet with or without 150 μg of iodine. Urine and serum samples were collected at baseline and once during the second and third trimesters. Urinary iodine concentration (UIC), serum thyroglobulin (Tg), thyroid-stimulating hormone (TSH), free thyroxine (FT4), and thyroid peroxidase antibodies (TPOabs) were analyzed. Neonatal TSH data were collected. UIC and Tg were also analyzed in a group of 89 thyroid-healthy non-pregnant women of reproductive age (WRA).

Results
At baseline, the intervention and the control groups had similar median UIC (interquartile range (IQR)): 110 μg/L (74–119) and 111 μg/L (66–168), respectively. The intervention group reached iodine sufficiency with median UIC (IQR) 139 μg/L (89–234) and 136 μg/L (91–211) in the second and third trimester, respectively, without significant difference from the lower limit of the recommended range, i.e. 150–250 μg/L (p = 0.42 and p = 0.87, respectively). The intervention group had higher median UIC and lower median Tg compared to the control group during the second (p < 0.001 and p = 0.019, respectively) and third trimester (p < 0.001 and p = 0.003, respectively), whereas thyroid hormones, serum TPOabs, and neonatal TSH were similar. The WRA group presented median UIC (IQR) 65 μg/L (30–98) and median Tg (IQR) 18 μg/L (13–27).

Conclusion
A daily supplement containing 150 μg of iodine to a group of pregnant women with mild iodine deficiency improved the iodine status from mild ID to iodine sufficiency. This improvement seems to have had a positive impact on maternal thyroglobulin. This study is now under extension to investigate the children’s neuropsychological development.

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Associations between maternal vitamin D status during three trimesters and cord blood 25(OH)D concentrations in newborns: a prospective Shanghai birth cohort study
Xirui Wang, European Journal of Nutrition volume 60, pages3473–3483 (2021)

Purpose
Prenatal vitamin D (VitD) deficiency influences children’s health in later life. We aimed to test the associations between maternal VitD status in each of the three trimesters of pregnancy and cord blood 25(OH)D concentrations in newborns.

Methods
Participants were pregnant women recruited from the Shanghai Birth Cohort (SBC) (n = 1100). Of all the participants, 946 completed the collection of venous blood at early (< 16 weeks, T1), mid- (24–28 weeks, T2), and late (32–34 weeks, T3) pregnancy as well as the corresponding cord blood in the newborns. Maternal serum 25(OH)D concentrations were measured by LC–MS/MS, and the information on confounding factors was obtained through a standardized questionnaire.

Results
The mean 25(OH)D concentrations at time points T1, T2, T3 in maternal blood and cord blood of the newborns were 26.31 ng/mL, 31.92 ng/mL, 35.62 ng/mL, and 19.77 ng/mL, respectively. Neonatal 25(OH)D level in cord blood was positively correlated with maternal serum 25(OH)D levels at each trimester, and the strongest correlation was found at time point T3.

Conclusion
Maternal 25(OH)D concentrations at each trimester were positively associated with neonatal VitD status in cord blood, and the strongest correlation was found in the late stage of pregnancy, which could be considered as a sensitive time window. Attention should be paid to the nutritional status of VitD during pregnancy to better prevent the VitD deficiency in neonates.

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Traduction de l'étude

Associations entre le statut maternel en vitamine D pendant trois trimestres et les concentrations de 25(OH)D dans le sang ombilical chez les nouveau-nés : une étude prospective de cohorte de naissance à Shanghai
Xirui Wang, European Journal of Nutrition volume 60, pages 3473-3483 (2021)

Objectif
La carence prénatale en vitamine D (VitD) influence la santé des enfants plus tard dans la vie. Nous avons cherché à tester les associations entre le statut VitD maternel au cours de chacun des trois trimestres de la grossesse et les concentrations de 25(OH)D dans le sang ombilical chez les nouveau-nés.

Méthodes
Les participantes étaient des femmes enceintes recrutées dans la cohorte de naissance de Shanghai (SBC) (n = 1100). De tous les participants, 946 ont terminé le prélèvement de sang veineux au début (< 16 semaines, T1), au milieu (24-28 semaines, T2) et en fin de grossesse (32-34 semaines, T3) ainsi que le cordon correspondant. sang chez les nouveau-nés. Les concentrations sériques maternelles de 25(OH)D ont été mesurées par LC-MS/MS, et les informations sur les facteurs de confusion ont été obtenues grâce à un questionnaire standardisé.

Résultats
Les concentrations moyennes de 25(OH)D aux points de temps T1, T2, T3 dans le sang maternel et le sang de cordon des nouveau-nés étaient respectivement de 26,31 ng/mL, 31,92 ng/mL, 35,62 ng/mL et 19,77 ng/mL. Le taux néonatal de 25(OH)D dans le sang de cordon était positivement corrélé avec les taux sériques maternels de 25(OH)D à chaque trimestre, et la corrélation la plus forte a été trouvée au moment T3.

Conclusion
Les concentrations maternelles de 25(OH)D à chaque trimestre étaient positivement associées au statut VitD néonatal dans le sang de cordon, et la corrélation la plus forte a été trouvée à la fin de la grossesse, qui pourrait être considérée comme une fenêtre temporelle sensible. Une attention particulière doit être portée à l'état nutritionnel de la VitD pendant la grossesse pour mieux prévenir la carence en VitD chez le nouveau-né.

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Association of vitamin D and gene variants in the vitamin D metabolic pathway with preterm birth
Nutrition Volume 89, September 2021, 111349 Shuojia Wang

Highlights
• Vitamin D deficiency is associated with short-term gestational weeks.
• Single-nucleotide polymorphism in the low-density lipoprotein receptor-related protein 2 (LRP2) gene is associated with the risk for preterm birth.
• Vitamin D and the vitamin D-binding protein(GC), vitamin D receptor(VDR) genes might exert interactions on the risk for preterm birth.

Objectives
The aim of this study was to explore the association of vitamin D (VitD) levels during pregnancy and its metabolic pathway genes with the risk for preterm birth (PTB) among pregnant women in southeast China.

Methods
This study was conducted in Zhoushan Maternal and Child Health Hospital, Zhejiang, from August 2011 to May 2018. Plasma 25-hydroxyvitamin vitamin D [25(OH)D] levels in three trimesters and single-nucleotide morphisms in the VitD metabolic pathway were measured. Relevant information was collected using questionnaires and an electronic medical recorder system. Multiple statistical methods including linear regression, logistic regression, and crossover analysis were applied.

Results
The prospective cohort study included 3465 pregnant women, of which 202 were PTB (week of gestation at delivery: 33.38 ± 4.05), accounting for 5.8%. After adjusting for potential confounders, VitD sufficiency (≥30 ng/mL) in the second and third trimesters was associated with longer gestational age at delivery compared with VitD deficiency (<20 ng/mL). However, no significant association was found between VitD with the risk for PTB. rs7041, rs10210408, and rs2228171 were associated with gestational week and the risk for PTB. Significant associations were found of rs10210408, rs2209314, rs1155563, rs2544381 and the status of VitD in the second and third trimester with the gestational week. We also found that rs7041 and VitD in the second trimester might exert interaction on gestational week and the risk for PTB (Pinter = 0.038; Pinter = 0.019); rs16846876 and VitD in the second trimester might exert interaction on gestational week (Pinter = 0.024); rs4334089 and VitD in the third trimester might exert interaction on gestational week (Pinter = 0.024). Similar results were found when we tested pregnant women's plasma 25(OH)D in the first and second trimesters.

Conclusions
Women with VitD deficiency were associated with shorter gestational weeks. Single-nucleotide morphisms in VitD metabolic pathway genes were significantly associated with gestation week and the risk for PTB, mainly in vitamin D–binding protein (GC) and low-density lipoprotein-related protein 2 (LRP2)genes. Additionally, maternal VitD with GC gene and maternal VitD with vitamin D receptor (VDR) gene might exert interactions on the risk for PTB.

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Vitamin D supplementation reduces serum lipids of children with hypertriacylglycerolemia: A randomized, triple-masked, placebo-controlled crossover trial
Ana Gabriella P.Alves Nutrition Volume 89, September 2021, 111296

Highlights
• Vitamin D supplementation improved children's lipid profile
• Vitamin D supplementation did not change children's body composition
• Vitamin D supplementation was beneficial to children even with sufficient 25-hydroxyvitamin D

Objectives
This study aimed to evaluate the effect of cholecalciferol supplementation on the body composition and metabolic profile of children with hypertriacylglycerolemia.

Methods
This is a randomized, triple-masked, placebo-controlled, crossover trial of 44 Brazilian children with hypertriacylglycerolemia, age 4 to 11 y. The sample included eutrophic and overweight/obese children according to body mass index for age, with sufficient and insufficient vitamin D basal levels. The intervention lasted 34 wk, with two periods of 12 wk each separated by a 10-wk washout. The two groups, supplemented and placebo, received five drops of cholecalciferol (equivalent to 1000 international unit/d) and five drops of sunflower oil, respectively, daily for 12 wk. Sociodemographic, economic, sunscreen use, percentage of body surface area daily exposed to sun, physical activity, anthropometry (body mass and height), body composition (waist circumference, body fat percentage, fat-free mass, triceps, and subscapular skinfolds), biochemical profile (25-hydroxyvitamin D, fasting glucose, and lipid fractions), blood pressure, and food intake data were collected.

Results
Of the 44 children who concluded the study, 56.80% were female, 54.50% were of brown race, 81.82% had sufficient serum 25-hydroxyvitamin D (≥75 nmol/L), and 50.00% were overweight/obese according to body mass index for age. There was a reduction in serum total cholesterol (P < 0.001), low-density lipoprotein cholesterol (P < 0.001), nonhigh-density lipoprotein cholesterol (P < 0.001), total cholesterol/high-density lipoprotein cholesterol (P = 0.001), and low/high-density lipoprotein cholesterol ratios (P < 0.001) in the supplemented group compared with the placebo group.

Conclusions
Cholecalciferol supplementation improved the lipid profile of children with hypertriacylglycerolemia without altering body composition.

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Traduction de l'étude

La supplémentation en vitamine D réduit les lipides sériques des enfants atteints d'hypertriacylglycérolémie : un essai croisé randomisé, à triple insu et contrôlé par placebo
Ana Gabriella P.Alves Nutrition Volume 89, septembre 2021, 111296

Points forts
• La supplémentation en vitamine D a amélioré le profil lipidique des enfants
• La supplémentation en vitamine D n'a pas modifié la composition corporelle des enfants
• La supplémentation en vitamine D a été bénéfique pour les enfants même avec suffisamment de 25-hydroxyvitamine D

Objectifs
Cette étude visait à évaluer l'effet de la supplémentation en cholécalciférol sur la composition corporelle et le profil métabolique des enfants atteints d'hypertriacylglycérolémie.

Méthodes
Il s'agit d'un essai croisé randomisé, à triple insu, contrôlé par placebo, portant sur 44 enfants brésiliens atteints d'hypertriacylglycérolémie, âgés de 4 à 11 ans. L'échantillon comprenait des enfants eutrophes et en surpoids/obèses selon l'indice de masse corporelle pour l'âge, avec des niveaux basaux de vitamine D suffisants et insuffisants. L'intervention a duré 34 semaines, avec deux périodes de 12 semaines chacune séparées par un wash-out de 10 semaines. Les deux groupes, supplémentés et placebo, ont reçu cinq gouttes de cholécalciférol (équivalent à 1000 unités internationales/j) et cinq gouttes d'huile de tournesol, respectivement, quotidiennement pendant 12 semaines. Sociodémographique, économique, utilisation de crème solaire, pourcentage de surface corporelle quotidiennement exposé au soleil, activité physique, anthropométrie (masse corporelle et taille), composition corporelle (tour de taille, pourcentage de graisse corporelle, masse maigre, triceps et plis cutanés sous-scapulaires), Le profil biochimique (25-hydroxyvitamine D, glycémie à jeun et fractions lipidiques), la pression artérielle et les données sur la prise alimentaire ont été recueillis.

Résultats

. Il y avait une réduction du cholestérol total sérique (P < 0,001), du cholestérol des lipoprotéines de basse densité (P < 0,001), du cholestérol des lipoprotéines non de haute densité (P < 0,001), du cholestérol total/cholestérol des lipoprotéines de haute densité (P = 0,001), et les ratios de cholestérol à lipoprotéines de basse/haute densité (P < 0,001) dans le groupe supplémenté par rapport au groupe placebo.

Conclusion
La supplémentation en cholécalciférol a amélioré le profil lipidique des enfants atteints d'hypertriacylglycérolémie sans altérer la composition corporelle.

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Blood Fatty Acid Analysis Reveals Similar n-3 Fatty Acid Composition in Non-Pregnant and Pregnant Women and Their Neonates in an Israeli Pilot Study
Alicia Leikin-Frenkel August 30, 2021

Highlights
• Higher total plasma amount of SAT, MUFA and n-6 are the main FA differences in pregnant compared to non-pregnant women.
• N-3 FA and n-3 PUFA percent distribution and n-3 Index are similar in the blood of Israeli pregnant compared to non-pregnant women.
• Plasma DHA levels of pregnant women and neonates are positively correlated whereas neonates present higher DHA levels and n-3 index, insinuating either an efficient mother-fetus FA transfer, an active fatty acid metabolism to PUFA in the fetus—or both.
• N-3 index is lower in the blood of Israeli pregnant women than in other countries
• The different fishery resources and dietary habits in Israel compared to other countries call to establish the specific local needs for intake of FA during pregnancy.

Maternal docosahexaenoic acid (DHA) is required during pregnancy to supply for normal fetal growth and development. This pilot study aimed to assess the unknown fatty acid (FA) composition in a cohort of non-pregnant and pregnant Israeli women at term and their offspring on a normal diet without n-3 FA supplementation. The fatty acid profile,analyzed using gas chromatography, showed significantly higher plasma monounsaturated (MUFA) and lower n-6 FA percent distribution with similar n-3 index, in pregnant compared to non-pregnant women. RBC exhibited significantly higher MUFA with similar n-3 index, in pregnant compared to non-pregnant women. N-3 FA significantly correlated between neonates’ plasma with higher n-3 index and pregnant women's DHA .

Conclusion: DHA levels in non-pregnant and pregnant Israeli women at term were comparable and the DHA in pregnant women's plasma positively correlated with their neonate's level, suggesting an efficient mother-fetus FA transfer and/or fetal fatty acid metabolism to longer FA products .

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Traduction de l'étude

Une analyse des acides gras dans le sang révèle une composition similaire en acides gras n-3 chez les femmes enceintes et non enceintes et leurs nouveau-nés dans une étude pilote israélienne
Alicia Leikin-Frenkel 30 août 2021

Points forts
• Une quantité plasmatique totale plus élevée de SAT, d'AGMI et de n-6 sont les principales différences d'AF chez les femmes enceintes par rapport aux femmes non enceintes.
• La distribution en pourcentage des AG N-3 et des AGPI n-3 et l'indice n-3 sont similaires dans le sang des femmes enceintes israéliennes par rapport aux femmes non enceintes.
• Les taux plasmatiques de DHA des femmes enceintes et des nouveau-nés sont positivement corrélés alors que les nouveau-nés présentent des taux de DHA et un indice n-3 plus élevés, insinuant soit un transfert d'AF mère-fœtus efficace, soit un métabolisme actif des acides gras en AGPI chez le fœtus, soit les deux.
• L'indice N-3 est plus bas dans le sang des femmes enceintes israéliennes que dans d'autres pays
• Les différentes ressources halieutiques et habitudes alimentaires en Israël par rapport à d'autres pays appellent à établir les besoins locaux spécifiques d'apport en AG pendant la grossesse.

L'acide docosahexaénoïque (DHA) maternel est nécessaire pendant la grossesse pour assurer une croissance et un développement fœtaux normaux. Cette étude pilote visait à évaluer la composition inconnue en acides gras (AG) dans une cohorte de femmes israéliennes enceintes et non enceintes à terme et de leur progéniture suivant un régime normal sans supplémentation en AG n-3. Le profil des acides gras, analysé à l'aide de la chromatographie en phase gazeuse, a montré une distribution de pourcentage d'acides gras monoinsaturés (MUFA) plasmatiquement plus élevée et plus faible n-6 avec un indice n-3 similaire, chez les femmes enceintes par rapport aux femmes non enceintes. Les globules rouges présentaient une AGMI significativement plus élevée avec un indice n-3 similaire, chez les femmes enceintes par rapport aux femmes non enceintes. L'AF N-3 était significativement corrélée entre le plasma des nouveau-nés avec un indice n-3 plus élevé et le DHA des femmes enceintes.

Conclusion : les niveaux de DHA chez les femmes israéliennes enceintes et non enceintes à terme étaient comparables et le DHA dans le plasma des femmes enceintes était positivement corrélé avec le niveau de leur nouveau-né, suggérant un transfert efficace des AG mère-fœtus et/ou un métabolisme fœtal des acides gras vers des produits AG plus longs.

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N-3 PUFA-Deficiency in Early Life Exhibits Aggravated MPTP-Induced Neurotoxicity in Old Age while Supplementation with DHA/EPA-Enriched Phospholipids Exerts a Neuroprotective Effect
Fang Wu, Molecular Nutrition & Food Research 11 August 2021

Introduction
Malnutrition in early life affects the growth and development of fetus and children, which has a long-term impact on adult health. Previous studies reveal a relationship between dietary omega-3 polyunsaturated fatty acid (n-3 PUFA) content, brain development, and the prevalence of neurodevelopmental disorders and inflammation. However, it is unclear about the effect of n-3 PUFA-deficiency in early life on the development of Parkinson's disease (PD) in old age, as well as the neuroprotective effect of DHA- and EPA-enriched phospholipids (DHA/EPA-PLs) supplemented in old age in long-term n-3 PUFA-deficient mice.

Methods and Results
The PD mice induced by 1-methyl-4-phenyl-1,2,3,6- tetrahydropyridine (MPTP) in n-3 PUFA-adequate (N) and -deficient (DEF) group are supplemented with a DHA/EPA-PLs diet for 2 weeks (N+DPL, DEF+DPL). DHA/EPA-PLs supplementation significantly protects against MPTP-induced impairments. The DEF+DPL group shows poorer motor performance, the loss of dopaminergic neurons, mitochondrial dysfunction, and neurodevelopment delay than the N+DPL group, and still did not recover to the Control level.

Conclusions
Dietary n-3 PUFA-deficiency in early life exhibits more aggravated MPTP-induced neurotoxicity in old age, than DHA/EPA-PLs supplementation recovers brain DHA levels and exerts neuroprotective effects in old age in long-term n-3 PUFA-deficient mice, which might provide a potential dietary guidance.

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Association of maternal vitamin B12 and folate levels in early pregnancy with gestational diabetes: a prospective UK cohort study (PRiDE study)
Ponnusamy Saravanan, Diabetologia volume 64, pages2170–2182 (2021)

Aims/hypothesis
The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide in all ethnic groups. Low vitamin B12 and low/high folate levels may contribute to GDM risk, but there is conflicting evidence. Our aim is to assess the relationships of early pregnancy vitamin B12 and folate levels with the risk of GDM status at 26–28 weeks of gestation.

Methods
This was a prospective, multi-centre, multi-ethnic cohort study (n = 4746) in the UK. Participants who were eligible to be selectively screened as per the National Institute for Health and Care Excellence (NICE) criteria were included in the study.

Results
GDM prevalence was 12.5% by NICE and 14.7% by International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Folate deficiency (1.3%) was rare but B12 insufficiency (42.3% at <220 pmol/l) and folate excess (36.5%) were common in early pregnancy. Early pregnancy median B12 levels were lower, and folate levels higher, in women who were diagnosed with GDM at 26–28 weeks. B12 was negatively associated with fasting plasma glucose (1 SD: −0.06 mmol/l; 95% CI −0.04, −0.08; p < 0.0001) and 2 h plasma glucose levels (−0.07 mmol/l; 95% CI −0.02, −0.12; p = 0.004). Higher B12 was associated with 14.4% lower RR of IADPSG-GDM (0.856; 95% CI 0.786, 0.933; p = 0.0004) after adjusting for key confounders (age, parity, smoking status, ethnicity, family history, household income and folate status). Approximately half of this association was mediated through BMI. Folate was positively associated with 2 h plasma glucose levels (0.08 mmol/l; 95% CI 0.04, 0.13; p = 0.0005) but its relationship with fasting plasma glucose was U-shaped (quadratic β: 0.011; p = 0.05). Higher folate was associated with 11% higher RR of IADPSG-GDM (adjusted RR 1.11; 95% CI 1.036, 1.182; p = 0.002) (age, parity, smoking status, ethnicity, family history, household income and B12 status). Although no interactions were observed for B12 and folate (as continuous variables) with glucose levels and GDM risk, a low B12–high folate combination was associated with higher blood glucose level and risk of IADPSG-GDM (adjusted RR 1.742; 95% CI 1.226, 2.437; p = 0.003).

Conclusions/interpretation
B12 insufficiency and folate excess were common in early pregnancy. Low B12 and high folate levels in early pregnancy were associated with small but statistically significant changes in maternal blood glucose level and higher RR of GDM. Our findings warrant additional studies on the role of unmetabolised folic acid in glucose metabolism and investigating the effect of optimising early pregnancy or pre-conception B12 and folate levels on subsequent hyperglycaemia.