Adipositas - Ursachen, Folgeerkrankungen, Therapie 2011; 05(04): 188-194
DOI: 10.1055/s-0037-1618757
Lipide und Ernährungstherapie
Schattauer GmbH

Fischöl in der Schwangerschaft? – Neue Erkenntnisse

Fish oil supplementation during pregnancy? – New insights
S. Brunner
1   Else Kröner-Fresenius-Zentrum für Ernährungsmedizin, Technische Universität München
,
D. Much
1   Else Kröner-Fresenius-Zentrum für Ernährungsmedizin, Technische Universität München
,
U. Amann-Gassner
1   Else Kröner-Fresenius-Zentrum für Ernährungsmedizin, Technische Universität München
,
H. Hauner
1   Else Kröner-Fresenius-Zentrum für Ernährungsmedizin, Technische Universität München
› Author Affiliations
Further Information

Publication History

Publication Date:
22 December 2017 (online)

Zusammenfassung

Der mögliche Nutzen einer mütterlichen Supplementierung mit langkettigen n-3-Fettsäuren (“Fischöl”) während der Schwangerschaft für die kindliche Entwicklung ist seit Jahren Gegenstand intensiver Forschung. Der Schwerpunkt der ersten klinischen Studien lag auf den Auswirkungen einer Fischölgabe auf den Schwangerschaftsverlauf und die Geburt. Es folgten Studien mit dem Fokus auf der neurologischen Entwicklung und der möglichen Primärprävention allergischer Erkrankungen.

Ein relativ neuer Aspekt im Zusammenhang mit Fischölsupplementierung während der Schwangerschaft ist dessen möglicher Einfluss auf die frühe Fettgewebsentwicklung der Nachkommen als Primärpräventionsstrategie gegen kindliches Übergewicht. Eine systematische Auswertung der verfügbaren Fachliteratur liefert keine überzeugenden Hinweise für den postulierten Nutzen einer Supplementierung mit Fischöl auf maternale und kindliche Parameter, sodass nach dem aktuellen Kenntnisstand eine generelle Supplementierung in der Schwangerschaft nicht empfohlen werden kann. Dies gilt auch für die alleinige Gabe von Docosahexaensäure (DHA).

Summary

In recent years, increasing attention has been given to the effects of maternal supplementation with n-3-long-chain polyunsaturated fatty acids (LCPUFA) during pregnancy on pregnancy outcome and later child development.

The first randomized, controlled trials focused on the effects of n-3-LCPUFA on pregnancy outcome as well as maternal and fetal birth outcomes followed by studies investigating the impact of maternal fish oil supplementation on neurological/cognitive development or atopic risk of the child.

A relatively new upcoming issue in the context of maternal supplementation with n-3-LCPUFA during pregnancy is the role of n-3-LCPUFA in influencing offspring body composition as a prevention strategy against childhood overweight.

A systematic evaluation of the available literature provides no convincing evidence for the postulated benefits of supplementation with n-3-LCPUFA. Thus, according to present knowledge, routine supplementation with n-3-LCPUFA or DHA for pregnant women is not recommended.

 
  • Literatur

  • 1 Olsen SF, Joensen HD. High liveborn birth weights in the Faroes: a comparison between birth weights in the Faroes and in Denmark. J Epidemiol Community Health 1985; 39 (01) 27-32.
  • 2 Olsen SF, Hansen HS, Sorensen TI, Jensen B, Secher NJ, Sommer S. et al. Intake of marine fat, rich in (n-3)-polyunsaturated fatty acids, may increase birthweight by prolonging gestation. Lancet 1986; 02 (8503): 367-369.
  • 3 Dyerberg J, Bang HO, Walters BNJ. et al. PREECLAMPSIA AND PROSTAGLANDINS. Lancet 1985; 325 (8440): 1267-1268.
  • 4 Mitchell MD. Prostaglandins during pregnancy and the perinatal period. J Reprod Fertil 1981; 62 (01) 305-315.
  • 5 Makrides M, Duley L, Olsen SF. Marine oil, and other prostaglandin precursor, supplementation for pregnancy uncomplicated by pre-eclampsia or intrauterine growth restriction. Cochrane Database Syst Rev 2006; 03: CD003402.
  • 6 Szajewska H, Horvath A, Koletzko B. Effect of n-3 long-chain polyunsaturated fatty acid supplementation of women with low-risk pregnancies on pregnancy outcomes and growth measures at birth: a meta-analysis of randomized controlled trials. Am J Clin Nutr 2006; 83 (06) 1337-1344.
  • 7 Horvath A, Koletzko B, Szajewska H. Effect of supplementation of women in high-risk pregnancies with long-chain polyunsaturated fatty acids on pregnancy outcomes and growth measures at birth: a meta-analysis of randomized controlled trials. Br J Nutr 2007; 98 (02) 253-259.
  • 8 Innis SM. Fatty acids and early human development. Early Hum. Dev 2007; 83 (12) 761-766.
  • 9 Lauritzen L, Hansen HS, Jørgensen MH, Michaelsen KF. The essentiality of long chain n-3 fatty acids in relation to development and function of the brain and retina. Prog Lipid Res 2001; 40 (1–2): 1-94.
  • 10 Clandinin MT, Chappell JE, Leong S, Heim T, Swyer PR, Chance GW. Intrauterine fatty acid accretion rates in human brain: implications for fatty acid requirements. Early Hum Dev 1980; 04 (02) 121-129.
  • 11 Makrides M, Collins CT, Gibson RA. Impact of fatt y acid status on growth and neurobehavioural development in humans. Matern Child Nutr 2011; 07 (Suppl. 02) 80-88.
  • 12 Hoffman DR, Boettcher JA, Diersen-Schade DA. Toward optimizing vision and cognition in term infants by dietary docosahexaenoic and arachidonic acid supplementation: a review of randomized controlled trials. Prostaglandins Leukot. Essent Fatty Acids 2009; 81 (2-3): 151-158.
  • 13 Ryan AS, Astwood JD, Gautier S, Kuratko CN, Nelson EB, Salem N. Effects of long-chain polyunsaturated fatty acid supplementation on neurodevelop-ment in childhood: a review of human studies. Prostaglandins Leukot. Essent Fatty Acids 2010; 82 (4-6): 305-314.
  • 14 Simmer K, Patole SK, Rao SC. Longchain polyunsaturated fatty acid supplementation in infants born at term. Cochrane Database Syst Rev 2008; (01) CD000376.
  • 15 Schulzke SM, Patole SK, Simmer K. Longchain polyunsaturated fatty acid supplementation in preterm infants. Cochrane Database Syst Rev 2011; (02) CD000375.
  • 16 Smithers LG, Gibson RA, McPhee A, Makrides M. Effect of long-chain polyunsaturated fatty acid supplementation of preterm infants on disease risk and neurodevelopment: a systematic review of randomized controlled trials. Am J Clin Nutr 2008; 87 (04) 912-920.
  • 17 Beyerlein A, Hadders-Algra M, Kennedy K, Fewtrell M, Singhal A, Rosenfeld E. et al. Infant formula supplementation with long-chain polyunsaturated fatty acids has no effect on Bayley developmental scores at 18 months of age - IPD meta-analysis of 4 large clinical trials. J Pediatr Gastroenterol Nutr 2010; 50 (01) 79-84.
  • 18 Dziechciarz P, Horvath A, Szajewska H. Effects of n-3 long-chain polyunsaturated fatty acid supplementation during. J Am Coll Nutr 2010; 29 (05) 443-454.
  • 19 Makrides M, Gibson RA, McPhee AJ. et al. Effect of DHA supplementation during pregnancy on maternal depression and neurodevelopment of young children: a randomized controlled trial. JAMA 2010; 304 (15) 1675-1683.
  • 20 Escolano-Margarit MV, Ramos R, Beyer J. et al. Prenatal DHA status and neurological outcome in children at age 5.5 years are positively associated. J Nutr 2011; 141 (06) 1216-1223.
  • 21 Campoy C, Escolano-Margarit MV, Ramos R. et al. Effects of prenatal fish-oil and 5-methyltetrahydroolate supplementation on cognitive development of children at 6.5 y of age. Am J Clin Nutr. 2011 doi: 10.3945/ajcn.110.001107.
  • 22 Klemens CM, Berman DR, Mozurkewich EL. The effect of perinatal omega-3 fatty acid supplementation on inflammatory markers and allergic diseases: a systematic review. BJOG 2011; 118 (08) 916-925.
  • 23 Furuhjelm C, Warstedt K, Fagerås M. et al. Allergic disease in infants up to 2 years of age in relation to plasma omega-3 fatty acids and maternal fish oil supplementation in pregnancy and lactation. Pediatr Allergy Immunol 2011; 22 (05) 505-514.
  • 24 Massiera F, Saint-Marc P, Seydoux J. et al. Arachidonic acid and prostacyclin signaling promote adipose tissue development: a human health concern?. J. Lipid Res 2003; 44 (02) 271-279.
  • 25 Ailhaud G, Massiera F, Weill P. et al. Temporal changes in dietary fats: role of n-6 polyunsaturated fatty acids in excessive adipose tissue development and relationship to obesity. Prog. Lipid Res 2006; 45 (03) 203-236.
  • 26 Azain MJ. Role of fatty acids in adipocyte growth and development. J. Anim. Sci 2004; 82 (03) 916-924.
  • 27 Muhlhausler BS, Gibson RA, Makrides M. The effect of maternal omega-3 long-chain polyunsaturated fatty acid (n-3 LCPUFA) supplementation during pregnancy and/or lactation on body fat mass in the offspring: a systematic review of animal studies. Prostaglandins Leukot. Essent. Fatty Acids 2011; 85 (02) 83-88.
  • 28 Ailhaud G, Guesnet P. Fatty acid composition of fats is an early determinant of childhood obesity: a short review and an opinion. Obes Rev 2004; 05 (01) 21-26.
  • 29 Helland IB, Smith L, Blomén B. et al. Effect of supplementing pregnant and lactating mothers with n-3 very-long-chain fatty acids on children’s IQ and body mass index at 7 years of age. Pediatrics 2008; 122 (02) e472-479.
  • 30 Lauritzen L, Hoppe C, Straarup EM, Michaelsen KF. Maternal fish oil supplementation in lactation and growth during the first 2.5 years of life. Pediatr. Res 2005; 58 (02) 235-242.
  • 31 Lucia BR, Bergmann KE, Haschke-Becher E. et al. Does maternal docosahexaenoic acid supplementation during pregnancy and lactation lower BMI in late infancy?. J Perinat Med 2007; 35 (04) 295-300.
  • 32 Asserhøj M, Nehammer S, Matthiessen J. et al. Maternal fish oil supplementation during lactation may adversely affect long-term blood pressure, energy intake, and physical activity of 7-year-old boys. J Nutr 2009; 139 (02) 298-304.
  • 33 Muhlhausler BS, Gibson RA, Makrides M. Effect of long-chain polyunsaturated fatty acid supplementation during pregnancy or lactation on infant and child body composition: a systematic review. Am J Clin Nutr 2010; 92 (04) 857-863.
  • 34 Rytter D, Bech BH, Christensen JH. et al. Intake of fish oil during pregnancy and adiposity in 19-y-old offspring: follow-up on a randomized controlled trial. Am J Clin Nutr 2011; 94 (03) 701-708.
  • 35 Hauner H, Vollhardt C, Schneider KTM. et al. The impact of nutritional fatty acids during pregnancy and lactation on early human adipose tissue development. Rationale and design of the INFAT study. Ann Nutr Metab 2009; 54 (02) 97-103.
  • 36 Poissonnet CM, Burdi AR, Bookstein FL. Growth and development of human adipose tissue during early gestation. Early Hum Dev 1983; 08 (01) 1-11.
  • 37 Koletzko B, Cetin I, Brenna JT. Dietary fat intakes for pregnant and lactating women. Br J Nutr 2007; 98 (05) 873-877.
  • 38 http://www.issfal.org/statements/pufa-recommendations/statement-4 (abgerufen am 25.08.2011)
  • 39 EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) European Food Safety Authority (EFSA) Parma Italy (2010). Scientific Opinion on Dietary Reference Values for fats, including saturated fatty acids, polyunsaturated fatty acids, monounsaturated fatty acids, trans fatty acids, and cholesterol. EFSA Journal. 2010 08. (3)
  • 40 Joint FAO/WHO Expert Consultation on Fats and fatty acids in Human Nutrition. Fats and fatty acids in human nutrition: Report of an Expert Consultation. 10-14 November 2008 Geneva. Rome: Food and Agriculture Organization of the United Nations; 2010. (FAO food and nutrition paper; vol 91)
  • 41 www.aid.de/shop/pdf/3389_2011_handlungsempf_schwangere_x000.pdf (abgerufen am 25. August 2011)
  • 42 Becker S, Schmid D, Amann-Gassner U, Hauner H. Verwendung von Nährstoffsupplementen vor und während der Schwangerschaft. Ernährungs -umschau 2011; (01) 36-41.