Maternal polyunsaturated fatty acid concentrations during pregnancy and childhood liver fat accumulation

Background & aims: Maternal polyunsaturated fatty acids (PUFA) concentrations in pregnancy are essential for fetal lipid metabolism and adipocyte differentiation. Whether suboptimal maternal gestational PUFA concentrations adversely affect offspring liver fat development is unknown. We aimed to examine the associations of maternal n-3 and n-6 PUFA concentrations in pregnancy with childhood liver fat accumulation. Methods: In a population-based prospective cohort study among 2424 mother–child pairs, we measured maternal total and individual n-3 and n-6 PUFA plasma concentrations at mean gestational age of 20.6 ± 1.1 weeks. Childhood liver fat fraction was obtained by MRI at 10 years. Non-alcoholic fatty liver disease was a liver fat fraction ≥5.0%. Results: We observed that 1-Standard deviation (SD) higher maternal n-3 PUFA concentrations, especially DHA, was associated with a lower childhood liver fat fraction [−0.07 SD-score (95% CI −0.11 to −0.02, p-value = 0.001) for both total n-3 PUFA and DHA concentrations]. Of n-6 PUFAs, 1-SD higher maternal dihomo-gamma-linolenic acid concentrations was associated with a higher childhood liver fat fraction [0.06 SD-score (95% CI 0.02–0.10, p-value = 0.004)]. Associations were not explained by maternal or childhood socio-demographic and lifestyle characteristics. Associations were stronger among boys and less consistent among girls. Among boys, higher maternal total n-3 PUFA concentrations were associated with a lower risk of childhood non-alcohol fatty liver disease [odds ratio 0.42 (95% CI 0.25–0.70, p-value = 0.001)]. Conclusions: Maternal lower n-3 PUFA and higher n-6 PUFA concentrations in pregnancy are associated with offspring liver fat accumulation in childhood. Optimizing maternal PUFA concentrations during pregnancy may be a target for preventing liver fat accumulation in their offspring.