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Background  Fetal docosahexaenoic acid (DHA) supply relies on preferential transplacental transfer, which is regulated by placental DHA lipid metabolism. Maternal hyperglycemia and obesity associate with higher birthweight and fetal DHA insufficiency but the role of placental DHA metabolism is unclear.    Methods  Explants from 17 term placenta were incubated with  13 C-labeled DHA for 48 h, at 5 or 10 mmol/L glucose treatment, and the production of 17 individual newly synthesized  13 C-DHA labeled lipids quantified by liquid chromatography mass spectrometry.    Results  Maternal BMI positively associated with  13 C-DHA-labeled diacylglycerols, triacylglycerols, lysophospholipids, phosphatidylcholine and phosphatidylethanolamine plasmalogens, while maternal fasting glycemia positively associated with five  13 C-DHA triacylglycerols. In turn,  13 C-DHA-labeled phospholipids and triacylglycerols positively associated with birthweight centile. In-vitro glucose treatment increased most  13 C-DHA-lipids, but decreased  13 C-DHA phosphatidylethanolamine plasmalogens. However, with increasing maternal BMI, the magnitude of the glucose treatment induced increase in  13 C-DHA phosphatidylcholine and  13 C-DHA lysophospholipids was curtailed, with further decline in  13 C-DHA phosphatidylethanolamine plasmalogens. Conversely, with increasing birthweight centile glucose treatment induced increases in  13 C-DHA triacylglycerols were exaggerated, while glucose treatment induced decreases in  13 C-DHA phosphatidylethanolamine plasmalogens were diminished.    Conclusions  Maternal BMI and glycemia increased the production of different placental DHA lipids implying impact on different metabolic pathways. Glucose-induced elevation in placental DHA metabolism is moderated with higher maternal BMI. In turn, findings of associations between many DHA lipids with birthweight suggest that BMI and glycemia promote fetal growth partly through changes in placental DHA metabolism.    Supplementary Information  The online version contains supplementary material available at 10.1186/s10020-021-00344-w.

Placental 13C-DHA metabolism and relationship with maternal BMI, glycemia and birthweight