Changes in cholesteryl ester transfer protein concentration during normal gestation

Background: It has been shown that endogenous estrogen may affect the concentration of cholesteryl ester transfer protein (CETP) and that the gestation in women is accompanied by increased levels of endogenous estrogen. Objectives: To examine the changes in CETP concentration and to investigate the relationship between CETP and estrogen levels during normal pregnancy. Methods: Serum concentrations of CETP, estrogen and lipid traits were determined from 296 healthy women at different times during gestation. Results: Pregnant women exhibited a significant elevation in the concentration of CETP as compared with non‐pregnant women (3.11 ± 1.51 mg/L vs. 2.64 ± 1.25 mg/L, p <0.001). The CETP concentration was highest in the first trimester (3.85 ± 1.33 mg/L, compared with controls, p <0.0001), declined progressively from the first to the third trimester and still remained elevated in the third trimester as compared with non‐pregnant subjects (p <0.05). A negative correlation was noted between serum CETP and estradiol (E₂) levels in pregnant women (r = –0.288, p <0.0001). In addition, significantly negative correlations between the serum CETP concentration and all the lipid traits examined were found in gestating women. Conclusion: CETP concentrations were significantly elevated in pregnancy and decreased progressively from early to late gestation. The results suggest that endogenous E₂ is either not involved or its effect on CETP is dominated by elevated lipid levels or some other factors during mid and late pregnancy.     

Calcium and magnesium concentrations in mature human milk: influence of calcium intake, age and socioeconomic level

Concentrations of calcium and magnesium were measured in mature milk, collected between 30 and 90 days after childbirth, from a group of 90 mothers between 14 and 39 years of age, exclusively breastfeeding. The group was divided into three sub-groups: low socioeconomic-level adolescents (LSAd), low socioeconomic-level adults (LSA), and high socioeconomic-level adults (HSA). Each mother's nutritional status was determined using the body-mass index (BMI) and her eating habits, obtained on the basis of a 24-h dietary recall. Adolescent and adult mothers in the low socioeconomic-level group had lower average calcium intake (LSAd = 618.4 +/- 555.2 mg and LSA = 679.4 +/- 411.4 mg) than adult mothers in the higher socioeconomic-level group (853.6 +/- 415.5 mg). The average concentration of calcium in the adolescent mothers' milk (LSAd) was significantly lower (5.30 +/- 1.42 mmol Ca/L, P = 0.01) than that of the two adult groups (LSA = 5.82 +/- 1.55 mmol Ca/L and HSA = 6.40 mmol Ca/L). The average magnesium concentrations for all groups did not show significant differences (LSAd = 1.06 +/- 0.18, LSA = 1.16 +/- 0.23 and HSA = 1.11 +/- 0.23 mmol Mg/L, for P= 0.16). These results indicate that magnesium concentrations in mature human milk do not seem to depend on maternal nutritional status. The condition of adolescence, however, associated with lower calcium intake by the mother, resulted in lower calcium concentrations in the milk secreted when compared to that of adult mothers.     

A randomized controlled trial of the effect of fish oil supplementation in late pregnancy and early lactation on the n−3 fatty acid content in human breast milk

The aim of this research was to investigate the effect of fish oil supplementation, in the third trimester of pregnancy and early lactation period of healthy pregnant Danish women. Forty-four pregnant women were randomly allocated to fish oil supplementation (1.3 g EPA and 0.9 g DHA per day) from week 30 of gestation (FO-group) or to a control regimen (olive oil or no oil; controls). The FO-group was randomly subdivided into women stopping fish oil supplementation at delivery [FO(pregn)], and women continuing supplementation for an, additional 30 d [FO(pregn/lact)]. Thirty-six women agreed to collect milk samples at days 4, 16, and 30 postpartum. The FA composition of the milk samples was determined by GLC. At days 4, 16, and 30 in lactation, FO(pregn/lact) women (n=12) had, respectively 2.3 (P=0.001), 4.1 (P=0.001), and 3.3 (P=0.001) times higher mean contents of LCPUFA(n−3) in their breast milk compared with controls (n=13), and 1.7 (P=0.005), 2.8 (P=0.001), and 2.8 (P=0.001), times higher LCPUFA(n−3) contents, respectively, at these days compared with FO(pregn) women (n=11). The latter group did not differ significantly from controls with regard to LCPUFA(n−3) content in the breast milk. Similar results were obtained when analyzing separately for effects on the milk content of DHA. Dietary supplementation with 2.7 g LCPUFA(n−3) per day from week 30 of gestation and onward more than tripled the LCPUFA(n−3) content in early breast milk; supplementation limited to pregnancy only was much less effective.     

Serum vitamin A during pregnancy and effects on obstetrics and perinatal outcomes in HIV infected pregnant women

To evaluate serum vitamin levels and its association with obstetrics and perinatal results in HIV infected pregnant women. Observational and prospective study carried out at Division of Infectious-Contagious Diseases in Gynecology and Obstetrics of the University Hospital, Medicine School of Ribeir?o Preto, University of S?o Paulo, involving 57 pregnant women divided into 3 groups: Group 1, with 12 normal pregnant women, it was the control group; Group 2, with 20 HIV infected pregnant women, using ZDV; and Group 3, with 25 HIV infected pregnant women, using therapy I contend ZDV, 3TC and nelfinavir. The evaluation of the serum vitamin level was obtained three times during pregnancy at equidistant time intervals and in the immediate period after birth. We also evaluated the levels of this vitamin and the hemoglobin in the blood of the umbilical cord. We obtained maternal and newborn infant anthropometric data, as well as the counting of lymphocyte TCD4 and viral load of the HIV during the pregnancy. Reduced serum vitamin levels were observed in the Group 1(25%), the Group 2(29,4%) and the Group 3(28,6%). Association was not observed between serum levels of maternal retinol and the duration of the gestation in groups 2 and 3. In groups 1 and 3, an association was observed between the maternal concentration of retinol and the newborn hemoglobin (p=0.05). In distinct way to the Control group, association was not observed between the retinol levels of the umbilical cord and the weight of the newborn in gestations of Group 2, while a trend to this association was observed in gestations of Group 3 (p=0.06). We observed high prevalence of hipovitaminosis A in the population of this study, regardless of antiretroviral scheme used.     

Apoptosis Signaling Is Altered in CD4(+)CD25(+)FoxP3(+) T Regulatory Lymphocytes in Pre-Eclampsia

The aim of our study was to estimate the surface expressions of CD95 (APO-1/Fas) antigen and the intracellular expressions of anti-apoptotic protein Bcl-2 and pro-apoptotic protein Bax in CD4(+)CD25(+)FoxP3(+) T regulatory lymphocytes (Tregs) as well as the percentage of CD8(+)CD28(+) T cytotoxic cells in peripheral blood of patients with pre-eclampsia in comparison with healthy pregnant women in the third trimester of physiological pregnancy. Twenty-four women with pre-eclampsia and 20 normal third trimester pregnant women were included in the study. The lymphocytes were isolated from peripheral blood samples and labeled with monoclonal antibodies. The expressions of surface antigens and intracellular proteins were estimated using flow cytometry. The population of CD4(+)CD25(+)FoxP3(+) Treg cells was significantly lower in peripheral blood of patients with pre-eclampsia when compared to normal third trimester pregnant women. The percentages of CD4(+)CD25(+)FoxP3(+) Treg cells that express Bcl-2 protein were significantly lower in peripheral blood of patients with pre-eclampsia when compared to healthy pregnant women, whereas the percentages of CD4(+)CD25(+)FoxP3(+) Treg cells with the expressions of Bax protein did not differ in both groups. Moreover, the mean fluorescence intensity (MFI) of Bcl-2 protein in CD4(+)CD25(+)FoxP3(+) Treg cells was significantly lower and MFI of Bax protein significantly higher in pre-eclampsia when compared to the control group. The percentage of CD8(+)CD28(+) T cells did not differ in both studied groups but MFI of CD28 antigen on T CD8(+) cells was significantly higher in pre-eclampsia when compared to the control group. The obtained results suggest that the deficit of CD4(+)CD25(+)FoxP3(+) Treg lymphocytes which is observed in pre-eclampsia may be associated with altered apoptosis signaling in Tregs.     

Development and validation of a quantitative choline food frequency questionnaire for use with drinking and non-drinking pregnant women in Cape Town,South Africa

Background

Although animal and human studies have demonstrated interactions between dietary choline and fetal alcohol spectrum disorders, dietary choline deficiency in pregnancy is common in the US and worldwide. We sought to develop and validate a quantitative food frequency questionnaire (QFFQ) to estimate usual daily choline intake in pregnant mothers.

Methods

A panel of nutrition experts developed a Choline-QFFQ food item list, including sources with high choline content and the most commonly consumed choline-containing foods in the target population. A data base for choline content of each item was compiled. For reliability and validity testing in a prospective longitudinal cohort, 123 heavy drinking Cape Coloured pregnant women and 83 abstaining/light-drinking controls were recruited at their first antenatal clinic visit. At 3 prenatal study visits, each gravida was interviewed about alcohol, smoking, and drug use, and administered a 24-hour recall interview and the Choline-QFFQ.

Results

Across all visits and assessments, > 78% of heavy drinkers and controls reported choline intake below the Dietary Reference Intakes adequate intake level (450 mg/day). Women reported a decrease in choline intake over time on the QFFQ. Reliability of the QFFQ across visits was good-to-acceptable for 2 of 4 group-level tests and 4 of 5 individual-level tests for both drinkers and controls. When compared with 24-hr recall data, validity of the QFFQ was good-to-acceptable for 3 of 4 individual-level tests and 3 of 5 group-level tests. For controls, validity was good-to-acceptable for all 4 individual-level tests and all 5 group-level tests.

Conclusions

To our knowledge, this is the first quantitative choline food frequency screening questionnaire to be developed and validated for use with both heavy and non-drinking pregnant women and the first to be used in the Cape Coloured community in South Africa. Given the high prevalence of inadequate choline intake and the growing evidence that maternal choline supplementation can mitigate some of the adverse effects of prenatal alcohol exposure, this tool may be useful for both research and future clinical outreach programs.

     

Individualized Follow-up of Pregnant Women with Asymptomatic Autoimmune Thyroid Disease

Maternal hormones are essential for the normal fetal development during pregnancy. Autoimmune thyroid disease is a frequent pathology in our iodine replete region. The aim of this study is to evaluate the occurrence of subclinical hypothyroidism (SCH) in cases with known autoimmune thyroid disease, which were in a euthyroid state prior to pregnancy, and to assess the association between supplemental treatments administered and the outcome of the pregnancy. The study is a prospective interventional controlled study. The two cohorts comprise the interventional group, consisting of 109 pregnant women with known autoimmune asymptomatic thyroid disease, without any levothyroxine (LT4) treatment and an aged-matched control group, with an unknown thyroid disease. After the pregnancy, a monthly evaluation of TSH, FT3, and FT4 was performed. Offspring evaluation was made at birth time. 88.8% of the women developed SCH in the first four weeks of pregnancy. Average LT4 doses increased as the pregnancy progressed. The monthly adjustment was 12.5 or 25 μg. All SCH cases developed in the first trimester of pregnancy. There was no significant difference regarding the gestational week, weight, or length at birth between the interventional group and controls, when TSH values were in the optimal range, during the whole pregnancy. Premature birth was described in one case in the interventional group.     

Reduced Placental CD24 in Preterm Preeclampsia Is an Indicator for a Failure of Immune Tolerance

Introduction: CD24 is a mucin-like glycoprotein expressed at the surface of hematopoietic and tumor cells and was recently shown to be expressed in the first trimester placenta. As it was postulated as an immune suppressor, CD24 may contribute to maternal immune tolerance to the growing fetus. Preeclampsia (PE), a major pregnancy complication, is linked to reduced immune tolerance. Here, we explored the expression of CD24 in PE placenta in preterm and term cases. Methods: Placentas were derived from first and early second trimester social terminations (N = 43), and third trimester normal term delivery (N = 67), preterm PE (N = 18), and preterm delivery (PTD) (N = 6). CD24 expression was determined by quantitative polymerase chain reaction (qPCR) and Western blotting. A smaller cohort included 3–5 subjects each of term and early PE, and term and preterm delivery controls analyzed by immunohistochemistry. Results: A higher expression (2.27-fold) of CD24 mRNA was determined in the normal term delivery compared to first and early second trimester cases. The mRNA of preterm PE cases was only higher by 1.31-fold compared to first and early second trimester, while in the age-matched PTD group had a fold increase of 5.72, four times higher compared to preterm PE. The delta cycle threshold (ΔCt) of CD24 mRNA expression in the preterm PE group was inversely correlated with gestational age (r = 0.737) and fetal size (r = 0.623), while correlation of any other group with these parameters was negligible. Western blot analysis revealed that the presence of CD24 protein in placental lysate of preterm PE was significantly reduced compared to term delivery controls (p = 0.026). In immunohistochemistry, there was a reduction of CD24 staining in villous trophoblast in preterm PE cases compared to gestational age-matched PTD cases (p = 0.042). Staining of PE cases at term was approximately twice higher compared to preterm PE cases (p = 0.025) but not different from normal term delivery controls. Conclusion: While higher CD24 mRNA expression levels were determined for normal term delivery compared to earlier pregnancy stages, this expression level was found to be lower in preterm PE cases, and could be said to be linked to reduced immune tolerance in preeclampsia.     

Effect of Mineral-Balanced Deep-Sea Water on Kidney Function and Renal Oxidative Stress Markers in Rats Fed a High-Salt Diet

This study investigated the effect of mineral-balanced deep-sea water (DSW) on kidney health using an animal model of kidney injury due to a high-sodium diet. High magnesium/low sodium (HMLS) and high magnesium/high calcium (HMHC) DSW samples with different mineral contents were prepared. Sprague–Dawley rats were fed an 8% sodium chloride (NaCl) diet for four weeks to induce kidney injury, and each group was supplied with purified water or mineral water. Kidney injury was observed in the NaCl group according to increased kidney injury markers and malondialdehydes, providing evidence of oxidative stress. However, the kidney injury was repaired by the intake of mineral-balanced DSW. It was confirmed that the HMLS and HMHC groups showed improved Na⁺ excretion through the urine. Kidney injury markers in urine decreased and upregulation of low-density lipoprotein receptor-related protein2 mRNA expression was observed in the HMLS and HMHC groups. In addition, superoxide dismutase activity was increased in the HMHC groups. The gene expression patterns of the RNA sequencing were similar between the CON and HMLS groups. These results suggest that DSW has beneficial effects on kidney health due to the balanced magnesium and calcium levels in models of kidney injury caused by excessive sodium intake.     

Prematurity and maternal folate deficiency: anemia during pregnancy study group results in Valencia, Venezuela

The purpose of this study was to determine the association and its magnitude between prematurity and folate deficiency in women in their third trimester of pregnancy, and at labor. An incident case-control study was conducted using 2 controls per case. Data was obtained in a tertiary hospital in Valencia, Venezuela. A total of 543 women who delivered between May and December 1996 entered into the study. Women having a preterm delivery (< 37 weeks of gestation at delivery) were defined as cases (n = 181). Anemia was defined according to WHO as Hb less than 11 g/dL, when a pregnant woman had a folate serum level < 3 microg/ml was considered a folate deficiency. Logistic regression was used to analyze the data and likelihood ratio test was done for model comparison. Folate deficiency was found to be significantly associated with prematurity (Odds Ratio: 1.97; 95%CI = 1.06 to 3.68 P = .032), after adjusting for prior preterm labor, prenatal care visits, prior abortion, prior fetal death, placental abruption, and premature rupture oval membranes. In conclusion, maternal folate deficiency at the end of the third trimester of pregnancy, at labor, was associated with an increased risk of prematurity.     

Dietary evaluation of pregnant adolescents during first, second and third trimester

In order to identify risk of inadequate intake of calories and nutrients during pregnancy, 75 pregnant adolescents (14 to 18 years old) apparently healthy, from low socioeconomic level, in their first prenatal control (12 weeks) were studied by two 24 hour recalls and a food frequency questionnaire at each trimester. Nutritional status was assessed by body mass index (pregestation weight/height) and classified according to American Medicine Institute reference. Paired t-test, frequency distribution and ANOVA were used for statistical analysis. Low weight was found in 34.6% of adolescent at the first visit and 5.3% were overweight. Even though, caloric intake was below recommendation, significant increases were observed between first and second trimester for energy, carbohydrates, niacin and zinc (p < 0.001) and for fat, proteins, riboflavin, thiamin, vitamin C, calcium and iron (p < 0.05). From second to third trimester, differences (p < 0.05) were significant only for vitamin A. Between first and third trimester, differences were significant (p < 0.05) for energy, proteins, carbohydrates, niacin, riboflavin, zinc and for thiamin, vitamin A and calcium (p < 0.05). A high proportion of pregnant adolescent did not reach recommendations for energy, folate, calcium and zinc. Food intake pattern did not change significantly among trimesters. Mean total weight gain was 9.2 kg and 0.412 +/- 0.4 g/week. Newborn's mean weight was 3.221 +/- 418 grams. It is concluded that adolescents are at high nutritional risk and deficiency of dietary intake should be followed. Attention should be addressed from the preconceptional period to postpartum in order to improve maternal and fetal conditions.     

Prevalence of anemia during pregnancy: results of Valencia (Venezuela) anemia during pregnancy study

To determine the prevalence of anemia during pregnancy in Venezuelan pregnant women. By using a cross-sectional study, 630 Venezuelan pregnant women in their third trimester at labor from the Valencia Anemia during Pregnancy Study were studied. Anemia during pregnancy was defined according to WHO guidelines (Hb < 11 g/dl), iron deficiency was considered when serum ferritin level was < 12 ng/ml, and when serum folate level was < 3 ng/ml, it was considered as folate deficiency. 630 pregnant women (mean [+/- SD] age, 24 +/- 6.4 years) having an average of Hb 11.38 +/- 1.47 g/dl [95%CI = 11.27 to 11.50] were studied. No patient had hemolytic anemia nor clinical infections. Almost all patients were from low or very low socioeconomic status. Prevalence of anemia was 34.44% (severe: 1.8%, moderate: 15.2%, and mild: 83%). Iron deficiency anemia (IDA) was present in 39.2% (95%CI = 32.7 to 45.7), prevalence of folate deficiency anemia (FDA) was 11.98% (95%CI = 7.6% to 16.3%). Combined anemia (IDA and FDA) occurred in 11.52% (95%CI = 7.27% to 15.7%). Multivariate analysis showed that multiparous (odds ratio -OR-: 1.95, 95%CI = 1.28 to 2.97, p = .002) and supplement use of iron (OR: .55 (95%CI = .33 to .91, p = .02) are associated with IDA. The factors associated with FDA were: supplement use of folic acid (OR: .37 (95%CI = .19 to .71, p = .003) and appropriate prenatal control (OR: .51 95%CI = .27 to .96, p = .04). Prevalence of anemia during pregnancy was found to be high. Educational efforts should be stressed in order to encourage improvements in the prenatal care visits.     

Dietary intake of essential and long-chain polyunsaturated fatty acids in pregnancy

The dietary intake of EFA and long-chain PUFA (LCPUFA) by women with (n=14) and without (n=31) gestational diabetes mellitus (GDM) was determined by repeated 24-h recalls. Women with GDM consumed significantly more energy as fat compared with women who had uncomplicated pregnancies; absolute dietary fat did not differ. Dietary n−3 LCPUFA was substantially lower than the current recommendation for pregnancy, whereas intake of saturated FA (SFA) exceeded it. We conclude that replacing dietary sources of SFA with those of EFA and LCPUFA, especially n−3 LCPUFA, would benefit the dietary fat profiles of all pregnant women.     

The Associations of SCFA with Anthropometric Parameters and Carbohydrate Metabolism in Pregnant Women

Short-chain fatty acids (SCFAs) mediate the transmission of signals between the microbiome and the immune system and are responsible for maintaining balance in the anti-inflammatory reaction. Pregnancy stages alter the gut microbiota community structure, which also synthesizes SCFAs. The study involved 90 pregnant women, divided into two groups: 48 overweight/obese pregnant women (OW) and 42 pregnant women with normal BMI (CG). The blood samples for glucose, insulin, and HBA1c were analyzed as well as stool samples for SCFA isolation (C2:0; C3:0; C4:0i; C4:0n; C5:0i; C5:0n; C6:0i; C6:0n) using gas chromatography. The SCFA profile in the analyzed groups differed significantly. A significant positive correlation between C2:0, C3:0, C4:0n and anthropometric measurements, and between C2:0, C3:0, C4:0n, and C5:0n and parameters of carbohydrate metabolism was found. SCFA levels fluctuate during pregnancy and the course of pregnancy and participate in the change in carbohydrate metabolism as well. The influence of C2:0 during pregnancy on anthropometric parameters was visible in both groups (normal weight and obese). Butyrate and propionate regulate glucose metabolism by stimulating the process of intestinal gluconeogenesis. The level of propionic acid decreases with the course of pregnancy, while its increase is characteristic of obese women, which is associated with many metabolic adaptations. Propionic and linear caproic acid levels can be an important critical point in maintaining lower anthropometric parameters during pregnancy.     

β-Hydroxy-β-Methylbutyrate (HMB) Supplementation Prevents Bone Loss during Pregnancy—Novel Evidence from a Spiny Mouse (Acomys cahirinus) Model

The aim of this study was to determine the effects of ß-hydroxy-ß-methylbutyrate (HMB) supplementation during pregnancy on postpartum bone tissue quality by assessing changes in trabecular and compact bone as well as in hyaline and epiphyseal cartilage. The experiment was carried out on adult 6-month-old female spiny mice (Acomys cahirinus) divided into three groups: pregnant control (PregCont), pregnant HMB-treated (supplemented with 0.02 g/kg b.w of HMB during the second trimester of pregnancy, PregHMB), and non-pregnant females (NonPreg). Cross-sectional area and cortical index of the femoral mid-shaft, stiffness, and Young modulus were significantly greater in the PregHMB group. Whole-bone mineral density was similar in all groups, and HMB supplementation increased trabecular number. Growth plate cartilage was the thinnest, while the articular cartilage was the thickest in the PregHMB group. HMB supplementation increased the content of proteoglycans in the articular cartilage and the percentage of immature collagen content in metaphyseal trabeculae and compact bone. In summary, dietary HMB supplementation during the second trimester of pregnancy intensifies bone metabolic processes and prevents bone loss during pregnancy.     

Nutritional status of marginated children of the Madrid's autonomous community, Spain

The nutritional status of 101 institutionalized students aged 6 to 13 was assessed from the dietary and biochemical points of view. The children were pupils of a Youth Care Boarding School. The dietary survey revealed an adequate nutrient intake which met the Recommended Dietary Allowances (RDA) in most cases as well as a high protein intake (250% of RDA). A slight deficiency in energy, zinc, magnesium and vitamins B2 and C was found in some cases in the eldest group. Blood parameters (erythrocyte counts, hematocrit, hemoglobin, mean corpuscular values, serum proteins, albumin, globulins, albumin/globulin ratio, urea and cholesterol) showed slightly lower values, mainly on hemoglobin, than those obtained from other similar groups. Nevertheless, urine parameters (nitrogen, urea, uric acid and creatinine) were higher, may be due to the high protein intake, energy deficiency and non-dietary factors such as lack of affection, socioeconomic problems, etc. All of these factors cause a rise in the students' catabolism. Correlations between dietary and biochemical data seem to corroborate that there is a shortage of energy, zinc, riboflavin, magnesium and vitamin C intakes in some cases, which limits the build up of several blood elements.     

High-DHA eggs: Feasibility as a means to enhance circulating DHA in mother and infant

Dietary DHA enhances infant attention and visual development. Because the DHA content of red blood cells and plasma lipids varies approximately threefold in pregnancy, maternal DHA status may influence subsequent infant function. It would be feasible to study the effects of higher maternal DHA intake on infant development if dietary intake of DHA could be increased by a reliable means. This study was designed to determine whether women provided with one dozen high-DHA hen eggs (135 mg DHA/egg) would consume the eggs and have higher blood DHA levels than women consuming ordinary eggs (18 mg DHA/egg). The study was a randomized, double-masked comparison of the effect of eggs with different concentrations of DHA on intake and blood lipid DHA content of women and their infants. A third nonrandomized group ate few eggs. In this study, DHA intake reported from eggs was eightfold higher in the high-DHA egg group compared to the ordinary egg group. Including all groups, DHA intake ranged from 0 to 284 mg/d. In this intake range, maternal blood lipid DHA content at enrollment best predicted DHA content at delivery, accounting for 36.5 and 51.7% of the variance in ordinary and high-DHA egg intake groups, respectively. The high-DHA vs. ordinary egg groups had similar maternal and cord blood lipid DHA, but there was a positive relationship between maternal plasma phospholipid DHA and daily DHA intake from eggs controlled for study duration (r=0.278, P=0.048). DHA intake and birth weight were also correlated (r=0.299, P=0.041). High-DHA eggs were well accepted and increased DHA intake. Other benefits of DHA intake during pregnancy were also suggested.