Geographic variations and determinants of EPA plus DHA and EPA alone in pregnant and lactating women from China.

Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are essential for maternal and fetal health, but epidemiological data is sparse in China. We examined the trends of EPA alone and a combination of EPA plus DHA in pregnant and lactating women in three distinct geographic regions in China, and explored their potential influencing factors. A total of 1015 healthy women during mid-pregnancy, late pregnancy, or lactation were recruited from Weihai (coastland), Yueyang (lakeland), and Baotou (inland) cities of China between May and July of 2014. Maternal EPA and DHA concentrations (percentage of total fatty acids) in plasma and erythrocytes were measured by capillary gas chromatography. Adjusted EPA plus DHA concentrations in both plasma and erythrocytes significantly declined from mid-pregnancy (2.92%,6.95%), to late pregnancy (2.20%,6.42%) and lactation (2.40%,6.29%) (Ptrend<0.001); and both concentrations were highest in coastland, followed by lakeland, and lowest in inland (P<0.001). Regarding EPA alone, the concentrations were higher in women during lactation or late pregnancy and in women in coastland and inland areas. Moreover, concentrations of EPA or EPA plus DHA were higher in women with older age, higher education, higher annual family income per capita, and higher dietary intake of marine aquatic product and mutton. In lactating women, erythrocyte EPA concentration was higher in those having breastfeeding partially versus exclusively. In conclusion, maternal plasma and erythrocyte concentrations of EPA plus DHA or EPA alone differed with geographic regions, physiological periods and maternal characteristics, indicating a need of population-specific health strategies to improve fatty acids status in pregnant and lactating women.