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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, Joachim W.

Editorial Board Member: / Bancalari, Eduardo / Greenough, Anne / Genc, Mehmet R. / Chervenak, Frank A. / Chappelle, Joseph / Bergmann, Renate L. / Bernardes, J.F. / Bevilacqua, G. / Blickstein, Isaac / Cabero Roura, Luis / Carbonell-Estrany, Xavier / Carrera, Jose M. / D`Addario, Vincenzo / D'Alton, MD, Mary E. / Dimitrou, G. / Grunebaum, Amos / Hentschel, Roland / Köpcke, W. / Kawabata, Ichiro / Keirse, M.J.M.C. / Kurjak M.D., Asim / Lee, Ben H. / Levene, Malcolm / Lockwood, Charles J. / Marsal, Karel / Makatsariya, Alexander / Nishida, Hiroshi / Ogata, Edward / Papp, Zoltán / Pejaver, Ranjan Kumar / Pooh, Ritsuko K. / Romero, Roberto / Saugstad, Ola D. / Schenker, Joseph G. / Sen, Cihat / Seri, Istvan / Vetter, Klaus / Winn, Hung N. / Young, Bruce K. / Zimmermann, Roland

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Prenatal long-chain polyunsaturated fatty acid status: the importance of a balanced intake of docosahexaenoic acid and arachidonic acid

Mijna Hadders-Algra1

1Department of Paediatrics – Developmental Neurology, University Medical Center Groningen, Groningen, The Netherlands

Corresponding author: Mijna Hadders-Algra, MD, PhD Developmental Neurology University of Groningen Medical Centre Hanzeplein 1 9713 GZ Groningen The Netherlands Tel.: +31 50 361 9158 Fax: +31 50 363 6905

Citation Information: Journal of Perinatal Medicine. Volume 36, Issue 2, Pages 101–109, ISSN (Online) 16193997, ISSN (Print) 03005577, DOI: 10.1515/JPM.2008.029, March 2008

Publication History

Published Online:


This review addresses the effect of prenatal long-chain polyunsaturated fatty acid (LCPUFA) status on neurodevelopmental outcome. It focuses on the major LPCUFA doxosahexaenoic acid (DHA; 22:6ω3) and arachidonic acid (AA; 20:4ω6). Due to enzymatic competition high DHA intake results in lower tissue levels of AA.

LCPUFA accumulation in the brain starts early and increases during the third trimester. Initially brain AA-accretion exceeds DHA-accretion; after term age DHA-accretion surpasses AA-accretion.

Animal studies indicated that early ω3-depletion results in poorer developmental outcome. They also showed that early ω3-supplementation had no effect on cognitive outcome, promotes visual development and impairs auditory and motor development. Only limited human data are available. Correlational studies suggest that neonatal AA status shows a positive relation with early neurodevelopmental outcome and that neonatal DHA status also might be correlated with improved outcome beyond infancy. Results of human intervention studies are equivocal: most studies were unable to demonstrate a positive effect of prenatal ω3-supplementation.

It is concluded that only limited evidence exists to support the notion that prenatal ω3-supplementation favours developmental outcome. Caution is warranted for an unbalanced high DHA intake during the first two trimesters of pregnancy, i.e., DHA without additional AA supplementation.

Keywords: Arachidonic acid; brain development; doxosahexaenoic acid; LCPUFA; neurodevelopmental outcome; prenatal nutrition; pregnancy; review; trans-fatty acids

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