1
|
Hernandez-Castro I, Rifas-Shiman SL, Lin PID, Chavarro JE, Gold DR, Zhang M, Mueller NT, James-Todd T, Coull B, Hivert MF, Oken E, Cardenas A. First trimester prenatal metal mixtures, vitamins, and hypertensive disorders of pregnancy in the project viva cohort. ENVIRONMENT INTERNATIONAL 2024; 190:108909. [PMID: 39079333 DOI: 10.1016/j.envint.2024.108909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 06/25/2024] [Accepted: 07/23/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND Hypertensive disorders of pregnancy (HDP) such as preeclampsia and gestational hypertension are major contributors to maternal and child morbidity and mortality. Previous studies have reported associations with selected metals and vitamins but are limited in sample size and non-prospective study designs. We evaluated prospective associations of metal mixtures with HDP and tested interactions by vitamins. STUDY DESIGN We measured first trimester (median = 10.1 weeks) concentrations of essential (copper, magnesium, manganese, selenium, zinc) and nonessential (arsenic, barium, cadmium, cesium, mercury, lead) metals in red blood cells (n = 1,386) and vitamins (B12 and folate) in plasma (n = 924) in Project Viva, a pre-birth US cohort. We collected diagnosis of HDP by reviewing medical records. We used multinomial logistic regression and Bayesian Kernel Machine Regression to estimate individual and joint associations of metals with HDP and interactions by vitamins, after adjusting for key covariates. RESULTS The majority of participants were non-Hispanic white (72.5 %), never smokers (68.5 %) with a mean (SD) age of 32.3 (4.6) years. Fifty-two (3.8 %) developed preeclampsia and 94 (6.8 %) gestational hypertension. A doubling in first trimester erythrocyte copper was associated with 78 % lower odds of preeclampsia (OR=0.22, 95 % confidence interval: 0.08, 0.60). We also observed significant associations between higher erythrocyte total arsenic and lower odds of preeclampsia (OR=0.80, 95 % CI: 0.66, 0.97) and higher vitamin B12 and increased odds of gestational hypertension (OR=1.79, 95 % CI: 1.09, 2.96), but associations were attenuated after adjustment for dietary factors. Lower levels of the overall metal mixture and essential metal mixture were associated with higher odds of preeclampsia. We found no evidence of interactions by prenatal vitamins or between metals. CONCLUSION Lower levels of a first-trimester essential metal mixture were associated with an increased risk of preeclampsia, primarily driven by copper. No associations were observed between other metals and HDP after adjustment for confounders and diet.
Collapse
Affiliation(s)
- Ixel Hernandez-Castro
- Department of Epidemiology and Population Health, Stanford School of Medicine, Stanford, CA, USA
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Pi-I D Lin
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Jorge E Chavarro
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Diane R Gold
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Mingyu Zhang
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Noel T Mueller
- Department of Epidemiology, Colorado School of Public Health, Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Tamarra James-Todd
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Brent Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA; Diabetes Unit, Massachusetts General Hospital, Boston, MA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Andres Cardenas
- Department of Epidemiology and Population Health, Stanford School of Medicine, Stanford, CA, USA.
| |
Collapse
|
2
|
O'Nan SL, Huang R, Zhao P, Garr Barry V, Lawlor M, Carter EB, Kelly JC, Frolova AI, England SK, Raghuraman N. Dietary risk factors for hypertensive disorders of pregnancy. Pregnancy Hypertens 2024; 36:101120. [PMID: 38508015 DOI: 10.1016/j.preghy.2024.101120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 03/12/2024] [Accepted: 03/14/2024] [Indexed: 03/22/2024]
Abstract
OBJECTIVE To assess whether diet quality and specific dietary components are associated with hypertensive disorders of pregnancy (HDP). STUDY DESIGN Nested case control study in a prospectively collected cohort of 450 participants with singleton pregnancies who completed the National Institutes of Health Diet Health Questionnaire II (DHQ-II) in the third trimester or within 3 months of delivery. Patients with fetal anomalies, conception by in-vitro fertilization, and deliveries at outside hospitals were excluded from the original prospective cohort study. Cases were patients diagnosed with HDP and controls were patients without HDP. Cases and controls were matched by BMI class in a 1:2 ratio. Exposures of interest were HEI-2015 score components and other DHQ-II dietary components including minerals, caffeine, and water. These dietary components were compared between cohorts using univariate analyses. MAIN OUTCOME MEASURES HEI-2015 total scores representing diet quality, component scores, and objective background data between patients with HDP and patients without HDP. RESULTS 150 patients with HDP were matched to 300 controls without HDP. Baseline demographics were similar between groups, including BMI. Patients with HDP were less likely to have high quality diets (HEI ≥ 70) than controls (7.3 % v 15.7 %, P = 0.02). HDP were associated with significantly higher dairy, saturated fat, and sodium intake compared to controls. Other components were similar between groups. CONCLUSION Patients with HDP are more likely to have lower diet quality and higher consumption of sodium, dairy, and saturated fats. These results can be used to study antenatal diet modification in patients at high risk of HDP.
Collapse
Affiliation(s)
- Suzanne L O'Nan
- Washington University School of Medicine in Saint Louis, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Saint Louis, MO, USA.
| | - Ruizhi Huang
- Washington University School of Medicine in Saint Louis, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Saint Louis, MO, USA
| | - Peinan Zhao
- Washington University School of Medicine in Saint Louis, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Saint Louis, MO, USA
| | - Valene Garr Barry
- Washington University School of Medicine in Saint Louis, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Saint Louis, MO, USA
| | - Megan Lawlor
- Washington University School of Medicine in Saint Louis, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Saint Louis, MO, USA
| | - Ebony B Carter
- Washington University School of Medicine in Saint Louis, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Saint Louis, MO, USA
| | - Jeannie C Kelly
- Washington University School of Medicine in Saint Louis, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Saint Louis, MO, USA
| | - Antonina I Frolova
- Washington University School of Medicine in Saint Louis, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Saint Louis, MO, USA
| | - Sarah K England
- Washington University School of Medicine in Saint Louis, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Saint Louis, MO, USA
| | - Nandini Raghuraman
- Washington University School of Medicine in Saint Louis, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Saint Louis, MO, USA
| |
Collapse
|
3
|
Wei X, Zou H, Zhang T, Huo Y, Yang J, Wang Z, Li Y, Zhao J. Gestational Diabetes Mellitus: What Can Medical Nutrition Therapy Do? Nutrients 2024; 16:1217. [PMID: 38674907 PMCID: PMC11055016 DOI: 10.3390/nu16081217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 04/12/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
Gestational diabetes mellitus (GDM) is one of the common complications during pregnancy. Numerous studies have shown that GDM is associated with a series of adverse effects on both mothers and offspring. Due to the particularity of pregnancy, medical nutrition treatment is considered to be the first choice for the treatment of GDM. This contribution reviews the research progress of medical nutrition treatment in GDM, summarizes the international recommendations on the intake of various nutrients and the influence of nutrients on the prevalence of GDM, and the improvement effect of nutritional intervention on it, in order to provide references for research in related fields of GDM and the targeted development of enteral nutrition.
Collapse
Affiliation(s)
- Xiaoyi Wei
- CAS Engineering Laboratory for Nutrition, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai 200031, China; (X.W.); (H.Z.); (T.Z.); (Y.H.); (Y.L.)
| | - Hong Zou
- CAS Engineering Laboratory for Nutrition, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai 200031, China; (X.W.); (H.Z.); (T.Z.); (Y.H.); (Y.L.)
| | - Tingting Zhang
- CAS Engineering Laboratory for Nutrition, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai 200031, China; (X.W.); (H.Z.); (T.Z.); (Y.H.); (Y.L.)
| | - Yanling Huo
- CAS Engineering Laboratory for Nutrition, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai 200031, China; (X.W.); (H.Z.); (T.Z.); (Y.H.); (Y.L.)
| | - Jianzhong Yang
- Sunline Research Laboratories, Jiangsu Sunline Deep Sea Fishery Co., Ltd., Lianyungang 222042, China; (J.Y.); (Z.W.)
| | - Zhi Wang
- Sunline Research Laboratories, Jiangsu Sunline Deep Sea Fishery Co., Ltd., Lianyungang 222042, China; (J.Y.); (Z.W.)
| | - Yu Li
- CAS Engineering Laboratory for Nutrition, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai 200031, China; (X.W.); (H.Z.); (T.Z.); (Y.H.); (Y.L.)
| | - Jiuxiang Zhao
- CAS Engineering Laboratory for Nutrition, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai 200031, China; (X.W.); (H.Z.); (T.Z.); (Y.H.); (Y.L.)
| |
Collapse
|
4
|
Alibrandi A, Zirilli A, Le Donne M, Giannetto C, Lanfranchi M, De Pascale A, Politi C, Incognito GG, Ercoli A, Granese R. Association between Fish Consumption during Pregnancy and Maternal and Neonatal Outcomes: A Statistical Study in Southern Italy. J Clin Med 2024; 13:2131. [PMID: 38610896 PMCID: PMC11012849 DOI: 10.3390/jcm13072131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/21/2024] [Accepted: 03/24/2024] [Indexed: 04/14/2024] Open
Abstract
Background: This research aimed to evaluate the association between the monthly consumption of fish (differentiated by type) and both gestational and neonatal outcomes. Methods: Women who were admitted for delivery in the last 6 months of 2023 were prospectively included and divided according to type of fish consumed (based on DHA and mercury content) and frequency of consumption. Neonatal outcomes included weight, length, head circumference, and 1st and 5th minute Apgar scores. Maternal outcomes were threats of abortion, preterm birth, gestational diabetes and hypertension, cesarean section, and differential body mass index (BMI). Results: Small-size oily fish with high DHA and low mercury content (type B fish) consumption was positively associated with neonatal weight and head circumference, and less weight gain in pregnancy. It was also significantly associated with lower incidences of gestational diabetes and hypertension, and cesarean section. Correlation between differential BMI and monthly consumption of fish resulted in statistical significance, especially in type B fish consumers. Conclusions: The consumption of type B fish was significantly associated with increased neonatal weight and head circumference and better maternal outcomes.
Collapse
Affiliation(s)
- Angela Alibrandi
- Department of Economics, University of Messina, 98100 Messina, Italy; (A.A.); (A.Z.); (C.G.); (M.L.); (A.D.P.)
| | - Agata Zirilli
- Department of Economics, University of Messina, 98100 Messina, Italy; (A.A.); (A.Z.); (C.G.); (M.L.); (A.D.P.)
| | - Maria Le Donne
- Unit of Gynecology and Obstetrics, Department of Human Pathology of Adults and Developmental Age, “G. Martino” University Hospital, 98100 Messina, Italy; (M.L.D.); (C.P.); (A.E.)
| | - Carlo Giannetto
- Department of Economics, University of Messina, 98100 Messina, Italy; (A.A.); (A.Z.); (C.G.); (M.L.); (A.D.P.)
| | - Maurizio Lanfranchi
- Department of Economics, University of Messina, 98100 Messina, Italy; (A.A.); (A.Z.); (C.G.); (M.L.); (A.D.P.)
| | - Angelina De Pascale
- Department of Economics, University of Messina, 98100 Messina, Italy; (A.A.); (A.Z.); (C.G.); (M.L.); (A.D.P.)
| | - Chiara Politi
- Unit of Gynecology and Obstetrics, Department of Human Pathology of Adults and Developmental Age, “G. Martino” University Hospital, 98100 Messina, Italy; (M.L.D.); (C.P.); (A.E.)
| | - Giosuè Giordano Incognito
- Department of General Surgery and Medical Surgical Specialties, University of Catania, 95123 Catania, Italy;
| | - Alfredo Ercoli
- Unit of Gynecology and Obstetrics, Department of Human Pathology of Adults and Developmental Age, “G. Martino” University Hospital, 98100 Messina, Italy; (M.L.D.); (C.P.); (A.E.)
| | - Roberta Granese
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, “G. Martino” University Hospital, 98100 Messina, Italy
| |
Collapse
|
5
|
Talebi S, Zeraattalab-Motlagh S, Rahimlou M, Sadeghi E, Rashedi MH, Ghoreishy SM, Mohammadi H. Dietary fat intake with risk of gestational diabetes mellitus and preeclampsia: a systematic review and meta-analysis of prospective cohort studies. Nutr Rev 2024:nuae033. [PMID: 38568994 DOI: 10.1093/nutrit/nuae033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
CONTEXT Gestational diabetes mellitus (GDM) and preeclampsia (PE) are commonly observed medical complications in pregnancy. Dietary total fat and fatty acids associated with GDM and PE risk have been examined in several epidemiological studies. In some instances, systematic reviews and meta-analyses might provide more accurate dietary recommendations. OBJECTIVES This systematic review and dose-response meta-analysis was conducted to investigate the association between dietary total fat and fatty acids and the risk of GDM and PE. DATA SOURCES Research on dietary fat intake and the risk of GDM and PE was conducted through systematic searches of the PubMed, Scopus, and Web of Science databases for articles published up to August 19, 2023. An investigation of associations between dietary intake of total fat and fatty acids and the risk of GDM and PE was performed using prospective cohort study designs. RESULTS Twenty-one prospective cohort studies were considered eligible. Findings indicated that higher intakes of total fat (relative risk [RR], 1.08; 95% confidence interval [CI], 1.02-1.14), animal fat (RR, 1.56; 95%CI, 1.34-1.89), vegetable fat (RR, 1.23; 95%CI, 1.05-1.45), dietary cholesterol (RR, 1.48; 95%CI, 1.10-2.00), and omega-3 fatty acid (RR, 1.11; 95%CI, 1.02-1.20) are associated with a greater risk of GDM. However, no significant association was found between dietary total fat and fatty acids and the risk of PE. Dose-response meta-analyses suggested every 10% increment in total energy intake from total fat, 5% from animal fat, 5% from vegetable fat, and 100 mg from cholesterol was related to 15%, 12%, 7%, 14%, and 20% higher GDM risk, respectively. CONCLUSIONS Overall, total fat, animal fat, vegetable fat, dietary cholesterol, and omega-3 fatty acid consumption are associated with a small but statistically significant increase in GDM risk. PROTOCOL REGISTRATION PROSPERO (CRD42023466844).
Collapse
Affiliation(s)
- Sepide Talebi
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mehran Rahimlou
- Department of Nutrition, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Erfan Sadeghi
- Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Minoo Hasan Rashedi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Mojtaba Ghoreishy
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
- Student Research Committee, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Hamed Mohammadi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
6
|
Burdeau JA, Stephenson BJK, Aris IM, Preston EV, Hivert MF, Oken E, Mahalingaiah S, Chavarro JE, Calafat AM, Rifas-Shiman SL, Zota AR, James-Todd T. First trimester plasma PER- AND Polyfluoroalkyl Substances (PFAS) and blood pressure trajectories across the second and third trimesters of pregnancy. ENVIRONMENT INTERNATIONAL 2024; 186:108628. [PMID: 38583297 PMCID: PMC11196104 DOI: 10.1016/j.envint.2024.108628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 03/31/2024] [Accepted: 04/02/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Evidence suggests that exposure to per- and polyfluoroalkyl substances (PFAS) increases risk of high blood pressure (BP) during pregnancy. Prior studies did not examine associations with BP trajectory parameters (i.e., overall magnitude and velocity) during pregnancy, which is linked to adverse pregnancy outcomes. OBJECTIVES To estimate associations of multiple plasma PFAS in early pregnancy with BP trajectory parameters across the second and third trimesters. To assess potential effect modification by maternal age and parity. METHODS In 1297 individuals, we quantified six PFAS in plasma collected during early pregnancy (median gestational age: 9.4 weeks). We abstracted from medical records systolic BP (SBP) and diastolic BP (DBP) measurements, recorded from 12 weeks gestation until delivery. BP trajectory parameters were estimated via Super Imposition by Translation and Rotation modeling. Subsequently, Bayesian Kernel Machine Regression (BKMR) was employed to estimate individual and joint associations of PFAS concentrations with trajectory parameters - adjusting for maternal age, race/ethnicity, pre-pregnancy body mass index, income, parity, smoking status, and seafood intake. We evaluated effect modification by age at enrollment and parity. RESULTS We collected a median of 13 BP measurements per participant. In BKMR, higher concentration of perfluorooctane sulfonate (PFOS) was independently associated with higher magnitude of overall SBP and DBP trajectories (i.e., upward shift of trajectories) and faster SBP trajectory velocity, holding all other PFAS at their medians. In stratified BKMR analyses, participants with ≥ 1 live birth had more pronounced positive associations between PFOS and SBP velocity, DBP magnitude, and DBP velocity - compared to nulliparous participants. We did not observe significant associations between concentrations of the overall PFAS mixture and either magnitude or velocity of the BP trajectories. CONCLUSION Early pregnancy plasma PFOS concentrations were associated with altered BP trajectory in pregnancy, which may impact future cardiovascular health of the mother.
Collapse
Affiliation(s)
- Jordan A Burdeau
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Briana J K Stephenson
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Izzuddin M Aris
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
| | - Emma V Preston
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA; Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA.
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
| | - Shruthi Mahalingaiah
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Massachusetts General Hospital, Boston, MA, USA.
| | - Jorge E Chavarro
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Antonia M Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
| | - Ami R Zota
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.
| | - Tamarra James-Todd
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
| |
Collapse
|
7
|
Scott M, Qamar Z. Navigating Nutrition Inequities: BIPOC Maternal Health and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)'s Fruit and Vegetable Voucher. J Perinat Neonatal Nurs 2024; 38:18-24. [PMID: 38278640 DOI: 10.1097/jpn.0000000000000793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2024]
Abstract
INTRODUCTION The proposal to administer cuts for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) could create deficiencies in nutrition for already food insecure, low-income Black, Indigenous, and Persons of Color (BIPOC) pregnant, postpartum women, and children. WIC is a US Department of Agriculturefunded nutritional program for women, infants, and children. The current proposal is to cut the funding by $800 million for the 2024 fiscal year, affecting 75% of its low-income recipients and predominantly BIPOC. METHODS Relevant websites and journal articles were analyzed to determine how the proposed cuts would create barriers within the social determinants of health that contribute to disparities in health outcomes of WIC recipients. RESULTS Many studies have demonstrated that nutrition in the first 1000 days is critical for the healthy development of newborns. Prior research suggests that maternal health outcomes for BIPOC populations are contingent upon the increased allocation of nutritional support programs such as WIC and SNAP (Supplemental Nutrition Assistance Program). Nutrients provided by the cash benefit voucher have been proven to contribute to participants' health outcomes, and allotment increases can benefit maternal and infant health outcomes. CONCLUSION AND FUTURE DIRECTIONS Neonatal nurses can help advocate for more robust policies that support the health of their patients. Future directions call for systematic changes in policies and legislation that directly affect maternal health outcomes, supportive breastfeeding policies, and applied research on solutions to improve maternal health outcomes of BIPOC populations in addition to increased awareness, education, and implementation of VeggieRx programs, investment in affordable, sustainable grassroots urban agriculture solutions.
Collapse
Affiliation(s)
- Monique Scott
- Public Health Department, San Francisco State University (SFSU), San Francisco, California; and Family, Interiors, Nutrition, and Apparel (FINA), San Francisco State University (SFSU), San Francisco, California
| | | |
Collapse
|
8
|
Brown RSE, Jacobs IM, Khant Aung Z, Knowles PJ, Grattan DR, Ladyman SR. High fat diet-induced maternal obesity in mice impairs peripartum maternal behaviour. J Neuroendocrinol 2023; 35:e13350. [PMID: 37926066 DOI: 10.1111/jne.13350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/20/2023] [Accepted: 10/11/2023] [Indexed: 11/07/2023]
Abstract
Obesity during pregnancy represents a significant health issue and can lead to increased complications during pregnancy and impairments with breastfeeding, along with long-term negative health consequences for both mother and offspring. In rodent models, diet-induced obesity (DIO) during pregnancy leads to poor outcomes for offspring. Using a DIO mouse model, consisting of feeding mice a high fat diet for 8 weeks before mating, we recapitulate the effect of high pup mortality within the first 3 days postpartum. To examine the activity of the dam around the time of birth, late pregnant control and DIO dams were recorded in their home cages and the behaviour of the dam immediately before and after birth was analysed. Prior to giving birth, DIO dams spent less time engaging in nesting behaviour, while after birth, DIO dams spent less time in the nest with their pups compared to control dams, indicating reduced pup-engagement in the early postpartum period. We have previously reported that lactogenic hormone action, mediated by the prolactin receptor, in the medial preoptic area of the hypothalamus (MPOA) is critical for the onset of normal postpartum maternal behaviour. We hypothesized that DIO dams may have lower lactogenic hormone activity during late pregnancy, which would contribute to impaired onset of normal postpartum maternal behaviour. Day 16 lactogenic activity, transport of prolactin into the brain, and plasma prolactin concentrations around birth were all similar in control and DIO dams. Moreover, endogenous pSTAT5, a marker of prolactin receptor activity, in the MPOA was unaffected by DIO. Overall, these data indicate that lactogenic activity in late pregnancy of DIO dams is not different to controls and is unlikely to play a major role in impaired onset of normal postpartum maternal behaviour.
Collapse
Affiliation(s)
- Rosemary Shanon Eileen Brown
- Centre for Neuroendocrinology, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
- Department of Physiology, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Ireland M Jacobs
- Centre for Neuroendocrinology, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Zin Khant Aung
- Centre for Neuroendocrinology, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Pene J Knowles
- Centre for Neuroendocrinology, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - David R Grattan
- Centre for Neuroendocrinology, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, Auckland, New Zealand
| | - Sharon R Ladyman
- Centre for Neuroendocrinology, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, Auckland, New Zealand
| |
Collapse
|
9
|
Hergenrader A, VanOrmer M, Slotkowski R, Thompson M, Freeman A, Paetz O, Sweeney S, Wegner L, Ali K, Bender N, Chaudhary R, Thoene M, Hanson C, Anderson-Berry A. Omega-3 Polyunsaturated Fatty Acid Levels in Maternal and Cord Plasma Are Associated with Maternal Socioeconomic Status. Nutrients 2023; 15:4432. [PMID: 37892508 PMCID: PMC10609830 DOI: 10.3390/nu15204432] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 10/16/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
Omega-3 (n-3) polyunsaturated fatty acids (PUFAs) play a crucial role in fetal growth and neurodevelopment, while omega-6 (n-6) PUFAs have been associated with adverse pregnancy outcomes. Previous studies have demonstrated that socioeconomic status (SES) influences dietary intake of n-3 and n-6 PUFAs, but few studies have evaluated the association between maternal and cord plasma biomarkers of PUFAs and socioeconomic markers. An IRB-approved study enrolled mother-infant pairs (n = 55) at the time of delivery. Maternal and cord plasma PUFA concentrations were analyzed using gas chromatography. Markers of SES were obtained from validated surveys and maternal medical records. Mann-Whitney U tests and linear regression models were utilized for statistical analysis. Maternal eicosapentaenoic acid (EPA) (p = 0.02), cord EPA (p = 0.04), and total cord n-3 PUFA concentrations (p = 0.04) were significantly higher in college-educated mothers vs. mothers with less than a college education after adjustment for relevant confounders. Insurance type and household income were not significantly associated with n-3 or n-6 PUFA plasma concentrations after adjustment. Our findings suggest that mothers with lower educational status may be at risk of lower plasma concentrations of n-3 PUFAs at delivery, which could confer increased susceptibility to adverse pregnancy and birth outcomes.
Collapse
Affiliation(s)
- Alexandra Hergenrader
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Matthew VanOrmer
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Rebecca Slotkowski
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Maranda Thompson
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Alyssa Freeman
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Olivia Paetz
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Sarah Sweeney
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Lauren Wegner
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Khadijjta Ali
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Nicole Bender
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Ridhi Chaudhary
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Melissa Thoene
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Corrine Hanson
- Medical Nutrition Education Program, College of Allied Health, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Ann Anderson-Berry
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA
| |
Collapse
|
10
|
Esquivel MK. Nutritional Status and Nutrients Related to Pre-Eclampsia Risk. Am J Lifestyle Med 2023; 17:41-45. [PMID: 36636396 PMCID: PMC9830236 DOI: 10.1177/15598276221129841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Elevated blood pressure during pregnancy, pre-eclampsia, is in part a result of inflammatory processes related to pregnancy. Reducing risk for pre-eclampsia is important to improve birth outcomes and reduce morbidity and mortality. Nutritional status and dietary intake of key foods and nutrients can aid in the reduction of pre-eclampsia risk. Excessive gestational weight gain is associated with pre-eclampsia risk, however, fluid retention, may be the driver of this relationship. While diets rich in fruits, vegetables, and dietary fiber can reduce pre-eclampsia risk and adherence to a western diet pattern can increase risk. Other nutrients, which may improve hypertension, such as sodium or salt, have little to no effect on pre-eclampsia risk. Key nutrients impacting pre-eclampsia risk are described in this article.
Collapse
Affiliation(s)
- Monica Kazlausky Esquivel
- Department of Human Nutrition, Food and Animal Sciences,
College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Honolulu, HI, USA
| |
Collapse
|
11
|
Associations of Dietary Patterns during Pregnancy with Gestational Hypertension: The "Born in Shenyang" Cohort Study. Nutrients 2022; 14:nu14204342. [PMID: 36297024 PMCID: PMC9611399 DOI: 10.3390/nu14204342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 10/05/2022] [Accepted: 10/14/2022] [Indexed: 11/23/2022] Open
Abstract
The literature on maternal dietary patterns and gestational hypertension (GH) risk is largely ambiguous. We investigated the associations of maternal dietary patterns with GH risk among 1092 pregnant women in a Chinese pre-birth cohort. We used both three-day food diaries (TFD) and food frequency questionnaires (FFQ) to assess the diets of pregnant women. Principal components analysis with varimax rotation was used to identify dietary patterns from the TFD and FFQ, respectively. In total, 14.5% of the participants were diagnosed with GH. Maternal adherence to a “Wheaten food−coarse cereals pattern (TFD)” was associated with a lower risk of GH (quartile 3 [Q3] vs. Q1, odds ratio [OR] = 0.53, 95%CI: 0.31, 0.90). Maternal adherence to a “Sweet food−seafood pattern (TFD)” was associated with lower systolic blood pressure (Q4 vs. Q1, β = −2.57, 95%CI: −4.19, −0.96), and mean arterial pressure (Q4 vs. Q1, β = −1.54, 95%CI: −2.70, −0.38). The protective associations of the “Sweet food-seafood (TFD)” and “Fish−seafood pattern (FFQ)” with the risk of GH were more pronounced among women who were overweight/obese before pregnancy (p for interaction < 0.05 for all). The findings may help to develop interventions and better identify target populations for hypertension prevention during pregnancy.
Collapse
|
12
|
Kinshella MLW, Omar S, Scherbinsky K, Vidler M, Magee LA, von Dadelszen P, Moore SE, Elango R. Maternal nutritional risk factors for pre-eclampsia incidence: findings from a narrative scoping review. Reprod Health 2022; 19:188. [PMID: 36064716 PMCID: PMC9442926 DOI: 10.1186/s12978-022-01485-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 07/21/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Pre-eclampsia is a leading cause of maternal mortality and morbidity that involves pregnancy-related stressors on the maternal cardiovascular and metabolic systems. As nutrition is important to support optimal development of the placenta and for the developing fetus, maternal diets may play a role in preventing pre-eclampsia. The purpose of this scoping review is to map the maternal nutritional deficiencies and imbalances associated with pre-eclampsia incidence and discuss evidence consistency and linkages with current understandings of the etiology of pre-eclampsia. METHODS A narrative scoping review was conducted to provide a descriptive account of available research, summarize research findings and identify gaps in the evidence base. Relevant observational studies and reviews of observational studies were identified in an iterative two-stage process first involving electronic database searches then more sensitive searches as familiarity with the literature increased. Results were considered in terms of their consistency of evidence, effect sizes and biological plausibility. RESULTS The review found evidence for associations between nutritional inadequacies and a greater risk of pre-eclampsia. These associations were most likely mediated through oxidative stress, inflammation, maternal endothelial dysfunction and blood pressure in the pathophysiology of pre-eclampsia. Maternal nutritional risk factors for pre-eclampsia incidence with the strongest consistency, effect and biological plausibility include vitamin C and its potential relationship with iron status, vitamin D (both on its own and combined with calcium and magnesium), and healthy dietary patterns featuring high consumption of fruits, vegetables, whole grains, fish, seafood and monounsaturated vegetable oils. Foods high in added sugar, such as sugary drinks, were associated with increased risk of pre-eclampsia incidence. CONCLUSION A growing body of literature highlights the involvement of maternal dietary factors in the development of pre-eclampsia. Our review findings support the need for further investigation into potential interactions between dietary factors and consideration of nutritional homeostasis and healthy dietary patterns. Further research is recommended to explore gestational age, potential non-linear relationships, dietary diversity and social, cultural contexts of food and meals.
Collapse
Affiliation(s)
- Mai-Lei Woo Kinshella
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada
| | - Shazmeen Omar
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada
| | - Kerri Scherbinsky
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada
- Department of Pediatrics, Rm170, BC Children's and Women's Hospital, University of British Columbia, 950 West 28th Avenue, Vancouver, Canada
| | - Marianne Vidler
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada
| | - Laura A Magee
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada
- Department of Women & Children's Health, King's College London, London, UK
| | - Peter von Dadelszen
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada
- Department of Women & Children's Health, King's College London, London, UK
| | - Sophie E Moore
- Department of Women & Children's Health, King's College London, London, UK
- MRC Unit The Gambia at the London, School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Rajavel Elango
- Department of Pediatrics, Rm170, BC Children's and Women's Hospital, University of British Columbia, 950 West 28th Avenue, Vancouver, Canada.
- School of Population and Public Health, University of British Columbia, Vancouver, Canada.
| |
Collapse
|
13
|
Arvizu M, Minguez-Alarcon L, Wang S, Mitsunami M, Stuart JJ, Rich-Edwards JW, Rosner B, Chavarro JE. Pre-pregnancy fat intake in relation to hypertensive disorders of pregnancy. Am J Clin Nutr 2022; 116:750-758. [PMID: 35575613 PMCID: PMC9437979 DOI: 10.1093/ajcn/nqac145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/16/2022] [Accepted: 05/12/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Many studies have linked intakes of fat and of specific fatty acids during pregnancy with preeclampsia; however, information on the association of intake before pregnancy with hypertensive disorders of pregnancy (HDP) is scant. OBJECTIVES We evaluated the associations of intakes of major and specific types of fat before pregnancy with the risks of HDP, including preeclampsia and gestational hypertension (GHTN). METHODS We followed 11,535 women without chronic disease participating in the Nurses' Health Study II from 1991 and 2009. Pre-pregnancy dietary fat was assessed by an FFQ. Intakes of total fat, saturated fat, trans fatty acid (TFA), MUFAs, PUFAs, and fat subtypes (omega-3 and omega-6) were categorized into quintiles of intake. HDP were self-reported. The RRs (95% CIs) of HDP were estimated by log-binomial generalized estimating equation regression models, with an exchangeable correlation matrix to account for repeated pregnancies while adjusting for potential confounders. RESULTS During 19 years of follow-up, there were 495 cases of preeclampsia (2.9%) and 561 (3.3%) cases of GHTN in 16,892 singleton pregnancies. The mean age at pregnancy was 34.6 years (SD, 3.9 years). Among major fat types, only pre-pregnancy TFA was related to a higher risk of HDP (RR, 1.32; 95% CI: 1.05-1.66), and only for preeclampsia (RR, 1.50; 95% CI: 1.07-2.10) but not for GHTN (RR, 1.21; 95% CI: 0.87-1.70). Among specific types of PUFAs, intake of arachidonic acid was positively related with GHTN (RR, 1.43; 95% CI: 1.00-2.04) but not preeclampsia (RR, 1.08; 95% CI: 0.75-1.57). In analyses restricted to pregnancies 1 year after the diet assessment, women with the highest intake of long-chain omega-3 fatty acids had a 31% lower risk of HDP (95% CI: 3%-51%), which was driven by preeclampsia (RR, 0.55; 95% CI: 0.33-0.92). CONCLUSIONS Pre-pregnancy intakes of total fat, saturated fat, and MUFA were unrelated to HDP, whereas TFA was positively related to HDP. These findings highlight the importance of ongoing efforts to eliminate TFA from the global food supply.
Collapse
Affiliation(s)
- Mariel Arvizu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Lidia Minguez-Alarcon
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Siwen Wang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Makiko Mitsunami
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jennifer J Stuart
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Janet W Rich-Edwards
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Bernard Rosner
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jorge E Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| |
Collapse
|
14
|
Hamsir F, As’ad S, Tahir AM, Soraya D, Fujiko M, Chalid SMT, Idris I, Bukhari A, Hatta M, Bahar B, Efendi S. Macro- and Micronutrient of Junk Food and Preeclampsia on Pregnant Women. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Preeclampsia (PE) is still a global public health issue in developed and developing countries. It is a major contributor to maternal and fetal morbidity and mortality. The pathophysiology of preeclampsia during pregnancy is unclear, but the WHO reported that PE is higher in developing countries than developed ones due to lifestyle and nutritional status.
AIM: This study aimed to describe the influence of macro- and micronutrients of junk food on PE.
METHODS: This case–control study was carried out on 148 samples, including pregnant women with preeclampsia (n = 74) and normal pregnant women (n = 74) with gestational age > 20 weeks. Data on junk food intake were collected using the SQ-FFQ form and then estimated using the Nutri Survey. Data were analyzed in SPSS version 17 using descriptive statistics. Pearson correlation coefficient was used to observe the correlation between variables with p < 0.05 and 95% confidence interval.
RESULTS: Binary logistic regression revealed that the intake of fat (p = 0.005), vitamin C (p = 0.002), and sodium (p = 0.036) contained in the junk food were significantly associated with PE. The frequency of consumption of junk food also had a significant effect on the incidence of preeclampsia (p = 0.013).
CONCLUSION: Intake of fat, vitamin C, and sodium were associated with PE, and they were risk factors of PE. The frequency of consuming junk food gave more risk to have PE.
Collapse
|
15
|
Dietary and serum vitamin D and preeclampsia risk in Chinese pregnant women: a matched case-control study. Br J Nutr 2022; 128:84-92. [PMID: 34353401 DOI: 10.1017/s0007114521002956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The effect of vitamin D (VD) on the risk of preeclampsia (PE) is uncertain. Few of previous studies focused on the relationship between dietary VD intake and PE risk. Therefore, we conducted this 1:1 matched case-control study to explore the association of dietary VD intake and serum VD concentrations with PE risk in Chinese pregnant women. A total of 440 pairs of participants were recruited during March 2016 to June 2019. Dietary information was obtained using a seventy-eight-item semi-quantitative FFQ. Serum concentrations of 25(OH)D2 and 25(OH)D3 were measured by liquid chromatography-tandem MS. Multivariate conditional logistic regression was used to estimate OR and 95 % CI. Restricted cubic splines (RCS) were plotted to evaluate the dose-response relationship of dietary VD intake and serum VD concentrations with PE risk. Compared with the lowest quartile, the OR of the highest quartile were 0·45 (95 % CI 0·29, 0·71, Ptrend = 0·001) for VD dietary intake and 0·26 (95 % CI 0·11, 0·60, Ptrend = 0·003) for serum levels after adjusting for confounders. In addition, the RCS analysis suggested a reverse J-shaped relationship between dietary VD intake and PE risk (P-nonlinearity = 0·02). A similar association was also found between serum concentrations of total 25(OH)D and PE risk (P-nonlinearity = 0·02). In conclusion, this study provides evidence that higher dietary intake and serum levels of VD are associated with the lower risk of PE in Chinese pregnant women.
Collapse
|
16
|
Preston EV, Hivert MF, Fleisch AF, Calafat AM, Sagiv SK, Perng W, Rifas-Shiman SL, Chavarro JE, Oken E, Zota AR, James-Todd T. Early-pregnancy plasma per- and polyfluoroalkyl substance (PFAS) concentrations and hypertensive disorders of pregnancy in the Project Viva cohort. ENVIRONMENT INTERNATIONAL 2022; 165:107335. [PMID: 35696844 PMCID: PMC9348856 DOI: 10.1016/j.envint.2022.107335] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/25/2022] [Accepted: 06/01/2022] [Indexed: 05/22/2023]
Abstract
BACKGROUND Hypertensive disorders of pregnancy (HDP), defined here as hypertensive disorders with onset in pregnancy (i.e., gestational hypertension, preeclampsia, and preeclampsia superimposed on chronic hypertension), affect up to 10% of pregnancies in the United States and are associated with substantial maternal and neonatal morbidity and mortality. Per- and polyfluoroalkyl substances (PFAS) are associated with adverse cardiometabolic outcomes during pregnancy, but associations between PFAS and HDP are inconsistent and joint effects of PFAS mixtures have not been evaluated. METHODS We studied 1,558 pregnant individuals from the Project Viva cohort, recruited during 1999-2002. We quantified concentrations of eight PFAS in plasma samples (median 9.7 weeks of gestation). Using clinical records, we calculated trimester-specific mean systolic (SBP) and diastolic (DBP) blood pressure and categorized HDP status [no HDP (normotensive & chronic hypertension), gestational hypertension, preeclampsia]. We estimated associations of individual PFAS with HDP using multinomial logistic regression and estimated associations with blood pressure using linear regression. We used Bayesian kernel machine regression (BKMR) and quantile g-computation to assess joint effects of the PFAS mixture on HDP and blood pressure measures. RESULTS Four percent of participants developed preeclampsia and 7% developed gestational hypertension. We observed higher odds of gestational hypertension, but not preeclampsia, per doubling of perfluorooctanoate (PFOA) [OR = 1.51 (95% confidence interval: 1.12, 2.03)], perfluorooctane sulfonate (PFOS) [OR = 1.38 (1.04, 1.82)], and perfluorohexane sulfonate [OR = 1.28 (1.06, 1.54)] concentrations. We observed higher mean DBP per doubling of PFOA [2nd trimester (T2): 0.39 mmHg (-0.01, 0.78); 3rd trimester (T3): 0.56 mmHg (0.14, 0.98)] and PFOS [T2: 0.46 mmHg (0.11, 0.82); T3: 0.43 mmHg (0.05, 0.80)]. The PFAS mixture was positively associated with odds of gestational hypertension [75th vs. 50th percentile: OR = 1.14 (95% credible interval:1.03, 1.25), BKMR] and mean DBP [T2 = 0.17 mmHg (-0.06, 0.40); T3 = 0.22 mmHg (-0.03, 0.48), BKMR]. CONCLUSIONS These findings suggest that exposure to certain PFAS may increase the odds of gestational hypertension during pregnancy, with potential implications for subsequent maternal and child health outcomes.
Collapse
Affiliation(s)
- Emma V Preston
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States; Diabetes Unit, Massachusetts General Hospital, Boston, MA, United States.
| | - Abby F Fleisch
- Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME, United States; Pediatric Endocrinology and Diabetes, Maine Medical Center, Portland, ME, United States.
| | - Antonia M Calafat
- National Center for Environmental Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, United States.
| | - Sharon K Sagiv
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California at Berkeley, Berkeley, CA, United States.
| | - Wei Perng
- Department of Epidemiology and the Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States.
| | - Jorge E Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States.
| | - Ami R Zota
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States.
| | - Tamarra James-Todd
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
| |
Collapse
|
17
|
Perry A, Stephanou A, Rayman MP. Dietary factors that affect the risk of pre-eclampsia. BMJ NUTRITION, PREVENTION & HEALTH 2022; 5:118-133. [PMID: 35814725 PMCID: PMC9237898 DOI: 10.1136/bmjnph-2021-000399] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 04/03/2022] [Indexed: 12/18/2022]
Abstract
Pre-eclampsia affects 3%–5% of pregnant women worldwide and is associated with a range of adverse maternal and fetal outcomes, including maternal and/or fetal death. It particularly affects those with chronic hypertension, pregestational diabetes mellitus or a family history of pre-eclampsia. Other than early delivery of the fetus, there is no cure for pre-eclampsia. Since diet or dietary supplements may affect the risk, we have carried out an up-to-date, narrative literature review to assess the relationship between nutrition and pre-eclampsia. Several nutrients and dietary factors previously believed to be implicated in the risk of pre-eclampsia have now been shown to have no effect on risk; these include vitamins C and E, magnesium, salt, ω-3 long-chain polyunsaturated fatty acids (fish oils) and zinc. Body mass index is proportionally correlated with pre-eclampsia risk, therefore women should aim for a healthy pre-pregnancy body weight and avoid excessive gestational and interpregnancy weight gain. The association between the risk and progression of the pathophysiology of pre-eclampsia may explain the apparent benefit of dietary modifications resulting from increased consumption of fruits and vegetables (≥400 g/day), plant-based foods and vegetable oils and a limited intake of foods high in fat, sugar and salt. Consuming a high-fibre diet (25–30 g/day) may attenuate dyslipidaemia and reduce blood pressure and inflammation. Other key nutrients that may mitigate the risk include increased calcium intake, a daily multivitamin/mineral supplement and an adequate vitamin D status. For those with a low selenium intake (such as those living in Europe), fish/seafood intake could be increased to improve selenium intake or selenium could be supplemented in the recommended multivitamin/mineral supplement. Milk-based probiotics have also been found to be beneficial in pregnant women at risk. Our recommendations are summarised in a table of guidance for women at particular risk of developing pre-eclampsia.
Collapse
Affiliation(s)
- Abigail Perry
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Anna Stephanou
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Margaret P Rayman
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| |
Collapse
|
18
|
Li N, Jiang J, Guo L. Effects of maternal folate and vitamin B12 on gestational diabetes mellitus: a dose-response meta-analysis of observational studies. Eur J Clin Nutr 2022; 76:1502-1512. [PMID: 35105943 DOI: 10.1038/s41430-022-01076-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 01/05/2022] [Accepted: 01/11/2022] [Indexed: 12/16/2022]
Abstract
To comprehensively estimate the association of gestational diabetes mellitus (GDM) risk with maternal red blood cell (RBC) folate, plasma/serum folate, dose and duration of folic acid supplement (FAS) intake and vitamin B12 separately. PubMed, Web of science, CNKI, and Wanfang Databases were searched through March 26, 2021. We synthesized data using random-effects model meta-analysis in Stata 12.0. Sensitivity, subgroup and dose-response analyses were also performed. The certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE). Twenty six datasets from thirteen eligible observational studies were included in the study. We found a significant increase of GDM risk with the highest versus lowest category of RBC folate (OR = 1.96, 95% CI: 1.48-2.61, I2 = 0.0%, moderate-certainty evidence) and plasma/serum folate (OR = 1.23, 1.02-1.48, I2 = 57.8%, low-certainty evidence). The dose-response analysis revealed that each 200 ng/ml increase in RBC folate was significantly associated with 8% higher GDM risk. No significant association between dose of FAS intake and GDM risk was found with very low cetainty. Meanwhile, longer duration (≥3 months) of FAS conferred 56% significant higher GDM risk (OR = 1.56, 1.02-2.39, very low certainty evidence). No significant association of GDM risk with highest plasma/serum B12 was observed compared to lowest B12 (OR = 0.77, 0.58-1.02, very low-certainty evidence). Moderate-certainty evidence suggests that higher RBC folate appears to significantly increase GDM risk. Higher plasma/serum folate may increase GDM risk but with low certainty. Further well-designed trials or prospective studies are needed.
Collapse
Affiliation(s)
- Nana Li
- Department of Nutrient, Zhengzhou Central Hospital Affiliated to Zhengzhou University, No.195, Tongbai Road, Zhengzhou, China.
| | - Jicheng Jiang
- Department of Big Data Center for Cardiovascular Disease, Henan Provincial People's Hospital, Central China Fuwai Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, China
| | - Leilei Guo
- Hospital Infection Management Section, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| |
Collapse
|
19
|
Kinshella MLW, Omar S, Scherbinsky K, Vidler M, Magee LA, von Dadelszen P, Moore SE, Elango R. Maternal Dietary Patterns and Pregnancy Hypertension in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis. Adv Nutr 2021; 12:2387-2400. [PMID: 34019634 PMCID: PMC8634459 DOI: 10.1093/advances/nmab057] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Healthy maternal diets can lower the odds of developing pre-eclampsia, a direct and second leading cause of maternal death, globally. However, there is a research gap in low- and middle-income countries (LMIC), which bear a disproportionate burden of these deaths. The objectives of this systematic review were to: 1) evaluate the association between dietary patterns in pregnancy and hypertensive disorders, including pre-eclampsia for pregnant and postpartum women in LMIC, and 2) compile barriers and facilitators to an adequate maternal diet. A systematic search was performed on MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health, Web of Science, Cochrane Central Register of Controlled Trials, African Journals Online, the WHO Regional Databases, 2 trial registries, Google Scholar, and reference lists. Included in the analysis were primary research studies of dietary patterns during pregnancy, with pregnancy hypertension outcome(s), and conducted in LMIC. Included studies were assessed using ROBINS-I risk of bias. Thirteen studies were included, of which 5 studies were included in a meta-analysis (Review Manager 5). Lower odds of pre-eclampsia were associated with adequate (compared with no or low) consumption of vegetables (OR: 0.38; 95% CI: 0.18, 0.80; I2 = 85%; P = 0.01) and adequate (compared with no or low) consumption of fruit (OR: 0.42; 95% CI: 0.24, 0.71; I2 = 79%; P = 0.008). No firm conclusions could be drawn about the impact on pre-eclampsia odds of any of the following during pregnancy: high consumption of meat or grains; a "Western" diet; or alcohol consumption. More LMIC-based research is needed to explore whether the apparent beneficial effects of fruits and vegetables on pre-eclampsia incidence might be enhanced when maternal malnutrition is prevalent, and/or whether other sociodemographic factors might contribute.
Collapse
Affiliation(s)
- Mai-Lei Woo Kinshella
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - Shazmeen Omar
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - Kerri Scherbinsky
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
- Department of Pediatrics, BC Children's and Women's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - Marianne Vidler
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - Laura A Magee
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
- Department of Women & Children's Health, King's College London, London, United Kingdom
| | - Peter von Dadelszen
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
- Department of Women & Children's Health, King's College London, London, United Kingdom
| | - Sophie E Moore
- Department of Women & Children's Health, King's College London, London, United Kingdom
- MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Rajavel Elango
- Department of Pediatrics, BC Children's and Women's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
20
|
Prospective Association Between Manganese in Early Pregnancy and the Risk of Preeclampsia. Epidemiology 2021; 31:677-680. [PMID: 32618710 DOI: 10.1097/ede.0000000000001227] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Manganese, an essential micronutrient, has been found in lower concentrations among women with preeclampsia in cross-sectional and case-control studies without establishment of a temporal relationship. METHODS We evaluated the prospective association of manganese (in red blood cells) in first trimester of pregnancy with incidence of preeclampsia (ascertained by reviewing medical records) among 1,312 women in eastern Massachusetts (Project Viva, 1999-2002). We used log-binomial regression to examine the manganese-preeclampsia relationship, adjusting for maternal age, race/ethnicity, parity, prepregnancy body mass index, blood pressure, and hematocrit. RESULTS The median (25th, 75th percentile) manganese concentrationin red blood cells was 16.2 ng/g (13.1, 20.4) and 48 (4%) women developed preeclampsia. We observed an inverse dose-response relationship between manganese and preeclampsia. Compared with women in the lowest tertile, women in the middle manganese tertile had 0.81 times the risk of preeclampsia (95% CI: 0.43, 1.5) and those in the highest tertile had 0.50 (95% CI: 0.25, 0.99) times the risk. CONCLUSIONS Our results provide insight into a potentially modifiable way to prevent preeclampsia.
Collapse
|
21
|
Li SN, Liu YH, Luo ZY, Cui YF, Cao Y, Fu WJ, Dou WF, Duan DD, Zhao XL, Chen YM, Lyu QJ, Chen QS, Zeng FF. The association between dietary fatty acid intake and the risk of developing preeclampsia: a matched case-control study. Sci Rep 2021; 11:4048. [PMID: 33603029 PMCID: PMC7893000 DOI: 10.1038/s41598-021-83674-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 01/28/2021] [Indexed: 01/06/2023] Open
Abstract
The association between dietary fat intake during pregnancy and the risk of developing preeclampsia has been examined in many epidemiological studies, but the results remain inconsistent. The aim of this study was to clarify this association in pregnant Chinese women. After conducting 1:1 matching, 440 pairs consisting of pregnant women with preeclampsia and hospital-based, healthy pregnant women matched by gestational week (± 1 week) and age (± 3 years) were recruited. A 79-item semi-quantitative food frequency questionnaire administered during face-to-face interviews was used to estimate the participants’ dietary intake of fatty acids. We found that the intakes of arachidonic acid (AA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) were inversely associated with the risk of developing preeclampsia. Compared with the lowest quartile intake, the multivariate-adjusted odds ratios (95% confidence interval) of the highest quartile intake were 0.42 (0.26–0.68, p-trend < 0.001) for EPA, 0.52 (0.3–0.83, p-trend = 0.005) for DHA, and 0.41 (0.19–0.88, p-trend = 0.007) for AA. However, we did not observe any significant associations between the intake of total fatty acids, saturated fatty acids, and mono-unsaturated fatty acids and the risk of developing preeclampsia. Our results showed that the dietary intake of long-chain polyunsaturated fatty acids (i.e., EPA, DHA, and AA) may protect pregnant Chinese women against the development of preeclampsia.
Collapse
Affiliation(s)
- Shu-Na Li
- Department of Epidemiology, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou, 510632, Guangdong, China
| | - Yan-Hua Liu
- Department of Nutrition, the First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, 450052, China.
| | - Ze-Yan Luo
- Department of Epidemiology, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou, 510632, Guangdong, China
| | - Yun-Feng Cui
- Department of Epidemiology, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou, 510632, Guangdong, China
| | - Yuan Cao
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China
| | - Wen-Jun Fu
- Department of Obstetrics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Wei-Feng Dou
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China
| | - Dan-Dan Duan
- Department of Clinical Nutrition, New Area People's Hospital of Luoyang, Luoyang, 471023, China
| | - Xian-Lan Zhao
- Department of Obstetrics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Yu-Ming Chen
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Quan-Jun Lyu
- Department of Nutrition, the First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, 450052, China
| | - Qing-Shan Chen
- Department of Epidemiology, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou, 510632, Guangdong, China
| | - Fang-Fang Zeng
- Department of Epidemiology, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou, 510632, Guangdong, China.
| |
Collapse
|
22
|
Alamolhoda SH, Simbar M, Mirmiran P, Mirabi P. Effect of low trans-fatty acid intakes on preeclampsia: A randomized controlled trial. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2020; 25:112. [PMID: 33912222 PMCID: PMC8067888 DOI: 10.4103/jrms.jrms_149_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 04/15/2020] [Accepted: 07/12/2020] [Indexed: 11/04/2022]
Abstract
Background: Preeclampsia (PE) is a high blood pressure disorder accompanied by proteinuria during pregnancy. It remains unclear whether dietary trans-fatty acid (TFA) can influence PE risk. We examined the effect of low TFA dietary intakes during pregnancy on the risk of PE. Materials and Methods: We conducted a randomized open-label controlled trial on 800 pregnant women admitted to public health centers from May 2014 to August 2016. In the intervention group, participants received a diet with TFA <1% and those in the comparison group, participants had dietary intakes with no change on TFA content. Dietary intakes were assessed by 24-h recalls at the first prenatal care visit (<8 weeks) and at gestational ages of 13, 25, and 35 weeks. The hazard ratio (95% confidence interval [CI]) for PE was calculated using the Cox proportional-hazards model. Results: There were statistically significant differences in intakes of daily TFAs between the groups (P < 0.05). The hazard ratio (95% CI) for the incidence of PE in the intervention group was 0.56 (0.33–0.93). Conclusion: Low TFA dietary intake during pregnancy reduced the risk of PE.
Collapse
Affiliation(s)
- Seideh Hanieh Alamolhoda
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Simbar
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery. Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvaneh Mirabi
- Infertility and Reproductive Health Research Center. Health Research Institute. Babol University of Medical Sciences, Babol, Iran
| |
Collapse
|
23
|
Pérez-Pérez A, Vilariño-García T, Guadix P, Dueñas JL, Sánchez-Margalet V. Leptin and Nutrition in Gestational Diabetes. Nutrients 2020; 12:E1970. [PMID: 32630697 PMCID: PMC7400219 DOI: 10.3390/nu12071970] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/25/2020] [Accepted: 06/30/2020] [Indexed: 12/12/2022] Open
Abstract
Leptin is highly expressed in the placenta, mainly by trophoblastic cells, where it has an important autocrine trophic effect. Moreover, increased leptin levels are found in the most frequent pathology of pregnancy: gestational diabetes, where leptin may mediate the increased size of the placenta and the fetus, which becomes macrosomic. In fact, leptin mediates the increased protein synthesis, as observed in trophoblasts from gestational diabetic subjects. In addition, leptin seems to facilitate nutrients transport to the fetus in gestational diabetes by increasing the expression of the glycerol transporter aquaporin-9. The high plasma leptin levels found in gestational diabetes may be potentiated by leptin resistance at a central level, and obesity-associated inflammation plays a role in this leptin resistance. Therefore, the importance of anti-inflammatory nutrients to modify the pathology of pregnancy is clear. In fact, nutritional intervention is the first-line approach for the treatment of gestational diabetes mellitus. However, more nutritional intervention studies with nutraceuticals, such as polyphenols or polyunsaturated fatty acids, or nutritional supplementation with micronutrients or probiotics in pregnant women, are needed in order to achieve a high level of evidence. In this context, the Mediterranean diet has been recently found to reduce the risk of gestational diabetes in a multicenter randomized trial. This review will focus on the impact of maternal obesity on placental inflammation and nutrients transport, considering the mechanisms by which leptin may influence maternal and fetal health in this setting, as well as its role in pregnancy pathologies.
Collapse
Affiliation(s)
- Antonio Pérez-Pérez
- Department of Medical Biochemistry and Molecular Biology, and Immnology, School of Medicine, Virgen Macarena University Hospital, 41009 Seville, Spain;
| | - Teresa Vilariño-García
- Department of Medical Biochemistry and Molecular Biology, and Immnology, School of Medicine, Virgen Macarena University Hospital, 41009 Seville, Spain;
| | - Pilar Guadix
- Obstetrics and Gynecology Service, Virgen Macarena University Hospital, 41009 Seville, Spain; (P.G.); (J.L.D.)
| | - José L. Dueñas
- Obstetrics and Gynecology Service, Virgen Macarena University Hospital, 41009 Seville, Spain; (P.G.); (J.L.D.)
| | - Víctor Sánchez-Margalet
- Department of Medical Biochemistry and Molecular Biology, and Immnology, School of Medicine, Virgen Macarena University Hospital, 41009 Seville, Spain;
| |
Collapse
|
24
|
Li Q, Xu S, Chen X, Zhang X, Li X, Lin L, Gao D, Wu M, Yang S, Cao X, Tan T, Hu W, Guo J, Huang L, Chen R, Zhou X, Cui W, Xiong T, Gao Q, Wu Y, Hong M, Wang X, Zhang G, Zhang Y, Zhong C, Xiong G, Yang H, Yang N, Yang X, Hao L, Jin Z, Yang N. Folic Acid Supplement Use and Increased Risk of Gestational Hypertension. Hypertension 2020; 76:150-156. [DOI: 10.1161/hypertensionaha.119.14621] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Current results regarding the effect of folic acid (FA) supplement use on gestational hypertension (GH) and preeclampsia are limited and inconsistent. We aimed to investigate whether FA supplement use was associated with GH and preeclampsia. Participants from the Tongji Maternal and Child Health Cohort with information on periconceptional FA supplement use and diagnosis of GH/preeclampsia were included (n=4853). Robust Poisson regression was used to assess the association of FA supplement use and GH and preeclampsia. Among the 4853 participants in this study, 1161 (23.9%) and 161 (3.3%) women were diagnosed with GH and preeclampsia, respectively. The risk ratio of developing GH was higher in women who used ≥800 µg/d FA supplement from prepregnancy through midpregnancy than nonusers (risk ratio, 1.33 [1.08–1.65]). After adjusting for social-demographic, reproductive, lifestyle factors, family history of hypertension, other supplement use, and gestational weight gain, the adverse association remained significant (risk ratio, 1.32 [1.06–1.64]). Restricting the analysis among women with normal weight, without family history of hypertension, and without gestational diabetes mellitus, the positive FA-GH association still existed. We did not find any significant association between FA supplement use and preeclampsia regardless of adjustment. High-dose (≥800 µg/d) FA supplement use from prepregnancy through midpregnancy was associated with increased risk of GH. Attention should be given to avoid the potential risk of GH due to inappropriate FA supplement use in women who are planning or capable of pregnancy.
Collapse
Affiliation(s)
- Qian Li
- From the Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China (Q.L., S.X., X. Chen, X. Zhang, X.L., L.L., D.G., M.W., S.Y., X. Cao, T.T., W.H., J.G., L. Huang, R.C., X. Zhou, W.C., T.X., Q.G., Y.W., M.H., X.W., G.Z., Y.Z., C.Z., X.Y., L. Hao, Nianhong Yang)
| | - Shangzhi Xu
- From the Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China (Q.L., S.X., X. Chen, X. Zhang, X.L., L.L., D.G., M.W., S.Y., X. Cao, T.T., W.H., J.G., L. Huang, R.C., X. Zhou, W.C., T.X., Q.G., Y.W., M.H., X.W., G.Z., Y.Z., C.Z., X.Y., L. Hao, Nianhong Yang)
| | - Xi Chen
- From the Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China (Q.L., S.X., X. Chen, X. Zhang, X.L., L.L., D.G., M.W., S.Y., X. Cao, T.T., W.H., J.G., L. Huang, R.C., X. Zhou, W.C., T.X., Q.G., Y.W., M.H., X.W., G.Z., Y.Z., C.Z., X.Y., L. Hao, Nianhong Yang)
| | - Xu Zhang
- From the Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China (Q.L., S.X., X. Chen, X. Zhang, X.L., L.L., D.G., M.W., S.Y., X. Cao, T.T., W.H., J.G., L. Huang, R.C., X. Zhou, W.C., T.X., Q.G., Y.W., M.H., X.W., G.Z., Y.Z., C.Z., X.Y., L. Hao, Nianhong Yang)
| | - Xiating Li
- From the Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China (Q.L., S.X., X. Chen, X. Zhang, X.L., L.L., D.G., M.W., S.Y., X. Cao, T.T., W.H., J.G., L. Huang, R.C., X. Zhou, W.C., T.X., Q.G., Y.W., M.H., X.W., G.Z., Y.Z., C.Z., X.Y., L. Hao, Nianhong Yang)
| | - Lixia Lin
- From the Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China (Q.L., S.X., X. Chen, X. Zhang, X.L., L.L., D.G., M.W., S.Y., X. Cao, T.T., W.H., J.G., L. Huang, R.C., X. Zhou, W.C., T.X., Q.G., Y.W., M.H., X.W., G.Z., Y.Z., C.Z., X.Y., L. Hao, Nianhong Yang)
| | - Duan Gao
- From the Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China (Q.L., S.X., X. Chen, X. Zhang, X.L., L.L., D.G., M.W., S.Y., X. Cao, T.T., W.H., J.G., L. Huang, R.C., X. Zhou, W.C., T.X., Q.G., Y.W., M.H., X.W., G.Z., Y.Z., C.Z., X.Y., L. Hao, Nianhong Yang)
| | - Meng Wu
- From the Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China (Q.L., S.X., X. Chen, X. Zhang, X.L., L.L., D.G., M.W., S.Y., X. Cao, T.T., W.H., J.G., L. Huang, R.C., X. Zhou, W.C., T.X., Q.G., Y.W., M.H., X.W., G.Z., Y.Z., C.Z., X.Y., L. Hao, Nianhong Yang)
| | - Sen Yang
- From the Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China (Q.L., S.X., X. Chen, X. Zhang, X.L., L.L., D.G., M.W., S.Y., X. Cao, T.T., W.H., J.G., L. Huang, R.C., X. Zhou, W.C., T.X., Q.G., Y.W., M.H., X.W., G.Z., Y.Z., C.Z., X.Y., L. Hao, Nianhong Yang)
| | - Xiyu Cao
- From the Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China (Q.L., S.X., X. Chen, X. Zhang, X.L., L.L., D.G., M.W., S.Y., X. Cao, T.T., W.H., J.G., L. Huang, R.C., X. Zhou, W.C., T.X., Q.G., Y.W., M.H., X.W., G.Z., Y.Z., C.Z., X.Y., L. Hao, Nianhong Yang)
| | - Tianqi Tan
- From the Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China (Q.L., S.X., X. Chen, X. Zhang, X.L., L.L., D.G., M.W., S.Y., X. Cao, T.T., W.H., J.G., L. Huang, R.C., X. Zhou, W.C., T.X., Q.G., Y.W., M.H., X.W., G.Z., Y.Z., C.Z., X.Y., L. Hao, Nianhong Yang)
| | - Wenqi Hu
- From the Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China (Q.L., S.X., X. Chen, X. Zhang, X.L., L.L., D.G., M.W., S.Y., X. Cao, T.T., W.H., J.G., L. Huang, R.C., X. Zhou, W.C., T.X., Q.G., Y.W., M.H., X.W., G.Z., Y.Z., C.Z., X.Y., L. Hao, Nianhong Yang)
| | - Jinrong Guo
- From the Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China (Q.L., S.X., X. Chen, X. Zhang, X.L., L.L., D.G., M.W., S.Y., X. Cao, T.T., W.H., J.G., L. Huang, R.C., X. Zhou, W.C., T.X., Q.G., Y.W., M.H., X.W., G.Z., Y.Z., C.Z., X.Y., L. Hao, Nianhong Yang)
| | - Li Huang
- From the Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China (Q.L., S.X., X. Chen, X. Zhang, X.L., L.L., D.G., M.W., S.Y., X. Cao, T.T., W.H., J.G., L. Huang, R.C., X. Zhou, W.C., T.X., Q.G., Y.W., M.H., X.W., G.Z., Y.Z., C.Z., X.Y., L. Hao, Nianhong Yang)
| | - Renjuan Chen
- From the Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China (Q.L., S.X., X. Chen, X. Zhang, X.L., L.L., D.G., M.W., S.Y., X. Cao, T.T., W.H., J.G., L. Huang, R.C., X. Zhou, W.C., T.X., Q.G., Y.W., M.H., X.W., G.Z., Y.Z., C.Z., X.Y., L. Hao, Nianhong Yang)
| | - Xuezhen Zhou
- From the Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China (Q.L., S.X., X. Chen, X. Zhang, X.L., L.L., D.G., M.W., S.Y., X. Cao, T.T., W.H., J.G., L. Huang, R.C., X. Zhou, W.C., T.X., Q.G., Y.W., M.H., X.W., G.Z., Y.Z., C.Z., X.Y., L. Hao, Nianhong Yang)
| | - Wenli Cui
- From the Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China (Q.L., S.X., X. Chen, X. Zhang, X.L., L.L., D.G., M.W., S.Y., X. Cao, T.T., W.H., J.G., L. Huang, R.C., X. Zhou, W.C., T.X., Q.G., Y.W., M.H., X.W., G.Z., Y.Z., C.Z., X.Y., L. Hao, Nianhong Yang)
| | - Ting Xiong
- From the Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China (Q.L., S.X., X. Chen, X. Zhang, X.L., L.L., D.G., M.W., S.Y., X. Cao, T.T., W.H., J.G., L. Huang, R.C., X. Zhou, W.C., T.X., Q.G., Y.W., M.H., X.W., G.Z., Y.Z., C.Z., X.Y., L. Hao, Nianhong Yang)
| | - Qin Gao
- From the Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China (Q.L., S.X., X. Chen, X. Zhang, X.L., L.L., D.G., M.W., S.Y., X. Cao, T.T., W.H., J.G., L. Huang, R.C., X. Zhou, W.C., T.X., Q.G., Y.W., M.H., X.W., G.Z., Y.Z., C.Z., X.Y., L. Hao, Nianhong Yang)
| | - Yuanjue Wu
- From the Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China (Q.L., S.X., X. Chen, X. Zhang, X.L., L.L., D.G., M.W., S.Y., X. Cao, T.T., W.H., J.G., L. Huang, R.C., X. Zhou, W.C., T.X., Q.G., Y.W., M.H., X.W., G.Z., Y.Z., C.Z., X.Y., L. Hao, Nianhong Yang)
| | - Miao Hong
- From the Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China (Q.L., S.X., X. Chen, X. Zhang, X.L., L.L., D.G., M.W., S.Y., X. Cao, T.T., W.H., J.G., L. Huang, R.C., X. Zhou, W.C., T.X., Q.G., Y.W., M.H., X.W., G.Z., Y.Z., C.Z., X.Y., L. Hao, Nianhong Yang)
| | - Xiaoyi Wang
- From the Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China (Q.L., S.X., X. Chen, X. Zhang, X.L., L.L., D.G., M.W., S.Y., X. Cao, T.T., W.H., J.G., L. Huang, R.C., X. Zhou, W.C., T.X., Q.G., Y.W., M.H., X.W., G.Z., Y.Z., C.Z., X.Y., L. Hao, Nianhong Yang)
| | - Guofu Zhang
- From the Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China (Q.L., S.X., X. Chen, X. Zhang, X.L., L.L., D.G., M.W., S.Y., X. Cao, T.T., W.H., J.G., L. Huang, R.C., X. Zhou, W.C., T.X., Q.G., Y.W., M.H., X.W., G.Z., Y.Z., C.Z., X.Y., L. Hao, Nianhong Yang)
| | - Yu Zhang
- From the Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China (Q.L., S.X., X. Chen, X. Zhang, X.L., L.L., D.G., M.W., S.Y., X. Cao, T.T., W.H., J.G., L. Huang, R.C., X. Zhou, W.C., T.X., Q.G., Y.W., M.H., X.W., G.Z., Y.Z., C.Z., X.Y., L. Hao, Nianhong Yang)
| | - Chunrong Zhong
- From the Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China (Q.L., S.X., X. Chen, X. Zhang, X.L., L.L., D.G., M.W., S.Y., X. Cao, T.T., W.H., J.G., L. Huang, R.C., X. Zhou, W.C., T.X., Q.G., Y.W., M.H., X.W., G.Z., Y.Z., C.Z., X.Y., L. Hao, Nianhong Yang)
| | | | - Hongying Yang
- Institute of Health Education, Hubei Provincial Center for Disease Control and Prevention, Hubei Provincial Academy of Preventive Medicine, P.R. China (H.Y.)
| | - Nianlan Yang
- Department of Anesthesiology & Perioperative Medicine, Medical College of Georgia, Augusta University (Nianlan Yang)
| | - Xuefeng Yang
- From the Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China (Q.L., S.X., X. Chen, X. Zhang, X.L., L.L., D.G., M.W., S.Y., X. Cao, T.T., W.H., J.G., L. Huang, R.C., X. Zhou, W.C., T.X., Q.G., Y.W., M.H., X.W., G.Z., Y.Z., C.Z., X.Y., L. Hao, Nianhong Yang)
| | - Liping Hao
- From the Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China (Q.L., S.X., X. Chen, X. Zhang, X.L., L.L., D.G., M.W., S.Y., X. Cao, T.T., W.H., J.G., L. Huang, R.C., X. Zhou, W.C., T.X., Q.G., Y.W., M.H., X.W., G.Z., Y.Z., C.Z., X.Y., L. Hao, Nianhong Yang)
| | - Zhichun Jin
- Hubei Maternal and Child Health Hospital, P.R. China (Z.J.)
| | - Nianhong Yang
- From the Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, P.R. China (Q.L., S.X., X. Chen, X. Zhang, X.L., L.L., D.G., M.W., S.Y., X. Cao, T.T., W.H., J.G., L. Huang, R.C., X. Zhou, W.C., T.X., Q.G., Y.W., M.H., X.W., G.Z., Y.Z., C.Z., X.Y., L. Hao, Nianhong Yang)
| |
Collapse
|
25
|
Adherence to a Dietary Approaches to Stop Hypertension (DASH)-style Diet in Relation to Preeclampsia: A Case-Control Study. Sci Rep 2020; 10:9078. [PMID: 32493995 PMCID: PMC7270088 DOI: 10.1038/s41598-020-65912-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Accepted: 05/12/2020] [Indexed: 12/11/2022] Open
Abstract
Maternal diet is an important potential factor associated with the risk of preeclampsia. However, it is unclear whether adherence to a Dietary Approaches to Stop Hypertension (DASH)-style diet can reduce the development of preeclampsia. To examine the potential association, we conducted a hospital-based case-control study at the First Affiliated Hospital of Zhengzhou University, China. A total of 449 cases with preeclampsia and 449 controls were studied. Dietary information was collected using a validated food frequency questionnaire (FFQ). DASH scores were calculated according to nutrients/food emphasised or minimised in the DASH diet. The calculated DASH scores ranged from 11 to 38 for all of the participants, and the DASH scores of the cases were significantly lower than those of the controls (23.48 ± 4.58 vs 24.51 ± 4.51; p = 0.001). Participants in the fourth quartile of the DASH score were 45% less likely to have preeclampsia than those in the first quartile in the crude model (Q4 vs Q1, odds ratio [OR]: 0.55; 95% confidence interval [CI]: 0.38, 0.80; ptrend = 0.001). The relationship remained significant in the model adjusted for multiple confounders, especially for major risk factors of preeclampsia (OR: 0.53; 95% CI: 0.36, 0.78; ptrend = 0.001). Our findings suggest an inverse relationship between adherence to a DASH-style diet and the odds of preeclampsia. Further larger-scale cohort studies or randomised controlled trials are warranted to confirm these relationships.
Collapse
|
26
|
Khaire A, Wadhwani N, Madiwale S, Joshi S. Maternal fats and pregnancy complications: Implications for long-term health. Prostaglandins Leukot Essent Fatty Acids 2020; 157:102098. [PMID: 32380367 DOI: 10.1016/j.plefa.2020.102098] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 03/12/2020] [Accepted: 03/23/2020] [Indexed: 12/19/2022]
Abstract
Pregnancy imposes increased nutritional requirements for the well being of the mother and fetus. Maternal lipid metabolism is critical for fetal development and long-term health of the offspring as it plays a key role in energy storage, tissue growth and cell signaling. Maternal fat composition is considered as a modifiable risk for abnormal lipid metabolism and glucose tolerance during pregnancy. Data derived from observational studies demonstrate that higher intake of saturated fats during pregnancy is associated with pregnancy complications (preeclampsia, gestational diabetes mellitus and preterm delivery) and poor birth outcomes (intra uterine growth retardation and large for gestational age babies). On the other hand, prenatal long chain polyunsaturated fatty acids status is shown to improve birth outome. In this article, we discuss the role of maternal lipids during pregnancy on fetal growth and development and its consequences on the health of the offspring.
Collapse
Affiliation(s)
- Amrita Khaire
- Mother and Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be) University, Pune Satara Road, Pune, 411043, India
| | - Nisha Wadhwani
- Mother and Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be) University, Pune Satara Road, Pune, 411043, India
| | - Shweta Madiwale
- Mother and Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be) University, Pune Satara Road, Pune, 411043, India
| | - Sadhana Joshi
- Mother and Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be) University, Pune Satara Road, Pune, 411043, India.
| |
Collapse
|
27
|
Hill AM, Nunnery DL, Ammerman A, Dharod JM. Racial/Ethnic Differences in Diet Quality and Eating Habits Among WIC Pregnant Women: Implications for Policy and Practice. Am J Health Promot 2019; 34:169-176. [PMID: 31658816 DOI: 10.1177/0890117119883584] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE One of the major federal food assistance programs, the Special Supplemental Program for Women, Infants, and Children (WIC), serves approximately 1.5 million low-income pregnant women per year; however, limited information is available on their dietary habits. This is critical because low-income women are at higher risk of gaining excess weight during pregnancy. Thus, the study objectives were to (1) determine the overall diet quality of WIC pregnant women and (2) examine diet quality and eating behaviors by race/ethnicity and other sociodemographics. DESIGN This was a cross-sectional study. SETTING One of the 3 WIC offices in a north-central county in North Carolina, USA. SAMPLE Pregnant women (n = 198) in the second trimester. MEASURES Interviews included sociodemographics, food security, diet, and eating behaviors. Diet quality was assessed by the Healthy Eating Index (HEI) 2010 scores. ANALYSIS Descriptives, bivariate analysis, and multivariate analysis. RESULTS Average participant age was 26 years, and the mean HEI-2010 score was 56 of maximum score of 100. Specifically, African American women consumed significantly lower servings of whole grains (β = -1.71; 95% CI: -3.10 to -0.32; P < .05) and dairy (β = -1.42; 95% CI: -2.51 to -0.33; P < .05) compared with non-Hispanic white women. Hispanic women scored higher in daily intake of fruits (β = 0.98; 95% CI: 0.17-1.79; P < .05) and for consuming empty calories in moderation (β = 1.57; 95% CI: 0.06-3.09; P < .05). Frequency of intake of fast foods/outside meals was higher among African American women (57%, P = .025). CONCLUSION Efforts are warranted to promote optimal nutrition among WIC pregnant women. Specifically, African American women are highly vulnerable to poor dietary habits during pregnancy. Further investigation of barriers/facilitators for healthy eating is necessary to address nutrition disparities among WIC pregnant women.
Collapse
Affiliation(s)
- Alla M Hill
- Department of Nutrition, The University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Danielle L Nunnery
- Department of Nutrition and Health Care Management, Appalachian State University, Boone, NC, USA
| | - Alice Ammerman
- Department of Nutrition, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jigna M Dharod
- Department of Nutrition, The University of North Carolina at Greensboro, Greensboro, NC, USA
| |
Collapse
|
28
|
Vegetable dietary pattern associated with low risk of preeclampsia possibly through reducing proteinuria. Pregnancy Hypertens 2019; 16:131-138. [PMID: 31056148 DOI: 10.1016/j.preghy.2019.04.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 03/17/2019] [Accepted: 04/06/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND Evidence on the potential roles that dietary patterns play in the risk of preeclampsia remains limited. OBJECTIVE To examine the associations between dietary patterns during pregnancy and the risk of preeclampsia. STUDY DESIGN We analyzed data from a cluster randomized controlled trial among 987 healthy pregnant women in three rural counties in northwestern China. Maternal diet during the whole pregnancy was assessed using a 107-item food frequency questionnaire with proportion size administered before delivery. Principal component factor analysis with varimax rotation was used to identify common dietary patterns. Preeclampsia was diagnosed by trained clinicians and recorded in delivery records. RESULTS Nineteen participants (1.9%) were diagnosed with preeclampsia. Gestational hypertension and proteinuria were only weakly correlated with each other (Kappa = 0.06): 10.7% participants with gestational hypertension only, 8.8% with proteinuria only, 1.9% with both, and 78.6% with neither. Five common dietary patterns were identified: vegetable, meat, fruit, snack, and wheat staple patterns. After adjusting for calories, other dietary pattern scores and baseline blood pressure, a higher vegetable pattern scores was associated with lower risk of preeclampsia (P for trend = 0.041; the highest vs lowest quartile, adjusted relative risk = 0.20 [95% confidence interval, 0.04-0.98]). A similar association was also observed for the risk of proteinuria (P for trend = 0.015): the highest vs lowest quartiles of the vegetable pattern score, adjusted relative risk = 0.44 (95% confidence interval, 0.24-0.80). The other four pattern scores were not associated with preeclampsia. CONCLUSIONS Adherence to vegetable dietary pattern may be associated with the lower risk of preeclampsia, possibly through reducing development of proteinuria. The original full study was registered at clinicaltrials.gov as NCT02537392.
Collapse
|
29
|
Lin CY, Chen YJ, Lee SH, Kuo CP, Lee MS, Lee MC. Uses of dietary supplements and herbal medicines during pregnancy in women undergoing assisted reproductive technologies- A study of taiwan birth cohort. Taiwan J Obstet Gynecol 2019; 58:77-81. [PMID: 30638486 DOI: 10.1016/j.tjog.2018.11.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2018] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE This study aimed to assess the efficacy of dietary supplements and herbal medicines for the care of pregnant women undergoing assisted reproductive technologies (ART). MATERIALS AND METHODS A total of 366 women undergoing ART and their children from the dataset of Taiwan Birth Cohort Study (TBCS, 2005) were enrolled in this study. Structured questionnaires were applied to collect the health information at 6-month follow-up after their delivery. The related use patterns were analyzed to investigate the final birth outcomes. RESULTS Comparing with those of non-ART group, the women undergoing ART consumed more supplements of multivitamin, fish oil, and calcium than herbal medicines during pregnancy. This study revealed that the consumptions of multivitamin, calcium pills, Genseng, and Suz-Wu-Tang were associated with low birth weight, whereas the intake of Huanglian was associated with birth weight. Besides, the uses of multivitamin and Suz-Wu-Tang were related to lower gestational age of infants. CONCLUSIONS Physicians and nurses must educate themselves in dietary supplements and herbal/alternative medicines for offering accurate advices for pregnant women to optimize their care. The results could be of reference for further investigation on longitudinal effects of dietary supplements and herbal medicines during pregnancy in women undergoing ART continuously followed with TBCS.
Collapse
Affiliation(s)
- Ching-Yi Lin
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Yu-Ju Chen
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Shu-Hsin Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; School of Nursing, Chung Shan Medical University, Taichung, Taiwan; Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan.
| | - Ching-Pyng Kuo
- School of Nursing, Chung Shan Medical University, Taichung, Taiwan
| | - Maw-Sheng Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Lee Women's Hospital, Taichung, Taiwan
| | - Meng-Chih Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan; Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan; College of Management, Chaoyang University of Technology, Taichung, Taiwan.
| |
Collapse
|
30
|
WANG Z, WANG C, QIU J, NI Y, CHAI S, ZHOU L, LI J, YAN B, YANG J, LIU Q. The Association between Dietary Vitamin C/E and Gestational Hypertensive Disorder: A Case-Control Study. J Nutr Sci Vitaminol (Tokyo) 2018; 64:454-465. [DOI: 10.3177/jnsv.64.454] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - Cheng WANG
- Gansu Provincial Maternity and Child-care Hospital
| | - Jie QIU
- Gansu Provincial Maternity and Child-care Hospital
| | - Yali NI
- Gansu Provincial Maternity and Child-care Hospital
| | - Sanming CHAI
- Gansu Provincial Maternity and Child-care Hospital
| | - Li ZHOU
- Gansu Provincial Maternity and Child-care Hospital
| | - Jing LI
- Gansu Provincial Maternity and Child-care Hospital
| | - Bo YAN
- Gansu Provincial Maternity and Child-care Hospital
| | - Jie YANG
- Gansu Provincial Maternity and Child-care Hospital
| | - Qing LIU
- Department of Gynecology and Obstetrics of Gansu Provincial Maternity and Child-care Hospital
| |
Collapse
|
31
|
Carmichael SL, Ma C, Feldkamp ML, Shaw GM. Comparing Usual Dietary Intakes Among Subgroups of Mothers in the Year Before Pregnancy. Public Health Rep 2018; 134:155-163. [PMID: 30593261 PMCID: PMC6410470 DOI: 10.1177/0033354918821078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The quantity and quality of dietary intake among women of reproductive age has important public health implications for nutritional status during pregnancy. We described dietary intake during the year before pregnancy among a large, diverse group of US mothers. METHODS We examined data from 11 109 mothers who gave birth from 1997 through 2011 and participated in a population-based case-control study, the National Birth Defects Prevention Study, as controls (mothers who had babies without major birth defects). We examined whether subgroups of mothers at elevated risk of adverse pregnancy outcomes were more likely than their reference groups to have high dietary intake (>90th percentile of intake) or low dietary intake (<10th percentile of intake). We examined dietary intake of 22 nutritional factors, which were estimated from responses to a food frequency questionnaire. RESULTS Participants who were aged <20, were nulliparous, had CONCLUSIONS Strategies are needed to ensure optimal nutrition among all childbearing women.
Collapse
Affiliation(s)
- Suzan L. Carmichael
- Division of Neonatology and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Chen Ma
- Division of Neonatology and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Marcia L. Feldkamp
- Division of Medical Genetics, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA
| | | | | |
Collapse
|
32
|
Sackey DS, Larbie C, Mensah FO. Geophagia, nutrition and health of women with pregnancy-induced hypertension. Afr Health Sci 2018; 18:1243-1254. [PMID: 30766591 PMCID: PMC6354851 DOI: 10.4314/ahs.v18i4.46] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Calcium is a major nutrient implicated in pregnancy-induced hypertension (PIH). Aside dietary sources, geophagia has been reported to provide calcium needed to prevent PIH. These soils are shown to contain significant amount of heavy metals which have been associated with hypertension. OBJECTIVE The aim of this study was to determine the relationship between geophagia and PIH, assess the dietary intakes and health of participants. METHODS This study was a case-control involving 30 women with PIH and 70 normotensive pregnant women. RESULTS Geophagia was not significantly associated with PIH. Women with PIH practicing geophagia recorded significantly low levels of haemoglobin, calcium and ferritin. Hypertensives recorded impaired fasting blood glucose (5.77±1.71mmol/L, p=0.051), higher levels of urea (3.60±1.29 mmol/L, p=0.000) and creatinine (382.67±11.66 µmol/L, p=0.000). Percentage intakes of macronutrients for normotensives were within the Adequate Macronutrient Distribution Range and PIH group recorded higher intakes of carbohydrate (72.75±16.16 %), lower protein (9.77±5.61 %) and fat (17.15±11.99%). Dietary calcium intakes in both groups were lower than recommended (< 1,000 mg/day). CONCLUSION In this study, geophagia during pregnancy is not directly associated with PIH but is detrimental to maternal health. The pregnant women in this study had considerably low intakes of energy and nutrients. There is a need for measures to ensure adequate maternal nutrition for a positive health and pregnancy outcomes.
Collapse
Affiliation(s)
- Deborah Sakua Sackey
- Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah. University of Science and Technology, Kumasi, Ghana
| | - Christopher Larbie
- Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah. University of Science and Technology, Kumasi, Ghana
| | - Faustina O Mensah
- Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah. University of Science and Technology, Kumasi, Ghana
| |
Collapse
|
33
|
Fat intake during pregnancy and risk of preeclampsia: a prospective cohort study in Denmark. Eur J Clin Nutr 2018; 73:1040-1048. [PMID: 30194370 DOI: 10.1038/s41430-018-0290-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 04/23/2018] [Accepted: 08/01/2018] [Indexed: 11/08/2022]
Abstract
BACKGROUND Previous studies suggest that eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and alpha-linolenic acid (ALA), may decrease the risk of preeclampsia, but many suffer from important methodological limitations. METHODS We prospectively examined the association between fat intake during pregnancy and preeclampsia and among 65,220 singleton pregnancies in the Danish National Birth Cohort (1996-2002). Women were asked to report their diet around gestation week 20 with a food frequency questionnaire. Preeclampsia diagnosis was obtained via linkage with the Danish National Patient Registry. We estimated relative risks (RR) and 95% confidence intervals (95% CI) of preeclampsia and severe preeclampsia according to fat intake using logistic regression models with generalized estimating equations to account for repeated pregnancies per woman while adjusting for potential confounders. RESULTS We documented 1302 cases of preeclampsia, including 301 cases of severe preeclampsia. Intake of long-chain omega-3 fatty acids was associated to preeclampsia. Women in the top quintile of DHA intake had a lower risk of preeclampsia (RR 0.67 (0.51-0.89)) and severe preeclampsia (RR 0.46 (0.25-0.83)) than women in the bottom quintile. Women who met daily recommended intake of EPA+DHA according to the Dietary Guidelines for Americans (≥250 mg/day), had a lower risk of severe preeclampsia (RR 0.77 (0.60-0.99)), but not of preeclampsia (RR 0.93 (0.82-1.05)). Conversely, ALA intake was associated with higher risk of severe preeclampsia (RR 1.71 (1.07-2.75)). CONCLUSIONS Higher intake of DHA is inversely related to preeclampsia and severe preeclampsia, whereas ALA increases the risk of severe preeclampsia among Danish women.
Collapse
|
34
|
Phang M, Skilton MR. Marine Omega-3 Fatty Acids, Complications of Pregnancy and Maternal Risk Factors for Offspring Cardio-Metabolic Disease. Mar Drugs 2018; 16:md16050138. [PMID: 29695082 PMCID: PMC5983270 DOI: 10.3390/md16050138] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 04/18/2018] [Accepted: 04/20/2018] [Indexed: 01/10/2023] Open
Abstract
Marine omega-3 polyunsaturated fatty acids (n-3 PUFA) are important nutrients during periods of rapid growth and development in utero and infancy. Maternal health and risk factors play a crucial role in birth outcomes and subsequently offspring cardio-metabolic health. Evidence from observational studies and randomized trials have suggested a potential association of maternal intake of marine n-3 PUFAs during pregnancy with pregnancy and birth outcomes. However, there is inconsistency in the literature on whether marine n-3 PUFA supplementation during pregnancy can prevent maternal complications of pregnancy. This narrative literature review summarizes recent evidence on observational and clinical trials of marine n-3 PUFA intake on maternal risk factors and effects on offspring cardio-metabolic health. The current evidence generally does not support a role of maternal n-3 PUFA supplementation in altering the incidence of gestational diabetes, pregnancy-induced hypertension, or pre-eclampsia. It may be that benefits from marine n-3 PUFA supplementation are more pronounced in high-risk populations, such as women with a history of complications of pregnancy, or women with low marine n-3 PUFA intake. Discrepancies between studies may be related to differences in study design, dosage, fatty acid interplay, and length of treatment. Further prospective double-blind studies are needed to clarify the impact of long-chain marine n-3 PUFAs on risk factors for cardio-metabolic disease in the offspring.
Collapse
Affiliation(s)
- Melinda Phang
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Sydney Medical School, University of Sydney, Camperdown 2006, Australia.
| | - Michael R Skilton
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Sydney Medical School, University of Sydney, Camperdown 2006, Australia.
| |
Collapse
|
35
|
Gicevic S, Gaskins AJ, Fung TT, Rosner B, Tobias DK, Isanaka S, Willett WC. Evaluating pre-pregnancy dietary diversity vs. dietary quality scores as predictors of gestational diabetes and hypertensive disorders of pregnancy. PLoS One 2018; 13:e0195103. [PMID: 29614105 PMCID: PMC5882133 DOI: 10.1371/journal.pone.0195103] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 03/17/2018] [Indexed: 12/31/2022] Open
Abstract
Background Dietary diversity scores (DDS) are considered as metrics for monitoring the implementation of the UN’s Sustainable Development Goals, but they need to be rigorously evaluated. Objective To examine two DDS, the Food Groups Index (FGI), and the Minimum Dietary Diversity-Women (MDD-W), alongside two dietary quality scores, the Alternate Healthy Eating Index (AHEI-2010) and the Prime Diet Quality Score (PDQS), with risks of gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDPs). Design The analysis included 21,312 (GDM) and 19,917 (HDPs) singleton births reported in the Nurses’ Health Study II cohort (1991–2001), among women without major chronic disease or GDM/HDPs. Scores were derived using prepregnancy diet collected by a comprehensive food frequency questionnaire. Multivariable models were utilized to calculate relative risks (RR) and confidence intervals (95%CIs). Results Incident GDM (n = 916) and HDPs (n = 1,421) were reported. The MDD-W and FGI were not associated with risk of GDM or HDPs, but the AHEI-2010 and PDQS were associated with a lower risk of GDM and marginally lower risk of HDP. The RR’s of GDM comparing the highest vs. lowest quintiles were 1.00 (95%CI: 0.79, 1.27; p-trend = 0.82) for MDD-W, 0.96 (95%CI: 0.76, 1.22; p-trend = 0.88) for FGI, 0.63 (95%CI: 0.50, 0.81; p-trend <0.0001) for the AHEI-2010 and 0.68 (95%CI: 0.54, 0.86; p-trend = 0.003) for the PDQS. Similarly, the RR’s of HDPs were 0.92 (95%CI: 0.75, 1.12, p-trend = 0.94) for MDD-W, 0.97 (95%CI: 0.79, 1.17; p-trend = 0.83) for FGI, 0.84 (95%CI: 0.70, 1.02; p-trend = 0.07) for AHEI-2010 and 0.89 (95%CI: 0.74, 1.09; p-trend = 0.07) for PDQS. Conclusions MDD-W and FGI did not predict the risk of GDM and HDPs. These DDS should not be widely used as metrics for achieving dietary goals in their present form. The Prime Diet Quality Score warrants further testing as a promising measure of a sustainable and healthy diet on a global scale.
Collapse
Affiliation(s)
- Selma Gicevic
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- * E-mail:
| | - Audrey J. Gaskins
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States of America
| | - Teresa T. Fung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Nutrition, Simmons College, Boston, Massachusetts, United States of America
| | - Bernard Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States of America
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Deirdre K. Tobias
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States of America
| | - Sheila Isanaka
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Walter C. Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States of America
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| |
Collapse
|
36
|
O'Callaghan KM, Kiely M. Systematic Review of Vitamin D and Hypertensive Disorders of Pregnancy. Nutrients 2018; 10:nu10030294. [PMID: 29494538 PMCID: PMC5872712 DOI: 10.3390/nu10030294] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 02/19/2018] [Accepted: 02/27/2018] [Indexed: 01/07/2023] Open
Abstract
This narrative systematic review evaluates growing evidence of an association between low maternal vitamin D status and increased risk of hypertensive disorders. The inclusion of interventional, observational, and dietary studies on vitamin D and all hypertensive disorders of pregnancy is a novel aspect of this review, providing a unique contribution to an intensively-researched area that still lacks a definitive conclusion. To date, trial evidence supports a protective effect of combined vitamin D and calcium supplementation against preeclampsia. Conflicting data for an association of vitamin D with gestational hypertensive disorders in observational studies arises from a number of sources, including large heterogeneity between study designs, lack of adherence to standardized perinatal outcome definitions, variable quality of analytical data for 25-hydroxyvitamin D (25(OH)D), and inconsistent data reporting of vitamin D status. While evidence does appear to lean towards an increased risk of gestational hypertensive disorders at 25(OH)D concentrations <50 nmol/L, caution should be exercised with dosing in trials, given the lack of data on long-term safety. The possibility that a fairly narrow target range for circulating 25(OH)D for achievement of clinically-relevant improvements requires further exploration. As hypertension alone, and not preeclampsia specifically, limits intrauterine growth, evaluation of the relationship between vitamin D status and all terms of hypertension in pregnancy is a clinically relevant area for research and should be prioritised in future randomised trials.
Collapse
Affiliation(s)
- Karen M O'Callaghan
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork T12 Y337, Ireland.
- Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork T12 DFK4, Ireland.
| | - Mairead Kiely
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork T12 Y337, Ireland.
- Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork T12 DFK4, Ireland.
| |
Collapse
|
37
|
Tripathi RR, Rifas-Shiman SL, Hawley N, Hivert MF, Oken E. Hypertensive Disorders of Pregnancy and Offspring Cardiometabolic Health at Midchildhood: Project Viva Findings. J Am Heart Assoc 2018; 7:e007426. [PMID: 29382664 PMCID: PMC5850245 DOI: 10.1161/jaha.117.007426] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 11/28/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Exposure to preeclampsia or gestational hypertension is associated with higher offspring systolic blood pressure (SBP), but less is known about associations with other cardiometabolic risk markers. METHODS AND RESULTS We studied 1097 children from the Project Viva cohort born 1999-2002. Exposures were preeclampsia or gestational hypertension and mean maternal SBP in each trimester from prenatal records. Outcomes were research measures in midchildhood (mean 8.0 years) of SBP, overall adiposity, and a global cardiometabolic risk score comprising measures of SBP, waist circumference, glycemia, and lipids. We conducted linear regression analyses adjusted for maternal characteristics and offspring sex and age. In adjusted models, maternal preeclampsia or gestational hypertension (n=98, 9.1%) versus normal blood pressure was associated with slightly higher offspring SBP z-score (0.15 units; 95% confidence interval [CI] -0.03, 0.32) but otherwise predicted better cardiometabolic health markers including metabolic risk z-score (-0.23 units; -95% CI 0.44, -0.03) and several of its components as well as lower body mass index z-score (-0.27 units; 95% CI -0.48, -0.06) and lower fat mass index (-0.91 kg/m2; 95% CI -1.35, -0.47). Similarly, higher mean third-trimester maternal SBP was associated with higher offspring SBP z-score (0.09 units per 10 mm Hg; 95% CI 0.02, 0.16) and lower overall and central adiposity but not with biomarkers of metabolic risk. Results for second-trimester SBP were generally similar. First-trimester blood pressure was associated with higher offspring blood pressure but not with other outcomes. CONCLUSIONS Higher maternal late-pregnancy SBP and hypertensive disorders of pregnancy were associated with higher offspring SBP but otherwise better cardiometabolic health.
Collapse
Affiliation(s)
- Ruby Reetika Tripathi
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
- Department of Chronic Disease Epidemiology, Yale University, New Haven, CT
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
| | - Nicola Hawley
- Department of Chronic Disease Epidemiology, Yale University, New Haven, CT
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
- Diabetes Unit, Massachusetts General Hospital, Boston, MA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| |
Collapse
|
38
|
Danielewicz H, Myszczyszyn G, Dębińska A, Myszkal A, Boznański A, Hirnle L. Diet in pregnancy-more than food. Eur J Pediatr 2017; 176:1573-1579. [PMID: 29101450 PMCID: PMC5682869 DOI: 10.1007/s00431-017-3026-5] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Revised: 09/25/2017] [Accepted: 09/26/2017] [Indexed: 01/08/2023]
Abstract
High food quality, together with adequate macro- and micronutrient intake in pregnancy, is crucial for the health status of the mother and child. Recent findings suggest that it could also be beneficial or harmful in the context of the well-being of the whole future population. According to the developmental origins of health and disease hypothesis, most conditions that occur in adulthood originate in foetal life. Moreover, some epigenetic events, modified inter alia by diet, impact more than one generation. Still, the recommendations in most countries are neither popularised nor very detailed. While it seems to be important to direct diet trends towards a healthier lifestyle, the methods of preventing specific disorders like diabetes or asthma are not yet established and require further investigation. CONCLUSION In this review, we will summarise the recommendations for diet composition in pregnancy, focusing on both diet quality and quantity. What is Known • High food quality, together with adequate macro- and micronutrient intake in pregnancy, is crucial for the health status of the mother and child. What is New • Recent findings suggest that the diet could be beneficial or harmful in the context of the well-being of the whole future population. Most conditions that occur in adulthood originate in foetal life. • Moreover, some epigenetic events, modified by diet impact more than one generation.
Collapse
Affiliation(s)
- H. Danielewicz
- 1st Department of Pediatrics, Allergy and Cardiology, Wroclaw Medical University, Chalubinskiego 2a 50-368, Wroclaw, Poland
| | - G. Myszczyszyn
- 1st Department of Obstetrics and Gynecology, Wroclaw Medical University, Chalubinskiego 3 50-368, Wroclaw, Poland
| | - A. Dębińska
- 1st Department of Pediatrics, Allergy and Cardiology, Wroclaw Medical University, Chalubinskiego 2a 50-368, Wroclaw, Poland
| | - A. Myszkal
- 1st Department of Obstetrics and Gynecology, Wroclaw Medical University, Chalubinskiego 3 50-368, Wroclaw, Poland
| | - A. Boznański
- 1st Department of Pediatrics, Allergy and Cardiology, Wroclaw Medical University, Chalubinskiego 2a 50-368, Wroclaw, Poland
| | - L. Hirnle
- 1st Department of Obstetrics and Gynecology, Wroclaw Medical University, Chalubinskiego 3 50-368, Wroclaw, Poland
| |
Collapse
|
39
|
Xiao JP, Lv JX, Yin YX, Jiang L, Li WS, Tao T, Liao XP, Xu ZC. Lower maternal and fetal vitamin D status and higher placental and umbilical vitamin D receptor expression in preeclamptic pregnancies. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2017; 10:10841-10851. [PMID: 31966427 PMCID: PMC6965872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 09/18/2017] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To explore associations between maternal and fetal vitamin D status in preeclamptic pregnancies. METHODS A case-control experiment was carried out with proportion ratio of 1:1 (controls: n = 60 vs cases: n = 60). Blood collection of both maternal and cord were performed before and during delivery, respectively, and 25(OH)D measurement was conducted. Difference analysis was performed according to returned data. Immunohistochemical analysis, together with semi-quantitative Western blot, was also performed to determine protein expression of vitamin D receptor in placenta and cord tissues of ESPE. RESULTS Mean ± SD values of maternal 25(OH)D in control and PE group were 38.06 ± 6.28 and 33.05 ± 4.10, respectively, and significant differences with P < 0.0001 were found between control and PE in both continuous and categorical variables, especially in ESPE subtype (32.96 ± 4.49). The deficiency category (< 30 nmol/L) showed increased odds of PE (OR, 2.83, 95% CI, 1.32-6.08) in both maternal 25(OH)D and cord 25(OH)D in multivariable logistic regression. Semi-quantitative analysis showed that expression of placenta VDR in the ESPE subgroup was significantly higher than that in control group with P < 0.001, while expression of umbilical vein VDR in ESPE subgroup was significantly higher than that in control group with P < 0.05. CONCLUSIONS The present study finds that lowest maternal and fetal vitamin D status in ESPE existed in the preeclampsia subsets. The VDR expression in placenta and fetus in ESPE were higher than that of normal pregnancy, which indicated that it might be related to placenta compensatory mechanism and is worthy of further research.
Collapse
Affiliation(s)
- Jian-Ping Xiao
- Institute for Fetology, First Hospital of Soochow UniversitySuzhou, China
- Prenatal Diagnosis Center, Wuxi Maternity and Children Health Hospital Affiliated Nanjing Medical UniversityWuxi, China
| | - Juan-Xiu Lv
- Institute for Fetology, First Hospital of Soochow UniversitySuzhou, China
| | - Yong-Xiang Yin
- Department of Pathology, Wuxi Maternity and Children Health Hospital Affiliated Nanjing Medical UniversityWuxi, China
| | - Ling Jiang
- Institute for Fetology, First Hospital of Soochow UniversitySuzhou, China
| | - Wei-Sheng Li
- Institute for Fetology, First Hospital of Soochow UniversitySuzhou, China
| | - Tao Tao
- Prenatal Diagnosis Center, Wuxi Maternity and Children Health Hospital Affiliated Nanjing Medical UniversityWuxi, China
| | - Xiang-Peng Liao
- Prenatal Diagnosis Center, Wuxi Maternity and Children Health Hospital Affiliated Nanjing Medical UniversityWuxi, China
| | - Zhi-Ce Xu
- Institute for Fetology, First Hospital of Soochow UniversitySuzhou, China
| |
Collapse
|
40
|
De Ocampo MPG, Araneta MRG, Macera CA, Alcaraz JE, Moore TR, Chambers CD. Folic acid supplement use and the risk of gestational hypertension and preeclampsia. Women Birth 2017; 31:e77-e83. [PMID: 28870524 DOI: 10.1016/j.wombi.2017.08.128] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 08/10/2017] [Accepted: 08/18/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Hypertensive disorders of pregnancy are among the leading causes of maternal morbidity and mortality. Studies suggest that the use of folic acid may lower the risk of hypertensive disorders in pregnant women. AIM The aim of this study was to assess the effects of timing and duration of folic acid-containing supplement use on the risk for gestational hypertension and preeclampsia. METHODS Exposures and outcomes data were obtained through interviews and review of participant's medical records from the MotherToBaby cohort studies across the United States and Canada. Demographics, medical history, lifestyle factors, substance use, and fetal sex were assessed as potential confounders. Unadjusted and adjusted risks for gestational hypertension and preeclampsia were examined using odds ratios and 95% confidence intervals. FINDINGS 3247 women were included in the study. Compared to non-supplement use, early and late supplement use were not significantly associated with the development of gestational hypertension or preeclampsia. The odds of developing gestational hypertension and preeclampsia were significantly reduced as the duration of folic acid-containing supplement use increased. CONCLUSION Findings from this study suggest that the use of folic acid-containing supplements may mitigate the risk for gestational hypertension and preeclampsia.
Collapse
Affiliation(s)
- Maria P G De Ocampo
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA; Division of Epidemiology and Biostatistics, San Diego State University, San Diego, CA, USA.
| | - Maria Rosario G Araneta
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
| | - Caroline A Macera
- Division of Epidemiology and Biostatistics, San Diego State University, San Diego, CA, USA
| | - John E Alcaraz
- Division of Epidemiology and Biostatistics, San Diego State University, San Diego, CA, USA
| | - Thomas R Moore
- Department of Reproductive Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Christina D Chambers
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
| |
Collapse
|
41
|
Benaim C, Freitas-Vilela AA, Pinto TDJP, Lepsch J, Farias DR, Dos Santos Vaz J, El-Bacha T, Kac G. Early pregnancy body mass index modifies the association of pre-pregnancy dietary patterns with serum polyunsaturated fatty acid concentrations throughout pregnancy in Brazilian women. MATERNAL AND CHILD NUTRITION 2017. [PMID: 28635163 DOI: 10.1111/mcn.12480] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Dietary patterns (DPs) have been described as an important factor that may influence polyunsaturated fatty acid (PUFA) concentrations and body mass index (BMI) during pregnancy. We aim to evaluate the association between pre-pregnancy DPs and serum PUFA percentages throughout pregnancy considering early pregnancy BMI as a possible effect modifier. A prospective cohort of 154 pregnant women was followed (5th-13th, 20th-26th, and 30th-36th gestational weeks). Serum PUFA concentrations (total n-3 and total n-6, eicosapentaenoic + docosahexaenoic acids) were measured in each trimester and expressed as percentages. The n-6/n-3 ratio was calculated. Longitudinal linear mixed-effects models including interaction terms between DPs and early pregnancy BMI were employed. Serum PUFA percentages declined, whereas the n-6/n-3 ratio, monounsaturated, and saturated percentages increased throughout pregnancy for all BMI categories. Three pre-pregnancy DPs were identified by principal component analysis (common Brazilian, healthy, and processed). Overweight women with higher adherence to the common-Brazilian and to the healthy DPs presented reduced n-3 PUFA percentage and increased n-6 percentages and n-6/n-3 ratio compared to under or normal weight women. Obese women with higher adherence to the processed DP presented a more pronounced decrease of total n-3 percentage compared to under or normal weight women. Early pregnancy BMI modified the effect of pre-pregnancy DPs on PUFA profile throughout gestation. Higher adherence to the healthy pattern was associated with increased n-3 percentage, except for overweight women. Only for processed DP was the behaviour of PUFA the same for all BMI categories, showing a worse evolution profile, that is, increased n-6 and reduced n-3 fractions.
Collapse
Affiliation(s)
- Camila Benaim
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil.,Post-Graduate Program in Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - Ana Amélia Freitas-Vilela
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | | | - Jaqueline Lepsch
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil.,Post-Graduate Program in Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - Dayana Rodrigues Farias
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil.,Post-Graduate Program in Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | | | - Tatiana El-Bacha
- Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - Gilberto Kac
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| |
Collapse
|
42
|
Aghajafari F, Field CJ, Kaplan BJ, Rabi DM, Maggiore JA, O’Beirne M, Hanley DA, Eliasziw M, Dewey D, Weinberg A, Ross SJ. The Current Recommended Vitamin D Intake Guideline for Diet and Supplements During Pregnancy Is Not Adequate to Achieve Vitamin D Sufficiency for Most Pregnant Women. PLoS One 2016; 11:e0157262. [PMID: 27367800 PMCID: PMC4930210 DOI: 10.1371/journal.pone.0157262] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 05/26/2016] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The aims of this study were to determine if pregnant women consumed the recommended vitamin D through diet alone or through diet and supplements, and if they achieved the current reference range vitamin D status when their reported dietary intake met the current recommendations. METHODS Data and banked blood samples collected in second trimester from a subset of 537 women in the APrON (Alberta Pregnant Outcomes and Nutrition) study cohort were examined. Frozen collected plasma were assayed using LC-MS/MS (liquid chromatography-tandem mass spectrometry) to determine 25(OH)D2, 25(OH)D3, 3-epi-25(OH)D3 concentrations. Dietary data were obtained from questionnaires including a Supplement Intake Questionnaire and a 24-hour recall of the previous day's diet. RESULTS Participants were 87% Caucasian; mean (SD) age of 31.3 (4.3); BMI 25.8 (4.7); 58% were primiparous; 90% had education beyond high school; 80% had a family income higher than CAN $70,000/year. 25(OH)D2, 25(OH)D3, and 3-epi-25(OH)D3) were identified in all of the 537 plasma samples;3-epi-25(OH)D3 contributed 5% of the total vitamin D. The median (IQR) total 25(OH)D (D2+D3) was 92.7 (30.4) nmol/L and 20% of women had 25(OH)D concentration < 75 nmol/L. The median (IQR) reported vitamin D intake from diet and supplements was 600 (472) IU/day. There was a significant relationship between maternal reported dietary vitamin D intake (diet and supplement) and 25(OH)D and 3-epi-25(OH)D3 concentrations in an adjusted linear regression model. CONCLUSIONS We demonstrated the current RDA (600 IU/ day) may not be adequate to achieve vitamin D status >75 nmol/L in some pregnant women who are residing in higher latitudes (Calgary, 51°N) in Alberta, Canada and the current vitamin D recommendations for Canadian pregnant women need to be re-evaluated.
Collapse
Affiliation(s)
- Fariba Aghajafari
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Catherine J. Field
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Bonnie J. Kaplan
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Doreen M. Rabi
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jack A. Maggiore
- Research and Development, Doctor’s Data, Inc., St. Charles, Illinois, United States of America
| | - Maeve O’Beirne
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - David A. Hanley
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Misha Eliasziw
- Department of Public Health and Community Medicine, Tufts University, Boston, Massachusetts, United States of America
| | - Deborah Dewey
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Amy Weinberg
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Sue J. Ross
- Department of Obstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada
| | | |
Collapse
|
43
|
Budzynska K, Filippelli AC, Sadikova E, Low Dog T, Gardiner P. Use and Factors Associated With Herbal/Botanical and Nonvitamin/Nonmineral Dietary Supplements Among Women of Reproductive Age: An Analysis of the Infant Feeding Practices Study II. J Midwifery Womens Health 2016; 61:419-26. [PMID: 27336953 DOI: 10.1111/jmwh.12482] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Little is known about the changes in prevalence of dietary supplement use in pregnancy, postpartum, and in a comparison group of nonpregnant women. METHODS We conducted a secondary analysis of the Infant Feeding Practices II study. The purpose of this study is to report the prevalence of herbal or botanical and nonvitamin, nonmineral dietary supplement use by US women with respect to demographic, behavioral, and health factors. We compared pregnant and postpartum women to a comparison group of nonpregnant women who had not given birth in the past 12 months. Our main outcome was the prevalence of dietary supplements. Multiple logistic regression models were used to examine factors associated with herbal or botanical and nonvitamin, nonmineral dietary supplement use during reproductive age, pregnancy, and postpartum. RESULTS The total sample included 1444 women assessed during the prenatal period, 1422 from the postpartum period, and 1517 women in a comparison group. In terms of herb or botanical use, 15% of the prenatal group, 16% of the postpartum group, and 22% of the comparison group reported using herbs or botanicals. The most frequently used nonvitamin, nonmineral supplement was omega-3 fatty acid. Among the total prenatal group and comparison group, women eating 5 or more servings of fruits or vegetables were less likely to report using herbs or botanicals. Women in the comparison group self-identifying as black were 4 times as likely to report using herbs or botanicals compared to participants self-identifying as white. In addition, women identifying as a race other than white were almost twice as likely to report herb or botanical use across all study groups. DISCUSSION This is one of the rare studies that shows the changing prevalence of herbs or botanicals and nonvitamin, nonmineral dietary supplement use in women in the reproductive stage of their lives.
Collapse
|
44
|
Hua X, Zhang J, Guo Y, Shen M, Gaudet L, Janoudi G, Walker M, Wen SW. Effect of folic acid supplementation during pregnancy on gestational hypertension/preeclampsia: A systematic review and meta-analysis. Hypertens Pregnancy 2016; 35:447-460. [PMID: 27315401 DOI: 10.1080/10641955.2016.1183673] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To evaluate the effect of folic acid supplementation during pregnancy on the risk of gestational hypertension/preeclampsia. METHODS A systematic review and meta-analysis were conducted. Medline, Embase, Scopus, and the Web of Science were searched from inception to December 2014. RESULTS Out of 1224 potentially relevant studies, 13 studies met our inclusion criteria (2 randomized controlled trials (RCTs), 10 cohort studies, and 1 case-control study). The pooled relative risk (RR) and 95% confidence interval (CI) of the two RCTs were 0.62 (0.45-0.87) in the trial arm as compared with the placebo arm. The pooled RR was 0.92 (95% CI: 0.79-1.08) for nine cohort studies with available data on folic acid supplementation in pregnancy and gestational hypertension/preeclampsia. Pooled RR was 0.88 (95% CI: 0.76-1.02) for eight cohort studies with available data on folic acid supplementation and preeclampsia. CONCLUSION Whether folic acid supplementation in pregnancy can prevent the occurrence of gestational hypertension/preeclampsia remains uncertain.
Collapse
Affiliation(s)
- Xiaolin Hua
- a Department of Obstetrics , Xinhua Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , China.,b Department of Obstetrics and Gynecology, Faculty of Medicine , OMNI Research Group, University of Ottawa , Ottawa , Ontario , Canada.,c Clinical Epidemiology Program , Ottawa Hospital Research Institute , Ottawa , Ontario , Canada
| | - Jiewen Zhang
- b Department of Obstetrics and Gynecology, Faculty of Medicine , OMNI Research Group, University of Ottawa , Ottawa , Ontario , Canada.,c Clinical Epidemiology Program , Ottawa Hospital Research Institute , Ottawa , Ontario , Canada.,d Department of Obstetrics and Gynecology , Beijing Friendship Hospital, Capital Medical University , Beijing , China
| | - Yanfang Guo
- b Department of Obstetrics and Gynecology, Faculty of Medicine , OMNI Research Group, University of Ottawa , Ottawa , Ontario , Canada.,c Clinical Epidemiology Program , Ottawa Hospital Research Institute , Ottawa , Ontario , Canada
| | - Minxue Shen
- b Department of Obstetrics and Gynecology, Faculty of Medicine , OMNI Research Group, University of Ottawa , Ottawa , Ontario , Canada.,c Clinical Epidemiology Program , Ottawa Hospital Research Institute , Ottawa , Ontario , Canada.,e School of Public Health , Central South University , Changsha , China
| | - Laura Gaudet
- b Department of Obstetrics and Gynecology, Faculty of Medicine , OMNI Research Group, University of Ottawa , Ottawa , Ontario , Canada.,c Clinical Epidemiology Program , Ottawa Hospital Research Institute , Ottawa , Ontario , Canada
| | - Ghayath Janoudi
- f Canadian Agency for Drugs and Technologies in Health , Ottawa , Ontario , Canada
| | - Mark Walker
- b Department of Obstetrics and Gynecology, Faculty of Medicine , OMNI Research Group, University of Ottawa , Ottawa , Ontario , Canada.,c Clinical Epidemiology Program , Ottawa Hospital Research Institute , Ottawa , Ontario , Canada.,g School of Epidemiology, Public Health, and Preventive Medicine , University of Ottawa Faculty of Medicine , Ottawa , Ontario , Canada
| | - Shi Wu Wen
- b Department of Obstetrics and Gynecology, Faculty of Medicine , OMNI Research Group, University of Ottawa , Ottawa , Ontario , Canada.,c Clinical Epidemiology Program , Ottawa Hospital Research Institute , Ottawa , Ontario , Canada.,e School of Public Health , Central South University , Changsha , China.,g School of Epidemiology, Public Health, and Preventive Medicine , University of Ottawa Faculty of Medicine , Ottawa , Ontario , Canada
| |
Collapse
|
45
|
Gaillard R, Rifas-Shiman SL, Perng W, Oken E, Gillman MW. Maternal inflammation during pregnancy and childhood adiposity. Obesity (Silver Spring) 2016; 24:1320-7. [PMID: 27094573 PMCID: PMC4918508 DOI: 10.1002/oby.21484] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 01/16/2016] [Accepted: 01/20/2016] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Maternal pre-pregnancy obesity is associated with offspring obesity. Underlying mechanisms may involve a maternal obesity-mediated proinflammatory state during pregnancy. Maternal C-reactive protein (CRP) level during pregnancy is a biomarker of low-grade systemic inflammation. METHODS Among 1,116 mother-child pairs, this study examined associations of maternal second-trimester CRP plasma level, measured by high-sensitivity CRP arrays, with mid-childhood DXA fat mass index (FMI), trunk fat mass index (trunkFMI), fat-free mass index (FFMI), and early and mid-childhood BMI-z and waist circumference (WC). Main analyses were adjusted for maternal sociodemographic and lifestyle-related characteristics, gestational age at blood draw, and child's age and sex. RESULTS Higher maternal CRP level was associated with higher mid-childhood FMI and trunkFMI (adjusted difference: 0.15 kg/m(2) [95% CI: 0.01, 0.29] [P = 0.04] and 0.06 kg/m(2) [95% CI: 0.00, 0.12] [P = 0.06], per SD increment in maternal CRP, respectively), but not FFMI. Higher maternal CRP level was associated with higher early and mid-childhood BMI-z and WC in the basic models [P < 0.05], but these associations attenuated after adjustment for maternal characteristics (adjusted difference in early and mid-childhood BMI-z and WC: 0.05 [95% CI: -0.03, 0.13] [P = 0.20], 0.10 cm [95% CI: -0.17, 0.37] [P = 0.46], 0.07 [95% CI: -0.01, 0.14] [P = 0.09], 0.34 cm [95% CI: -0.25, 0.94] [P = 0.26], per SD increment in maternal CRP, respectively). CONCLUSIONS Higher second-trimester maternal CRP level was associated with higher mid-childhood overall and central adiposity.
Collapse
Affiliation(s)
- Romy Gaillard
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Sheryl L. Rifas-Shiman
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Wei Perng
- Department of Nutritional Sciences, Department of Epidemiology, University of Michigan , School of Public Health, Ann Arbor, MI
| | - Emily Oken
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Matthew W. Gillman
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| |
Collapse
|
46
|
Diet quality before or during pregnancy and the relationship with pregnancy and birth outcomes: the Australian Longitudinal Study on Women's Health. Public Health Nutr 2016; 19:2975-2983. [PMID: 27238757 DOI: 10.1017/s1368980016001245] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To assess whether diet quality before or during pregnancy predicts adverse pregnancy and birth outcomes in a sample of Australian women. DESIGN The Dietary Questionnaire for Epidemiological Studies was used to calculate diet quality using the Australian Recommended Food Score (ARFS) methodology modified for pregnancy. SETTING A population-based cohort participating in the Australian Longitudinal Study on Women's Health (ALSWH). SUBJECTS A national sample of Australian women, aged 20-25 and 31-36 years, who were classified as preconception or pregnant when completing Survey 3 or Survey 5 of the ALSWH, respectively. The 1907 women with biologically plausible energy intake estimates were included in regression analyses of associations between preconception and pregnancy ARFS and subsequent pregnancy outcomes. RESULTS Preconception and pregnancy groups were combined as no significant differences were detected for total and component ARFS. Women with gestational hypertension, compared with those without, had lower scores for total ARFS, vegetable, fruit, grain and nuts/bean/soya components. Women with gestational diabetes had a higher score for the vegetable component only, and women who had a low-birth-weight infant had lower scores for total ARFS and the grain component, compared with those who did not report these outcomes. Women with the highest ARFS had the lowest odds of developing gestational hypertension (OR=0·4; 95 % CI 0·2, 0·7) or delivering a child of low birth weight (OR=0·4; 95 % CI 0·2, 0·9), which remained significant for gestational hypertension after adjustment for potential confounders. CONCLUSIONS A high-quality diet before and during pregnancy may reduce the risk of gestational hypertension for the mother.
Collapse
|
47
|
Bartsch E, Medcalf KE, Park AL, Ray JG. Clinical risk factors for pre-eclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies. BMJ 2016; 353:i1753. [PMID: 27094586 PMCID: PMC4837230 DOI: 10.1136/bmj.i1753] [Citation(s) in RCA: 512] [Impact Index Per Article: 64.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To develop a practical evidence based list of clinical risk factors that can be assessed by a clinician at ≤ 16 weeks' gestation to estimate a woman's risk of pre-eclampsia. DESIGN Systematic review and meta-analysis of cohort studies. DATA SOURCES PubMed and Embase databases, 2000-15. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Cohort studies with ≥ 1000 participants that evaluated the risk of pre-eclampsia in relation to a common and generally accepted clinical risk factor assessed at ≤ 16 weeks' gestation. DATA EXTRACTION Two independent reviewers extracted data from included studies. A pooled event rate and pooled relative risk for pre-eclampsia were calculated for each of 14 risk factors. RESULTS There were 25,356,688 pregnancies among 92 studies. The pooled relative risk for each risk factor significantly exceeded 1.0, except for prior intrauterine growth restriction. Women with antiphospholipid antibody syndrome had the highest pooled rate of pre-eclampsia (17.3%, 95% confidence interval 6.8% to 31.4%). Those with prior pre-eclampsia had the greatest pooled relative risk (8.4, 7.1 to 9.9). Chronic hypertension ranked second, both in terms of its pooled rate (16.0%, 12.6% to 19.7%) and pooled relative risk (5.1, 4.0 to 6.5) of pre-eclampsia. Pregestational diabetes (pooled rate 11.0%, 8.4% to 13.8%; pooled relative risk 3.7, 3.1 to 4.3), prepregnancy body mass index (BMI) >30 (7.1%, 6.1% to 8.2%; 2.8, 2.6 to 3.1), and use of assisted reproductive technology (6.2%, 4.7% to 7.9%; 1.8, 1.6 to 2.1) were other prominent risk factors. CONCLUSIONS There are several practical clinical risk factors that, either alone or in combination, might identify women in early pregnancy who are at "high risk" of pre-eclampsia. These data can inform the generation of a clinical prediction model for pre-eclampsia and the use of aspirin prophylaxis in pregnancy.
Collapse
Affiliation(s)
| | | | - Alison L Park
- Institute for Clinical Evaluative Sciences, Toronto, Canada
| | - Joel G Ray
- Departments of Medicine, Health Policy Management and Evaluation, and Obstetrics and Gynecology, St Michael's Hospital, University of Toronto, Toronto, Canada
| |
Collapse
|
48
|
Mezouar D, Merzouk H, Merzouk AS, Merzouk SA, Belarbi B, Narce M. In vitro effects of vitamins C and E, n-3 and n-6 PUFA and n-9 MUFA on placental cell function and redox status in type 1 diabetic pregnant women. Placenta 2016; 42:114-21. [PMID: 27238721 DOI: 10.1016/j.placenta.2016.04.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 03/22/2016] [Accepted: 04/14/2016] [Indexed: 10/21/2022]
Abstract
The aim of this investigation was to determine the in vitro effects of vitamin C and E, n-3 and n-6 PUFA and n-9 MUFA on placental cell proliferation and function in type 1 diabetes. Placenta tissues were collected from 30 control healthy and 30 type 1 diabetic women at delivery. Placental cells were isolated and were cultured in RPMI medium supplemented with vitamin C (50 μM), vitamin E (50 μM), n-3 PUFA (100 μM), n-6 PUFA (100 μM) or n-9 MUFA (100 μM). Cell proliferation, cell glucose uptake and intracellular oxidative status were investigated. Our results showed that basal placental cell proliferation, glucose uptake, malondialdehyde (MDA) and carbonyl proteins were higher while intracellular reduced glutathione (GSH) levels and catalase activities were lower in placentas from diabetic women as compared to controls. Vitamins C and E induced a modulation of placental cell proliferation and glucose consumption without affecting intracellular redox status in both diabetic and control groups. N-3 and n-6 PUFA diminished placental cell proliferation and enhanced intracellular oxidative stress while n-9 MUFA had no effects in the two groups. Co-administration of n-3 or n-6 PUFA and vitamin C or E were capable of reversing back the PUFA-decreased cell proliferation and normalizing placental cell function and redox status especially in diabetes. In conclusion, PUFA and antioxidant vitamin combinations may be beneficial in improving placenta function and in reducing placental oxidative stress in type 1 diabetic pregnancy.
Collapse
Affiliation(s)
- Djamila Mezouar
- Laboratory of Physiology, Physiopathology and Biochemistry of Nutrition, Department of Biology, Faculty of Natural and Life Sciences, Earth and Universe, University Abou-Bekr Belkaïd, Tlemcen 13000, Algeria
| | - Hafida Merzouk
- Laboratory of Physiology, Physiopathology and Biochemistry of Nutrition, Department of Biology, Faculty of Natural and Life Sciences, Earth and Universe, University Abou-Bekr Belkaïd, Tlemcen 13000, Algeria.
| | - Amel Saidi Merzouk
- Laboratory of Physiology, Physiopathology and Biochemistry of Nutrition, Department of Biology, Faculty of Natural and Life Sciences, Earth and Universe, University Abou-Bekr Belkaïd, Tlemcen 13000, Algeria
| | - Sid Ahmed Merzouk
- Department of Technical Sciences, Faculty of Engineering, University Abou-Bekr Belkaïd, Tlemcen 13000, Algeria
| | - Boumediene Belarbi
- Gynecology and Obstetrics Department, Mother and Infant Hospital Center, University Abou-Bekr Belkaïd, Tlemcen 13000, Algeria
| | - Michel Narce
- INSERM UMR866, "Lipids Nutrition Cancer," Faculty of Life, Earth and Environment Sciences, University of Burgundy, Dijon 21000, France
| |
Collapse
|
49
|
Le Donne M, Alibrandi A, Vita R, Zanghì D, Triolo O, Benvenga S. Does eating oily fish improve gestational and neonatal outcomes? Findings from a Sicilian study. Women Birth 2016; 29:e50-7. [PMID: 26837604 DOI: 10.1016/j.wombi.2015.12.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 12/29/2015] [Accepted: 12/29/2015] [Indexed: 01/14/2023]
Abstract
BACKGROUND Fish is a source of long-chain polyunsaturated n-3 fatty acids, but it may also contain a number of pollutants. METHODS Between April and July 2013, we selected 114 women who gave birth to living babies, and divided them according to type and frequency of the fish consumed. We evaluated both gestational and neonatal outcomes. Docosahexaenoic acid (DHA) supplementation was taken into account. FINDINGS One hundred and four women (91.2%) consumed fish on the average of 4.7 times/month, while 10 (8.8%) did not consume fish at all. Fifty-nine women (51.8%) were taking supplements containing DHA (200mg/day), almost all of whom (n=55) consumed fish. Pregnancy induced hypertension was more frequent in non-fish eaters than in fish eaters (20% vs 4.8%, P=0.056). Consumption of small size oily fish correlated positively with both neonatal weight (r=0.195, P=0.037) and head circumference (r=0.211, P=0.024). In contrast, consumption of lean fish or shellfish correlated negatively with neonatal head circumference (r=0.206, P=0.028, or r=0.192, P=0.041). DISCUSSION These data agree with previous observational studies and reinforce the protective role of small oily fish consumption on preterm birth risk, neonatal weight, length and head circumference. CONCLUSION Small oily fish consumption should be favored over other types of fish.
Collapse
Affiliation(s)
- Maria Le Donne
- Department of Pediatrics, Gynecology, Microbiology and Biomedical Sciences, University of Messina School of Medicine, Messina 98125, Italy.
| | | | - Roberto Vita
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Delia Zanghì
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Onofrio Triolo
- Department of Pediatrics, Gynecology, Microbiology and Biomedical Sciences, University of Messina School of Medicine, Messina 98125, Italy
| | - Salvatore Benvenga
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy; Master Program on Childhood, Adolescent and Women's Endocrine Health, University of Messina School of Medicine, Messina, Italy; Interdepartmental Program of Clinical and Molecular Endocrinology & Women's Endocrine Health, University Hospital Policlinico G. Martino, Messina 98125, Italy
| |
Collapse
|
50
|
Kemse NG, Kale AA, Joshi SR. Supplementation of maternal omega-3 fatty acids to pregnancy induced hypertension Wistar rats improves IL10 and VEGF levels. Prostaglandins Leukot Essent Fatty Acids 2016; 104:25-32. [PMID: 26802939 DOI: 10.1016/j.plefa.2015.11.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 11/09/2015] [Accepted: 11/27/2015] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Our recent study demonstrates the beneficial effect of a combined supplementation of vitamin B12, folic acid, and docosahexaenoic acid in reducing the severity of pregnancy induced hypertension (PIH). It is also known to be associated with angiogenic imbalance and inflammation. The current study examines whether the individual/combined supplementation of folic acid, vitamin B12 and omega-3 fatty acid during pregnancy can ameliorate the inflammatory markers and restore the angiogenic balance in a rat model of PIH. MATERIALS AND METHODS There were total of six groups, control and five treatment groups: PIH Induced; PIH+vitamin B12; PIH+folic acid; PIH+Omega-3 fatty acids and PIH+combined micronutrient supplementation (vitamin B12+folic acid+omega-3 fatty acids). Hypertension during pregnancy was induced using L- Nitroarginine methylester (L-NAME; 50mg/kg body weight/day). Dams were dissected at d20 of gestation and placental tissues were collected for further analysis. RESULTS Animals from the PIH induced group demonstrated lower (p<0.01 for both) IL-10 and VEGF levels as compared to control. However, PIH induction did not alter the protein levels of eNOS, IL-6, Flt and mRNA levels of VEGF and VEGFR-1/ Flt-1. Individual micronutrient supplementation of vitamin B12 and folate did not offer benefit. In contrast individual omega-3 fatty acid as well as combined micronutrient supplementation showed IL-10 and VEGF levels comparable to that of control. CONCLUSION Omega 3 fatty acid supplementation plays a key role in reducing inflammation in pregnancy induced hypertension.
Collapse
Affiliation(s)
- Nisha G Kemse
- Department of Nutritional Medicine, Interactive Research School for Health Affairs, Bharati, Vidyapeeth Deemed University, Pune Satara Road, Pune 411043, India
| | - Anvita A Kale
- Department of Nutritional Medicine, Interactive Research School for Health Affairs, Bharati, Vidyapeeth Deemed University, Pune Satara Road, Pune 411043, India
| | - Sadhana R Joshi
- Department of Nutritional Medicine, Interactive Research School for Health Affairs, Bharati, Vidyapeeth Deemed University, Pune Satara Road, Pune 411043, India.
| |
Collapse
|