Effect Of Phospholipid DHA On Adverse Pregnancy Outcome Of Pregnant Women With Gestational Diabetes Mellitus And Its Mechanism

ObjectiveIn this study,we measured the concentration of docosahexaenoic acid(DHA)in peripheral blood and umbilical cord blood of pregnant women with gestational diabetes mellitus(GDM)to analyze the efficacy of phospholipid-based DHA in improving gestational diabetes mellitus patients and to provide a theoretical basis for clinical supplementation of DHA.MethodsA total of one hundred pregnant women from our hospital were diagnosed with GDM were randomly divided into two groups,experimental group(oral phospholipid DHA 320 mg/day(fish seed oil))and the control group(oral non-phospholipid DHA320 mg/day(fish oil or algal oil)).A total of eighty patients with GDM were included,50 in the experimental group and 30 in the control group.The general clinical data of the two groups of patients,peripheral blood in the third trimester of pregnancy,and umbilical venous blood of newborns were collected,and the content of various fatty acids in erythrocyte membrane of maternal peripheral blood and umbilical cord blood was determined by gas chromatography-mass spectrometry combination(GC-MS),and the final result was expressed as the percentage of each fatty acid to the total fatty acid(the main index was DHA content).The placental tissues of two groups were collected,and the expression of MFSD2 a gene in the placenta was detected by Quantitative Real-time PCR(Q-PCR).The baseline data,pregnancy outcome,neonatal outcome,DHA content of erythrocyte membrane of maternal peripheral blood and cord blood,and Major facilitator superfamily domain containing 2a gene expression in placental tissue were compared between the two groups.Results1.Pregnancy outcome and neonatal outcome of patients in both groups(1)Comparing the week of gestation of delivery,time of DHA administration,fetal malformation,premature rupture of membranes and preterm delivery of patients in the experimental and control groups,the differences were not statistically significant(P>0.05).Comparing the delivery methods of the two groups,the cesarean delivery rate was 24% in the experimental group and 50% in the control group.The cesarean delivery rate in the control group was higher than that in the experimental group,which was mainly related to the patients’ previous history of cesarean delivery,and the difference was statistically significant(P<0.05).(2)Comparing the neonatal head circumference,length,fetal weight,and whether the fetus was transferred to the department in the experimental and control groups,the differences were not statistically significant(P>0.05).The above results indicated that there was no significant difference in the effect of taking phospholipid-based DHA on pregnancy outcome and neonatal outcome of pregnant women.2.The results of fatty acid content on maternal peripheral blood and umbilical cord blood erythrocyte membrane(1)The level of DHA on erythrocyte membranes of maternal peripheral blood in the experimental group(8.72 ± 1.01)was higher than that in the control group(7.04 ±1.18),and the difference was statistically significant(P<0.05).(2)The level of DHA on the erythrocyte membrane of fetal cord blood in the experimental group(7.98 ± 1.04)was higher than the level of DHA in the control group(6.99 ± 0.83),and the difference was statistically significant(P<0.05).(3)The levels of Omega-3,Omega-3 index and EPA in maternal peripheral blood of the experimental group were higher than those of the control group,and the differences were statistically significant(P<0.05).(4)The levels of Omega-3,Omega-3 index and EPA on the erythrocyte membrane of fetal cord blood in the experimental group were all higher than those in the control group,and the differences were statistically significant(P<0.05).The above results indicated that the administration of phospholipid-based DHA significantly increased the levels of DHA on the erythrocyte membranes of maternal peripheral blood and fetal umbilical cord blood,and the administration of phospholipid-based DHA increased the levels of Omega-3,Omega-3 index,and EPA in maternal blood and fetal umbilical cord blood.3.The results of MFSD2 a gene expression in placentaThe level of MFSD2 a gene expression in the placenta of the experimental group was higher than that of the control group of pregnant women,and the difference was statistically significant(P<0.05).ConclusionSupplementation of phospholipid-based DHA in GDM patients increased DHA levels in maternal peripheral blood and fetal umbilical blood erythrocyte membranes,and improved maternal-fetal DHA transport efficiency in GDM patients.The expression of MFSD2 a gene was significantly increased in the placenta of GDM pregnant women in the phospholipid-based DHA group.