Maternal fatty composition during early pregnancy and asthma

  • Aanvrager: Mevrouw W.M. Harskamp-van Ginkel

European Academy of Paediatric Societies October 19th 2014 Margreet Harskamp AMC Department of Public Health Amsterdam Projectnummer 7.2.14.050CO

Maternal Fatty Acid Composition During Early Prgenancy and Asthma At Age 7 Years

The topic of fetal programming and epigenetics is still new and unknown by many paediatricians. On the morning of my presentation, Dr M. Hanson gave a lecture on ‘Epigenetics & Cardiovascular Development’, during which he referred to several (Dutch) birth cohorts. He explained how non-communicable disease exposes a major threat to global health and the economies in both developed and developing countries. Risk of such disease is set in part during early life, when environmental influences including mother’s diet, body composition and exposure to stress, affect the development of her fetus and newborn, establishing its responses to later environmental challenges such as an obesogenic lifestyle. Epidemiological, human clinical and basic science research has now indicated underlying mechanisms, many of which involve epigenetic processes. A priority is to develop epigenetic biomarkers of risk and to deploy the necessary complex interventions, which in many populations will require wider social and educational initiatives as well as public health campaigns [1].

Our research is on Maternal Fatty Acid Composition During Early Prgenancy and Asthma At Age 7 Years. Polyunsaturated fatty acids (PUFA’s) are essential fatty acids that the body cannot synthesize itself and maternal PUFA intake during pregnancy and lactation effect early development [2]. The two fatty acids that are essential for humans and are ingested through vegetable oils, fish oils and animal fats are omega-3 (n-3) and omega-6 (n-6) PUFA’s [3]. The first group, n-3 PUFA’s, has anti-inflammatory effects, by decreasing production of the n-6 PUFA Arachidonic acid (AA). AA is increasingly recognized as a key mediator and regulator of inflammation, also in asthma [4]. Asthmatic inflammation is mediated by leukotrienes and prostaglandins, proinflammatory mediators arising via AA metabolism [5]. Epidemiologic data link high n-6 PUFA or low n-3 PUFA consumption with childhood asthma. A recent meta-analysis of prospective cohort studies indicates that fish or n-3 intake by infants may be beneficial to prevent asthma in children (relative risk 0.76 (95%CI, 0.61-0.94) [6]. Meta-analysis on fish or n-3 PUFA intake during adulthood or in randomized clinical trials in adults and children do not show this significant association [6-8]. Hypothesized is that n-3 PUFA’s are most important in the stage of immune system development, but the earliest reported measurements in maternal blood samples in relation to asthma outcomes are at 34 weeks gestation [9, 10].
The Amsterdam Born Children and Their Development (ABCD) cohort provides a unique opportunity to assess the effect of gestational fatty acid composition on asthma at the age of 7 years in a large birth cohort.
In 2,105 women, we determined maternal PUFA levels in plasma phospholipids drawn at about week 13 of pregnancy. Child asthma at age 7 (n=154 cases) was based on parental report of physician diagnosis. We categorized PUFA levels and omega-3 to omega-6 ratios in quartiles with the lowest quartile as the reference category in multivariate logistic regression. Risk ratios were adjusted for: gestational age at blood draw; maternal education; western ethnicity; maternal age; parental asthma; and prepregnancy body mass index.
Higher omega-3 levels were related to lower asthma risk with a trend across the quartiles (risk ratio for the top quartile = 0.73, 95% CI (0.45-1.17, P trend across quartiles = 0.04) and higher omega-6 levels showed opposite associations but also not statistically significant and with no significant trend. Higher ratios of omega-3 to omega-6 were associated with slightly lower risks of asthma with a trend across quartiles (risk ratio for top quartile = 0.80, 95% CI 0.50-1.27, P trend across quartiles = 0.04).
We conclude that we found some suggestion of a reduced risk of childhood asthma at age 7 with higher maternal plasma levels of omega-3 and a higher ratio of omega-3 to omega-6 PUFAs.

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