Léveillé Pauline, Rouxel Clémence, Plourde Mélanie
a Faculté de médecine et des sciences de la santé, Université de Sherbrooke , Sherbrooke , Canada.
b Research Center on Aging, Health and Social Services Centre - University Institute of Geriatrics of Sherbrooke.
J Matern Fetal Neonatal Med. 2018 May;31(10):1358-1363. doi: 10.1080/14767058.2017.1314460. Epub 2017 Apr 19.
Docosahexaenoic acid (DHA) is vital for fetal development especially during the third trimester of gestation when the speed of fetal brain growth is at its peak. Diabetes modifies the maternal fatty acid profile, which may in turn change the quantity and/or quality of lipids transferred to the fetus. Neonates born to diabetic mothers might be more vulnerable to DHA deficiency leading to lower cognitive scores together with lower overall intellectual quotients when compared to control. We reviewed the influence of type 1 or type 2 pre-gestational (PGD) and gestational diabetes mellitus (GDM) on maternal and fetal DHA levels.
We searched MEDLINE articles about PGD and/or GDM and DHA published before October 2016.
Maternal blood DHA level seems higher in those with diabetes than those without diabetes. However, DHA in cord plasma of neonates born to PGD and/or GDM mothers seem lower compared to neonates born to nondiabetic mothers.
Altogether, these results suggest that the transfer of DHA from the mother to the fetus may be deficient or dysregulated in diabetic pregnancies. What remains to be understood is how placental lipid transport is regulated and whether there is a link with clinical neurodevelopmental phenotypes in the newborns.
二十二碳六烯酸（DHA）对胎儿发育至关重要，尤其是在妊娠晚期，此时胎儿大脑生长速度达到峰值。糖尿病会改变母体脂肪酸谱，进而可能改变转运至胎儿的脂质的数量和/或质量。与对照组相比，糖尿病母亲所生新生儿可能更容易出现DHA缺乏，导致认知得分降低以及总体智商较低。我们回顾了1型或2型孕前糖尿病（PGD）和妊娠期糖尿病（GDM）对母体和胎儿DHA水平的影响。
我们检索了2016年10月之前发表的关于PGD和/或GDM以及DHA的MEDLINE文章。
糖尿病患者的母体血液DHA水平似乎高于非糖尿病患者。然而，与非糖尿病母亲所生新生儿相比，PGD和/或GDM母亲所生新生儿的脐血血浆中的DHA似乎较低。
总体而言，这些结果表明，在糖尿病妊娠中，DHA从母体向胎儿的转运可能不足或失调。有待了解的是胎盘脂质转运是如何调节的，以及这是否与新生儿的临床神经发育表型有关。
