ABSTRACT
Polyunsaturated fatty acids (PUFAs) are required by the embryo and oocytes, but until around 25 weeks of gestation, their accumulation by the fetus is relatively small and increases logarithmically with gestational age. Docosahexaenoic acid (DHA) and arachidonic acid (AA) are involved in neurotransmission and retinal function; additionally, AA is of particular importance for growth and development. In humans, mitochondrial fatty acid oxidation plays an important role in placental and fetal metabolism. The sources of PUFA needed to sustain fetal growth are both maternal diet and fat stores and fetal synthesis. In the maternal circulation, PUFAs are carried in their esteried form by plasma lipoproteins; both placental lipoprotein receptors and lipases ensure that they are hydrolyzed before or after their receptor-mediated uptake and fatty acids are released to the fetal circulation. Nonesteried fatty acids in maternal plasma could also be a source of PUFAs for the fetus, crossing the placenta, thanks to the fatty acid-binding proteins and fatty acid transfer proteins. Pregnancy is a state of mild controlled inammation, and eicosanoids derived from PUFAs can modulate the proinammatory/anti-inammatory balance at various points. On the contrary, the role of PUFAs in placental oxidative stress is controversial, with different authors reporting that PUFAs either limit oxidative stress, have no effect, or cause an increase in oxidative stress. Some bioactive proteins called adipokines can be synthesized by the placenta, as is the case of leptin, or have their effect on the placenta by interacting with their receptors, as is the case for adiponectin and others. These adipokines can be also synthesized by the fetus and have different effects on maternal metabolism and fetal
7.1 Introduction ............................................................................................................................94 7.2 Importance of LCPUFA to Fetal Growth ...............................................................................95 7.3 LCPUFA as a Source of Energy for the Fetus ........................................................................96 7.4 LCPUFA and Neurological and Visual Development ............................................................97 7.5 Sources of PUFAs to Sustain Fetal Growth ...........................................................................98
