DHA与婴幼儿神经发育

大量科学证实大脑和神经系统的发育会受到遗传、环境、教育、营养与疾病等许多因素的影响.人每日摄入的营养素量,80%用于神经系统的发展和大脑活动.妊娠期母亲的营养摄入和婴儿出牛后早期的营养对婴幼儿神经系统的发育具有极其苇要的意义.许多研究结果显示,DHA在婴幼儿脑发育和视觉功能发育当中具有重要的作用.近年来,关于DHA对婴幼儿神经发育的影响已成为儿童保健学与营养学界关注的热点.     

DHA营养干预对优生的作用

目的 探索DHA临床应用,探讨DHA营养干预对优生的作用.方法 2008年、2009年,浙江某省级医院历时2年(近730 d)对60名育龄妇女分为两个组别进行跟踪对比调查,对一个组别的调查对象在怀孕期间内进行DHA营养干预,另一个组别不进行干预,对比结果在下一代当中进行调查比较后获取,调查内容涉及智力、视力、行为、语言、认知、交往、情感等方面,以6、12、24个月为阶段分别获取统计数据,基于科学统计数据的显示结果,对DHA营养干预对优生的作用进行综合分析.结果 从母亲孕期开始进行DHA营养干预的儿童,其智力、视力发育,以及行为、语言、认知等一系列表现,均优于未进行DHA营养干预的组别,附带调查成果表明,孕期开始进行DHA营养干预的妇女,孕期身体状况亦得到较大改观(相对于未进行干预的妇女).结论 DHA营养干预对优生优育,以及婴幼儿健康成长可起到至关重要的作用,母亲孕期即开始合理的进行DHA营养干预,更利于优生.     

影响6月龄婴儿发育水平的相关因素分析

【目的】 研究影响婴儿早期发育状况的相关因素,为婴儿发育的早期促进提供参考依据。 【方法】 收集2008-2010年在浏阳市妇幼保健院心理行为发育门诊进行盖泽尔发育测试的6月龄婴儿共518例,从喂养方式、母亲文化程度、家庭经济收入、早教方式、营养状况、定期检查、主要抚养人等15个方面进行多因素分析,分别比较对婴儿发育水平的影响。 【结果】 相关因素的分析显示母亲文化、喂养方式、早教方式、孕母营养等12种因素影响婴儿的早期发育水平。经多元回归分析,母亲文化、喂养方式、早教方式、孕母营养、营养状况、主要抚养人6项因素与6月龄婴儿的发育商呈正相关。 【结论】 母亲受教育程度、母乳喂养、早期教育、孕期营养、主要抚养人以及婴儿营养状况对6月龄婴儿的发育水平有显著性影响,在婴儿发育的早期促进中应重视这些因素的影响。     

强化EPA、DHA肠内营养对危重症患者营养状况的影响

目的研究强化二十碳五烯酸(EPA)、二十二碳六烯酸(DHA)肠内营养对危重症患者营养状况的影响。方法选取重症医学科40例危重症患者分为2组,每组20例:实验组[T,105 k J(25 kcal)/kg bw肠内营养+EPA1.05g/d+DHA 0.70g/d]、对照组[C,105 k J(25 kcal)/kg bw肠内营养,不强化EPA、DHA]。连续7d后,采用生化检测法检测两组强化前后总蛋白、白蛋白、血红蛋白水平。另选体检健康人群为空白组[B,n=20],采用气相色谱法检测血清十八碳三烯酸(ALA)、EPA、DHA水平。结果与B组相比,T组强化前血清ALA、EPA水平均较低,差异有统计学意义(P0.05);强化后,ALA、EPA呈不同程度上升,DHA有一定程度下降,但无统计学差异(P0.05)。强化前,T组与C组相比总蛋白、白蛋白、血红蛋白无统计学差异(P0.05)。强化后,T组总蛋白显著上升(P0.01),白蛋白、血红蛋白略有下降,差异无统计学意义(P0.05);C组总蛋白、白蛋白、血红蛋白均显著下降(P0.01)。结论强化EPA、DHA肠内营养可能有助于改善危重症患者营养状况,对疾病预后起到一定的积极作用。     

重视围生期营养,提高围生期保健质量

围生期保健是降低婴儿及母亲发病率和死亡率、保障母婴健康及安全分娩的重要措施.围生期营养是围生期保健的重要内容.围生期对母亲而言,将经历孕晚期、分娩和产褥期;对胎儿而言,是其在子宫内生长、发育及各器官不断发育、完善过程.     

优质的营养 健康的“摇篮”

纽崔莱蛋白质粉 母亲是胎儿及初生婴儿生长发育所需营养的直接来源,母亲营养好,胎儿及婴儿的健康发育生长才有保障。 孕妇及乳母比平时需要更多、更全面的营养,其中,蛋白质是很重要的一种。孕妇妊娠期蛋白质不足,会使胎儿脑细胞数目减少,影响大脑的功能;初生婴儿体重增加很快,大脑细胞的增殖也很快,母乳中蛋白质不足,婴儿的体格及智力发育均会受到明显影响。     

宝贝的蛋黄添加一二三

在母亲的孕程中,DHA的补充是十分重要的。DHA是细胞膜(尤其在视网膜及中枢神经细胞膜中)磷脂的主要结构脂肪酸,在胎儿、婴儿脑发育期与视功能有很大关系。孕妇可以从孕妇奶粉、深海鱼、植物的种子中摄取。     

胎儿出生体重与母亲营养关系的探讨

胎儿生长发育与多种因素有关,如孕妇的外环境,母体的生理条件,胎盘脐带的发育等,尤其和母亲的营养状况有直接而密切的关系.为了进一步了解母亲营养和胎儿生长发育之间的关系,加强围产保健,降低宫内发育迟缓(IUGR)的发病和低体重儿(LBWI)的发生,我们对1年中在我院分娩的孕妇营养状况及胎儿出生体重进行调查分析,结果报告如下.     

母体二十二碳六烯酸摄入水平与婴儿智能发育的关系

目的:探讨母体二十二碳六烯酸(DHA)摄入水平与婴儿智能发育的关系。方法:将孕妇分为A组(DHA平均摄入量<80mg/d)、B组(DHA平均摄入量80～159mg/d)、C组(DHA平均摄入量≥160mg/d)各20例,用毛细管气相色谱法测定3组孕妇于妊娠(20±2)周、(32±2)周、生后4周及足月时的静脉血及其新生儿脐血血清的DHA水平,对其婴儿于出生后3～4个月采用中国儿童发展中心(CDCC)制定的0～3岁婴幼儿智能发育量表进行评价,得出精神和运动发育指数(MDI和PDI)。结果:C组血清DHA含量高于B、A组,差异非常显著(P<0.01),C组MDI、PDI显著高于B、A组(P<0.01)。结论:母体二十二碳六烯酸(DHA)的摄入水平与婴儿智能发育有密切关系。     

脐血与母亲血维生素C营养水平调查及孕期营养指导

目的:探讨脐血与母亲血维生素C营养水平对胎儿生长发育的影响。方法:以在荆州市妇幼保健院分娩的178例正常新生儿和68例母亲为调查对象,测定脐血与母亲血维生素C水平,并对孕妇的膳食营养摄入、生活因素进行了调查。结果:脐血与母亲血维生素C水平均值分别为16.49μmol/L和9.06μmol/L,分别有40.45%和55.9%低于正常水平。结论:本地孕妇维生素C营养状况不容乐观,孕妇维生素C营养状况与胎儿的营养状况相关,基层妇幼保健人员应重视母孕期营养指导并提出相应的指导方法。     

Frequencies and demographic determinants of breastfeeding and DHA supplementation in a nationwide sample of mothers in Germany

Purpose

German guidelines recommend breast milk as ideal for infant’s nutrition, supporting exclusive breastfeeding for at least 4 months. Moreover, in mothers with insufficient fish intake, DHA status may be improved by supplementation during pregnancy and lactation. However, little is known on current rates of breastfeeding and DHA supplementation in Germany. The objective of this study was to analyse frequencies and demographic determinants of breastfeeding and DHA supplementation in Germany.

Methods

Data derived from a nationwide consumer survey of 986 mothers with children between 5 and 36 months of age in Germany.

Results

78.3 % reported that they ever breastfed their children, and 55.6 % of the mothers exclusively breastfed for at least 4 months. Mothers who did not breastfeed were less likely to be informed by their paediatrician or midwife and were more often not informed at all; 27.8 % of mothers used DHA supplements during pregnancy, 16.8 % postnatal. DHA supplementation was more common in women with a high versus a low fish intake. The social status was the major determinant of breastfeeding initiation and exclusivity and also DHA supplementation.

Conclusion

Breastfeeding initiation and duration of exclusive breastfeeding in Germany need to be improved. Professional counselling and support, with a focus on mothers from lower social classes, appears necessary to increase current rates of breastfeeding initiation, duration, and exclusiveness, but also to ensure a sufficient supply with DHA in pregnant and lactating women, particularly in women with low fish consumption.     

婴儿口腔颊粘膜细胞与血浆、红细胞膜脂肪酸构成相关性的初步探讨

目的:通过测定婴儿口腔颊粘膜细胞中的脂肪酸成份来了解婴儿体内的脂肪营养状况。方法:自2005年9月1日至12月30日在上海交通大学医学院附属新华医院新生儿病房住院的足月新生儿共27例,胎龄(37～41)w。同时采集婴儿的口腔颊粘膜细胞和血液标本。应用气相色谱仪测定婴儿口腔颊粘膜细胞,血浆和红细胞膜中的脂肪酸成分,并进行统计学分析。结果:口腔粘膜细胞中的AA和DHA的含量与血浆中的含量显著相关,r分别为0.36(P=0.042)和0.38(P=0.033)。口腔颊粘膜细胞中的AA/DHA比值与血浆和红细胞膜中的AA/DHA比值无显著性统计学差异(P=0.134)。结论:测定新生儿口腔颊粘膜细胞中的脂肪酸成分能反映新生儿体内的脂肪酸情况,口腔粘膜细胞的采集简便易行,对婴儿无创伤,特别适用于新生儿和小婴儿的营养调查。     

Maternal dietary DHA supplementation to improve inflammatory outcomes in the preterm infant

Dietary DHA (22:6n-3) is a long-chain PUFA that has provocative effects on inflammatory signal events that could potentially affect preterm infant health. It is well known that the essential fatty acid of the (n-3) series; α-linolenic acid (18:3n:3) can be desaturated and elongated in the liver endoplasmic reticulum and peroxisome to produce the 22-carbon DHA. Nevertheless, concern exists as to the efficiency of this mechanism in providing the preterm infant with adequate DHA. Activity of the δ-6-desaturase and the δ-5-desaturase necessary for DHA synthesis is decreased by protein deprivation. The combined effects of suboptimal intake of both DHA and protein in the preterm infants could have substantial clinical consequences.     

孕妇、乳母及婴儿补充钙和维生素D对婴儿骨碱性磷酸酶的影响

目的调查研究孕妇、乳母及婴儿补充钙和维生素D的状况与婴儿骨质发育的关系。方法对2006年10月～2008年1月在北京妇产医院儿科就诊的1176例健康母-婴进行面对面的回顾性问卷调查,了解在母亲孕期和哺乳期以及婴儿期补充钙和维生素D的状况,同时检测婴儿全血骨碱性磷酸酶(BAP)的活性,并测量婴儿前囟斜径。用卡方检验和logistic回归对调查结果进行统计分析。结果母亲孕期补钙对婴儿的BAP活性没有显著影响(P=0.154)。在188名纯母乳喂养儿中,母亲在哺乳期补充钙和维生素D,可显著降低婴儿全血BAP的活性(P=0.018)。用logistic回归分析婴儿的喂养方式和是否补充钙和维生素D对婴儿全血BAP活性的影响,结果表明仅婴儿补充钙和维生素D可显著降低全血BAP的活性(P=0.000),而喂养方式对BAP活性没有显著影响影响。对婴儿前囟门大小的分析,42天内婴儿的前囟门大小与BAP活性有明显负关联,但与母亲孕期是否补钙没有关联。结论母亲哺乳期和婴儿补充钙和维生素D可显著降低婴儿全血BAP的活性。婴儿前囟门大小不能作为是否缺钙的判断依据。     

Acides gras oméga-3 et oméga-6 au cours de la grossesse et de la petite enfance

N-3 Fatty acids are biologically important nutrients. One n-3 fatty acid, docosahexaenoic acid, is an important component of neural and retinal membranes and accumulates rapidly in the brain and retina during the later part of gestation and early postnatal life. It is reasonable to hypothesize that maternal n-3 fatty acid intakes might have significant effects on subsequent infant visual function and neurodevelopmental status. Much interest has been expressed about the long-chain polyunsaturated fatty acid (LCPUFA) requirements of both preterm and term infants, whereas relatively little attention has been given to the LCPUFA needs of mothers, who may provide the primary source of LCPUFAs for their fetuses and breast-fed infants. The aim of this review is to synthesize the recent data on the importance of maternal status and nutrition on the fetus and infant development.     

DHA in Pregnant and Lactating Women from Coastland,Lakeland, and Inland Areas of China: Results of a DHA Evaluation in Women (DEW) Study

Few studies have examined docosahexaenoic acid (DHA) in pregnant and lactating women in developing countries like China, where DHA-enriched supplements are increasingly popular. We aimed to assess the DHA status among Chinese pregnant and lactating women residing areas differing in the availability of aquatic products. In total, 1211 women in mid-pregnancy (17 ± 2 weeks), late pregnancy (39 ± 2 weeks), or lactation (42 ± 7 days) were enrolled from Weihai (coastland), Yueyang (lakeland), and Baotou (inland) city, with approximately 135 women in each participant group by region. DHA concentrations were measured using capillary gas chromatography, and are reported as weight percent of total fatty acids. Mean plasma DHA concentrations were higher in coastland (mid-pregnancy 3.19%, late pregnancy 2.54%, lactation 2.24%) and lakeland women (2.45%, 1.95%, 2.26%) than inland women (2.25%, 1.67%, 1.68%) (p values < 0.001). Similar differences were observed for erythrocyte DHA. We conclude that DHA concentrations of Chinese pregnant and lactating women are higher in coastland and lakeland regions than in inland areas. DHA status in the study population appears to be stronger than populations from other countries studied to date.     

Self-Reported DHA Supplementation during Pregnancy and Its Association with Obesity or Gestational Diabetes in Relation to DHA Concentration in Cord and Maternal Plasma: Results from NELA,a Prospective Mother-Offspring Cohort

Maternal supplementation of docosahexaenoic acid (DHA) during pregnancy has been recommended due to its role in infant development, but its effect on materno-fetal DHA status is not well established. We evaluated the associations between DHA supplementation in pregnant women with obesity or gestational diabetes mellitus (GDM) and maternal and neonatal DHA status. Serum fatty acids (FA) were analyzed in 641 pregnant women (24 weeks of gestation) and in 345 venous and 166 arterial cord blood samples of participants of the NELA cohort. Obese women (n = 47) presented lower DHA in serum than those lean (n = 397) or overweight (n = 116) before pregnancy. Linoleic acid in arterial cord was elevated in obese women, which indicates lower fetal retention. Maternal DHA supplementation (200 mg/d) during pregnancy was associated with enhanced maternal and fetal DHA levels regardless of pre-pregnancy body mass index (BMI), although higher arterial DHA in overweight women indicated an attenuated response. Maternal DHA supplementation was not associated with cord venous DHA in neonates of mothers with GDM. The cord arteriovenous difference was similar for DHA between GDM and controls. In conclusion, maternal DHA supplementation during pregnancy enhanced fetal DHA status regardless of the pre-pregnancy BMI while GDM may reduce the effect of DHA supplementation in newborns.     

Omega 3 fatty acids on child growth, visual acuity and neurodevelopment

The aim of this review is to evaluate the effects of omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA) supplementation in pregnant and lactating women and infants during postnatal life, on the visual acuity, psychomotor development, mental performance and growth of infants and children. Eighteen publications (11 sets of randomized control clinical trial [RCTs]) assessed the effects of the n-3 LCPUFA supplementation during pregnancy on neurodevelopment and growth, in the same subjects at different time points; 4 publications (2 data sets from RCTs) addressed physiological responses to n-3 LCPUFA supplementation during pregnancy & lactation and 5 publications (3 data sets from RCTs) exclusively during lactation. Some of these studies showed beneficial effects of docosahexaenoic acid (DHA) supplementation during pregnancy and/or lactation especially on visual acuity outcomes and some on long-term neurodevelopment; a few, showed positive effects on growth. There were also 15 RCTs involving term infants who received infant formula supplemented with DHA, which met our selection criteria. Many of these studies claimed a beneficial effect of such supplementation on visual, neural, or developmental outcomes and no effects on growth. Although new well designed and conducted studies are being published, evidence from RCTs does not demonstrate still a clear and consistent benefit of n-3 LCPUFA supplementation during pregnancy and/or lactation on term infants growth, neurodevelopment and visual acuity. These results should be interpreted with caution due to methodological limitations of the included studies.     

Maternal nutrition and optimal infant feeding practices: executive summary

Much recent attention has been paid to the effect of the fetal environment on not only healthy birth outcomes but also long-term health outcomes, including a role as an antecedent to adult diseases. A major gap in our understanding of these relations, however, is the effect of maternal nutrition and nutrient transport on healthy fetal growth and development. In addition, this gap precludes evidence-based recommendations about how to best feed preterm infants. The biological role of the mother and the effect of her nutritional status on infant feeding extend to postnatal infant feeding practices. Currently, evidence is incomplete about not only the composition of human milk, but also the maternal nutritional needs to support extended lactation and the appropriate nutrient composition of foods that will be used to complement breastfeeding at least through the first year of life. Consequently, a conference, organized by the National Institute of Child Health and Human Development, the National Institutes of Health Office of Dietary Supplements, and the US Department of Agriculture Children's Nutrition Research Center was held to explore current knowledge and develop a research agenda to address maternal nutrition and infant feeding practices. These proceedings contain presentations about the effect of maternal nutrition and the placental environment on fetal growth and birth outcomes, as well as issues pertaining to feeding preterm and full-term infants.     

孕乳期补充鱼油对大鼠行为发育的影响

目的探讨孕、乳期补充富含DHA鱼油对大鼠行为发育的影响.方法以出生前、后脑发育关键期大鼠为研究对象,设1个对照组和添加鱼油的3个剂量组(其中DHA的量分别为0、7.5、15.0、30.0 g/kg饲料),喂养期限为孕0日至仔鼠45日龄.观察妊娠、分娩一般指标,进行断乳前行为发育评价、幼鼠学习行为测试等.结果与对照组相比,DHA 15.0 g/kg饲料组新生鼠脑重显著增加(P＜0.05);2项新生反射指标平面翻正、视觉定向发育显著提前(P＜0.05);跳台潜伏期延长,错误次数减少和避暗潜伏期延长(P＜0.05).结论孕、乳期补充一定剂量的DHA,可对子代大鼠神经发育产生有益影响;孕、乳期补充DHA的较适剂量为15.0 g/kg饲料.