Prenatal and early postnatal long-chain polyunsaturated fatty acid status : do they affect neurodevelopmental outcome in healthy term infants?

Long-chain metabolites of the parent essential fatty acids called long-chain polyunsaturated fatty acids (LCPUFAs) are major membrane components in the central nervous system. Dictary intake partly determines the availability of LCPUFAs as building btocks for neuronal structures. Fifty till sixty percent of the dry brain weight consists of fatty acids of which about twenty percent are LCPUFAs. In particuIar two LCPUFAs, docosahexaenoic acid (DHA) and arachidonic acid (AA) are being incorporated into neuronal tissue. Conversion of the essential fatty acid alpha-linolenic acid into DHA is inefficient in humans, so DHA status is relatively dependent on dietary intake of DHA, which is currently low in western societies. Many studies have provided evidence that DHA and AA play a role in adequate functioning of the central nervous system. During the so-called brain growth spurt, which takes place shortly before and after birth until about the age of 2 years, large amounts of fatty acids are being incorporated into the nervous system. It is therefore remadiable that conventional formula feeding does not contain LCPUFAs, whereas breastfeedmg does contain LCPUFAs. LCPUFAs could partially explain the observed positive effect of breastfeeding on neurodeve lopment. To study the potential beneficial effects of LCPUFAs and the type of early postnatal feeding on neurodeveloprnental outcome we investigated 472 healthy term infants in a double blind randomized controlled trial with a breastfed reference group. Follow-up after two months of LCPUFA supplementation was conducted at the ages of 3 and 18 months to evaluate neurodevelopmental outcome. In addition, we evaluated the relationships between prenatal LCPUFA status and the neurodevelopmental outcome at 3 and 18 months in the same study cohort. For this we collected samples of the umbilical vein and artery for the determination of the LCPUFA content. The LCPUFA content was used as a marker of prenatal LCPUFA status