孕期多不饱和脂肪酸对母婴健康影响的研究进展

Research progress in the association between maternal prenatal polyunsaturated fatty acids and maternal and infant health

孕期营养与妊娠结局及子代健康密切相关。长链多不饱和脂肪酸(polyunsaturated fatty acids,PUFAs)主要包括二十二碳六烯酸(docosahexaenoic acid,DHA)、二十碳五烯酸(eicosapentaenoic acid,EPA)、花生四烯酸(arachidonic acid,AA)、α-亚麻酸(α-linolenic acid,ALA)及亚油酸(linoleic acid,LA)。人体DHA、EPA和AA主要通过膳食摄入或由必需脂肪酸ALA及LA合成。PUFAs是体内胆固醇酯、磷脂及脂肪的重要组成成分,参与细胞膜的构成,可作为第二信使前体传递信号;可转化合成激素及PUFAs衍生物,通过多种途经,发挥复杂的生物学功能。妇女孕期n-3 PUFAs(EPA、DHA)不足,可能与先兆子痫、早产及产后抑郁的发病风险增高有关,并影响儿童心血管远期健康,但这些相关性还存在一定的争议。母亲孕期n-3 PUFAs(EPA、DHA)的摄入可能与儿童喘息及哮喘风险降低有关,而n-6 PUFAs(AA)摄入量过多可能与哮喘、过敏性鼻炎的风险增加有关。对DHA不足的早产儿,及时补充DHA可促进神经发育。目前缺乏孕妇及新生儿这一敏感人群PUFAs正常参考范围,有必要进一步研究和建立相关标准,以便合理指导孕妇孕期PUFAs营养。

The nutritional status during pregnancy is closely related to the pregnancy outcome of the mother and the health of the offspring.Long chain polyunsaturated fatty acids(PUFAs)mainly include docosahexaenoic acid(DHA),eicosapentaenoic acid(EPA),arachidonic acid(AA),α-linolenic acid(ALA)and linoleic acid(LA).DHA,EPA and AA in human body are mainly from diet or synthesized from essential fatty acids ALA and LA.As the important components of cholesterol esters,phospholipids and fat in human body,PUFAs play complex biological functions through a variety of ways.For instance,PUFAs can participate in the composition of cell membrane,work as the second messenger precursors to transmit signals,and transform into hormones and PUFAs derivatives.Lack of PUFAs(EPA and DHA)during pregnancy may be related to the increased risk of preeclampsia,preterm delivery and postpartum depression,and affect the long-term cardiovascular health of children,but these correlations are still controversial.The increased intake of n-3 PUFAs(EPA and DHA)during pregnancy might be associated with the reduced risk of wheezing and asthma,while the increased intake of n-6 PUFAs(AA)might be associated with the increased risk of asthma and allergic rhinitis.For premature infants with insufficient DHA,timely supplementation of DHA could promote neurodevelopment.At present,there is a lack of normal reference range of PUFAs for pregnant women and newborns as the sensitive population.Thus,it is necessary to further study and establish the normal reference range of PUFAs in order to reasonably guide the nutrition of PUFAs during pregnancy.