Perinatal supply and metabolism of long-chain polyunsaturated fatty acids: importance for the early development of the nervous system

Ann N Y Acad Sci. 2002 Jun;967:299-310. doi: 10.1111/j.1749-6632.2002.tb04285.x.


The long-chain polyunsaturated fatty acids, arachidonic (AA) and docosahexaenoic acid (DHA), are essential structural lipid components of biomembranes. During pregnancy, long-chain polyunsaturated fatty acids (LC-PUFA) are preferentially transferred from mother to fetus across the placenta. This placental transfer is mediated by specific fatty acid binding and transfer proteins. After birth, preterm and full-term babies are capable of converting linoleic and alpha-linolenic acids into AA and DHA, respectively, as demonstrated by studies using stable isotopes, but the activity of this endogenous LC-PUFA synthesis is very low. Breast milk provides preformed LC-PUFA, and breast-fed infants have higher LC-PUFA levels in plasma and tissue phospholipids than infants fed conventional formulas. Supplementation of formulas with different sources of LC-PUFA can normalize LC-PUFA status in the recipient infants relative to reference groups fed human milk. Some, but not all, randomized, double-masked placebo-controlled clinical trials in preterm and healthy full-term infants demonstrated benefits of formula supplementation with DHA and AA for development of visual acuity up to 1 year of age and of complex neural and cognitive functions. From the available data, we conclude that LC-PUFA are conditionally essential substrates during early life that are related to the quality of growth and development. Therefore, a dietary supply during pregnancy, lactation, and early childhood that avoids the occurrence of LC-PUFA depletion is desirable, as was recently recommended by an expert consensus workshop of the Child Health Foundation.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Arachidonic Acid / pharmacokinetics
  • Arachidonic Acid / pharmacology*
  • Docosahexaenoic Acids / pharmacokinetics
  • Docosahexaenoic Acids / pharmacology*
  • Female
  • Humans
  • Infant
  • Infant Behavior / drug effects
  • Infant, Newborn
  • Infant, Premature
  • Maternal-Fetal Exchange
  • Milk, Human
  • Nervous System / growth & development*
  • Pregnancy
  • Visual Acuity / drug effects


  • Docosahexaenoic Acids
  • Arachidonic Acid