Higher maternal plasma docosahexaenoic acid during pregnancy is associated with more mature neonatal sleep-state patterning

Background: The effect of docosahexaenoic acid (DHA) on the developing fetal central nervous system (CNS) and related functional outcomes in infancy remain unexplored. Sleep and wake states of newborns provide a tool for assessing the functional integrity of the CNS. Objective: We investigated whether CNS integrity in newborns, measured with sleep recordings, was associated with maternal concentrations of long-chain polyunsaturated fatty acids, especially DHA. Design: Plasma phospholipid fatty acid concentrations were measured in 17 women at parturition. On postpartum day 1 (PI) and day 2 (P2), a pressure-sensitive pad under the infants' bedding recorded body movements and respiratory patterns to measure sleep and wake states. Results: Maternal plasma phospholipid DHA ranged from 1.91% to 4.5% by wt of total fatty acids. On the basis of previously published data and the median DHA concentration, the women were divided into 2 groups: high DHA (> 3.0% by wt of total fatty acids) and low DHA (less than or equal to 3.0% by wt of total fatty acids). Infants of high-DHA mothers had a significantly lower ratio of active sleep (AS) to quiet sleep (QS) and less AS than did infants of low-DHA mothers. Furthermore, the former infants had less sleep-wake transition and more wakefulness on P2. Correlations of maternal DHA status with infant sleep states were consistent with these data. Also, the ratio of maternal n-6 to n-3 fatty acids on P I was inversely associated with OS and positively associated with arousals in QS. On P2, maternal n-6:n-3 was positively associated with AS, sleep-wake transition, and AS:QS. Conclusion: The sleep patterns of infants born to mothers with higher plasma phospholipid DHA suggest greater CNS maturity.