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Gaddy JA, Moore RE, Lochner JS, Rogers LM, Noble KN, Giri A, Aronoff DM, Cliffel D, Eastman AJ. Palmitate and group B Streptococcus synergistically and differentially induce IL-1β from human gestational membranes. Front Immunol 2024; 15:1409378. [PMID: 38855112 PMCID: PMC11158625 DOI: 10.3389/fimmu.2024.1409378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 05/10/2024] [Indexed: 06/11/2024] Open
Abstract
Introduction Rupture of the gestational membranes often precedes major pregnancy complications, including preterm labor and preterm birth. One major cause of inflammation in the gestational membranes, chorioamnionitis (CAM) is often a result of bacterial infection. The commensal bacterium Streptococcus agalactiae, or Group B Streptococcus (GBS) is a leading infectious cause of CAM. Obesity is on the rise worldwide and roughly 1 in 4 pregnancy complications is related to obesity, and individuals with obesity are also more likely to be colonized by GBS. The gestational membranes are comprised of several distinct cell layers which are, from outermost to innermost: maternally-derived decidual stromal cells (DSCs), fetal cytotrophoblasts (CTBs), fetal mesenchymal cells, and fetal amnion epithelial cells (AECs). In addition, the gestational membranes have several immune cell populations; macrophages are the most common phagocyte. Here we characterize the effects of palmitate, the most common long-chain saturated fatty acid, on the inflammatory response of each layer of the gestational membranes when infected with GBS, using human cell lines and primary human tissue. Results Palmitate itself slightly but significantly augments GBS proliferation. Palmitate and GBS co-stimulation synergized to induce many inflammatory proteins and cytokines, particularly IL-1β and matrix metalloproteinase 9 from DSCs, CTBs, and macrophages, but not from AECs. Many of these findings are recapitulated when treating cells with palmitate and a TLR2 or TLR4 agonist, suggesting broad applicability of palmitate-pathogen synergy. Co-culture of macrophages with DSCs or CTBs, upon co-stimulation with GBS and palmitate, resulted in increased inflammatory responses, contrary to previous work in the absence of palmitate. In whole gestational membrane biopsies, the amnion layer appeared to dampen immune responses from the DSC and CTB layers (the choriodecidua) to GBS and palmitate co-stimulation. Addition of the monounsaturated fatty acid oleate, the most abundant monounsaturated fatty acid in circulation, dampened the proinflammatory effect of palmitate. Discussion These studies reveal a complex interplay between the immunological response of the distinct layers of the gestational membrane to GBS infection and that such responses can be altered by exposure to long-chain saturated fatty acids. These data provide insight into how metabolic syndromes such as obesity might contribute to an increased risk for GBS disease during pregnancy.
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Affiliation(s)
- Jennifer A. Gaddy
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
- Tennessee Valley Healthcare Systems, Department of Veterans Affairs, Nashville, TN, United States
| | - Rebecca E. Moore
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
- Publications Division, American Chemical Society, Washington, DC, United States
| | - Jonathan S. Lochner
- Department of Microbiology, Immunology and Tropical Medicine, George Washington University, Washington, DC, United States
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Lisa M. Rogers
- Department Internal Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Kristen N. Noble
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Ayush Giri
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
- Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - David M. Aronoff
- Department Internal Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
| | - David Cliffel
- Department of Chemistry, Vanderbilt University, Nashville, TN, United States
| | - Alison J. Eastman
- Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN, United States
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Powell TL, Uhlson C, Madi L, Berry KZ, Chassen SS, Jansson T, Ferchaud-Roucher V. Fetal sex differences in placental LCPUFA ether and plasmalogen phosphatidylethanolamine and phosphatidylcholine contents in pregnancies complicated by obesity. Biol Sex Differ 2023; 14:66. [PMID: 37770949 PMCID: PMC10540428 DOI: 10.1186/s13293-023-00548-1] [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: 05/15/2023] [Accepted: 09/13/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND We have previously reported that maternal obesity reduces placental transport capacity for lysophosphatidylcholine-docosahexaenoic acid (LPC-DHA), a preferred form for transfer of DHA (omega 3) to the fetal brain, but only in male fetuses. Phosphatidylethanolamine (PE) and phosphatidylcholine (PC), have either sn-1 ester, ether or vinyl ether (plasmalogen) linkages to primarily unsaturated and monounsaturated fatty acids and DHA or arachidonic acid (ARA, omega 6) in the sn-2 position. Whether ether and plasmalogen PC and PE metabolism in placenta impacts transfer to the fetus is unexplored. We hypothesized that ether and plasmalogen PC and PE containing DHA and ARA are reduced in maternal-fetal unit in pregnancies complicated by obesity and these differences are dependent on fetal sex. METHODS In maternal, umbilical cord plasma and placentas from obese women (11 female/5 male infants) and normal weight women (9 female/7 male infants), all PC and PE species containing DHA and ARA were analyzed by LC-MS/MS. Placental protein expression of enzymes involved in phospholipid synthesis, were determined by immunoblotting. All variables were compared between control vs obese groups and separated by fetal sex, in each sample using the Benjamini-Hochberg false discovery rate adjustment to account for multiple testing. RESULTS Levels of ester PC containing DHA and ARA were profoundly reduced by 60-92% in male placentas of obese mothers, while levels of ether and plasmalogen PE containing DHA and ARA were decreased by 51-84% in female placentas. PLA2G4C abundance was lower in male placentas and LPCAT4 abundance was lower solely in females in obesity. In umbilical cord, levels of ester, ether and plasmalogen PC and PE with DHA were reduced by 43-61% in male, but not female, fetuses of obese mothers. CONCLUSIONS We found a fetal sex effect in placental PE and PC ester, ether and plasmalogen PE and PC containing DHA in response to maternal obesity which appears to reflect an ability of female placentas to adapt to maintain optimal fetal DHA transfer in maternal obesity.
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Affiliation(s)
- Theresa L Powell
- Department of Obstetrics and Gynecology, Division of Reproductive Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Department of Pediatrics, Section of Neonatology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Charis Uhlson
- Department of Pediatrics, Section of Neonatology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Lana Madi
- Department of Obstetrics and Gynecology, Division of Reproductive Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Karin Zemski Berry
- Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Stephanie S Chassen
- Department of Pediatrics, Section of Neonatology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Thomas Jansson
- Department of Obstetrics and Gynecology, Division of Reproductive Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Veronique Ferchaud-Roucher
- Nantes Université, CHU Nantes, INRAE UMR 1280 PhAN, CRNH Ouest, 44000, Nantes, France.
- Nantes Université, INRAE, UMR 1280 PhAN, CHU Hôtel Dieu, HNB1, 1 place Alexis Ricordeau, 44093, Nantes, France.
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St-Laurent A, Plante AS, Lemieux S, Robitaille J, MacFarlane AJ, Morisset AS. Higher Than Recommended Folic Acid Intakes is Associated with High Folate Status Throughout Pregnancy in a Prospective French-Canadian Cohort. J Nutr 2023; 153:1347-1358. [PMID: 36848988 DOI: 10.1016/j.tjnut.2023.02.027] [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: 11/07/2022] [Revised: 02/16/2023] [Accepted: 02/22/2023] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND Folate and vitamin B12 status during pregnancy are important for maternal and neonatal health. Maternal intake and prepregnancy body mass index (ppBMI) can influence biomarker status. OBJECTIVES This study aimed to, throughout pregnancy; 1) assess folate and B12 status including serum total folate, plasma total vitamin B12, and homocysteine (tHcy); 2) examine how these biomarkers are associated with intakes of folate and B12 and with ppBMI; and 3) determine predictors of serum total folate and plasma total vitamin B12. METHODS In each trimester (T1, T2, and T3), food and supplement intakes of 79 French-Canadian pregnant individuals were assessed by 3 dietary recalls (R24W) and a supplement use questionnaire. Fasting blood samples were collected. Serum total folate and plasma total vitamin B12 and tHcy were assessed by immunoassay (Siemens ADVIA Centaur XP). RESULTS Participants were 32.1 ± 3.7 y and had a mean ppBMI of 25.7 ± 5.8 kg/m2. Serum total folate concentrations were high (>45.3 nmol/L, T1: 75.4 ± 55.1, T2: 69.1 ± 44.8, T3: 72.1 ± 52.1, P = 0.48). Mean plasma total vitamin B12 concentrations were >220 pmol/L (T1: 428 ± 175, T2: 321 ± 116, T3: 336 ± 128, P < 0.0001). Mean tHcy concentrations were <11 μmol/L across trimesters. Most participants (79.6%-86.1%) had a total folic acid intake above the Tolerable Upper Intake Level (UL, >1000 μg/d). Supplement use accounted for 71.9%-76.1% and 35.3%-41.8% of total folic acid and vitamin B12 intakes, respectively. The ppBMI was not correlated with serum total folate (P > 0.1) but was weakly correlated with and predicted lower plasma total vitamin B12 in T3 (r = -0.23, P = 0.04; r2 = 0.08, standardized beta [sβ] = -0.24, P = 0.01). Higher folic acid intakes from supplements predicted higher serum total folate (T1: r2 = 0.05, sβ = 0.15, P = 0.04, T2: r2 = 0.28, sβ = 0.56, P = 0.01, T3: r2 = 0.19, sβ = 0.44, P < 0.0001). CONCLUSIONS Most pregnant individuals had elevated serum total folate concentrations, reflecting total folic acid intakes above the UL driven by supplement use. Vitamin B12 concentrations were generally adequate and differed by ppBMI and pregnancy stage.
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Affiliation(s)
- Audrey St-Laurent
- School of Nutrition, Laval University, Quebec City, Canada; Endocrinology and Nephrology Unit, CHU of Quebec-Laval University Research Center, Quebec City, Canada; NUTRISS Research Center, Institute of Nutrition and Functional Foods, Laval University, Quebec City, Canada
| | - Anne-Sophie Plante
- School of Nutrition, Laval University, Quebec City, Canada; Endocrinology and Nephrology Unit, CHU of Quebec-Laval University Research Center, Quebec City, Canada
| | - Simone Lemieux
- School of Nutrition, Laval University, Quebec City, Canada; NUTRISS Research Center, Institute of Nutrition and Functional Foods, Laval University, Quebec City, Canada
| | - Julie Robitaille
- School of Nutrition, Laval University, Quebec City, Canada; Endocrinology and Nephrology Unit, CHU of Quebec-Laval University Research Center, Quebec City, Canada; NUTRISS Research Center, Institute of Nutrition and Functional Foods, Laval University, Quebec City, Canada
| | - Amanda J MacFarlane
- Nutrition Research Division, Health Canada, Ottawa, Ontario, Canada; Agriculture, Food, and Nutrition Evidence Center, Texas A&M University, Fort Worth, Texas, USA
| | - Anne-Sophie Morisset
- School of Nutrition, Laval University, Quebec City, Canada; Endocrinology and Nephrology Unit, CHU of Quebec-Laval University Research Center, Quebec City, Canada; NUTRISS Research Center, Institute of Nutrition and Functional Foods, Laval University, Quebec City, Canada.
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Fayezi S, Mehdizadeh A, Germeyer A, Strowitzki T, Fayyazpour P, Nowrouzi Z, Zarezadeh R. Maternal erythrocyte fatty acid composition as a predictive marker for pregnancy health. Biofactors 2022; 48:763-778. [PMID: 35357720 DOI: 10.1002/biof.1840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/14/2022] [Indexed: 12/11/2022]
Abstract
Pregnancy is accompanied by a surge in demand for fatty acids (FAs) in order to support maternal health, as well as fetal growth and development. Of particular demand is essential for long-chain polyunsaturated FAs. FAs are primarily obtained from dietary sources and are distributed in the body. In comparison with the use of self-reporting approaches, measuring the FA levels within different blood compartments can present a more accurate image of nutritional, and thus tissue, FA composition. Hence, the FA profile of plasma or serum is commonly used for physiological analyses. Nevertheless, plasma and serum FAs are not yet incorporated into cell membranes, and consequently may not be a suitable reflection of the FA status of body tissues. The evaluation of erythrocyte FA levels offers a superior possibility for the following reasons: the biological fluctuation of erythrocyte FA composition is low, phospholipids account for almost all the lipid content of erythrocytes, and the FA profiles of erythrocytes represent those of tissues. Here, we elaborate on whether the status of maternal erythrocyte FAs can serve as a prognostic biomarker for reproductive health and fetomaternal complications, including embryonic and fetoplacental development, gestational length, and preeclampsia. In addition, factors with the potential of altering the maternal erythrocyte FAs such as maternal diet, lifestyle habits, genetics, and body composition are discussed.
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Affiliation(s)
- Shabnam Fayezi
- Department of Gynecologic Endocrinology and Fertility Disorders, Women's Hospital, Ruprecht-Karls University of Heidelberg, Heidelberg, Germany
- Department of Reproductive Biology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Mehdizadeh
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ariane Germeyer
- Department of Gynecologic Endocrinology and Fertility Disorders, Women's Hospital, Ruprecht-Karls University of Heidelberg, Heidelberg, Germany
| | - Thomas Strowitzki
- Department of Gynecologic Endocrinology and Fertility Disorders, Women's Hospital, Ruprecht-Karls University of Heidelberg, Heidelberg, Germany
| | - Parisa Fayyazpour
- Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Student's Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Nowrouzi
- Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Student's Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Zarezadeh
- Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Student's Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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van Weelden W, Seed PT, Antoun E, Godfrey KM, Kitaba NT, Lillycrop KA, Dalrymple KV, Sobczyńska-Malefora A, Painter RC, Poston L, White SL, Flynn AC. Folate and vitamin B12 status: associations with maternal glucose and neonatal DNA methylation sites related to dysglycaemia, in pregnant women with obesity. J Dev Orig Health Dis 2022; 13:168-176. [PMID: 33972006 PMCID: PMC7612506 DOI: 10.1017/s2040174421000246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Recent studies implicate maternal gestational diabetes mellitus (GDM) in differential methylation of infant DNA. Folate and vitamin B12 play a role in DNA methylation, and these vitamins may also influence GDM risk. The aims of this study were to determine folate and vitamin B12 status in obese pregnant women and investigate associations between folate and vitamin B12 status, maternal dysglycaemia and neonatal DNA methylation at cytosine-phosphate-guanine sites previously observed to be associated with dysglycaemia. Obese pregnant women who participated in the UK Pregnancies Better Eating and Activity Trial were included. Serum folate and vitamin B12 were measured at the oral glucose tolerance test (OGTT) visit. Cord blood DNA methylation was assessed using the Infinium MethylationEPIC BeadChip. Regression models with adjustment for confounders were used to examine associations. Of the 951 women included, 356 (37.4%) were vitamin B12 deficient, and 44 (4.6%) were folate deficient. Two-hundred and seventy-one women (28%) developed GDM. Folate and vitamin B12 concentrations were not associated with neonatal DNA methylation. Higher folate was positively associated with 1-h plasma glucose after OGTT (β = 0.031, 95% CI 0.001-0.061, p = 0.045). There was no relationship between vitamin B12 and glucose concentrations post OGTT or between folate or vitamin B12 and GDM. In summary, we found no evidence to link folate and vitamin B12 status with the differential methylation of neonatal DNA previously observed in association with dysglycaemia. We add to the evidence that folate status may be related to maternal glucose homoeostasis although replication in other maternal cohorts is required for validation.
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Affiliation(s)
- Wenneke van Weelden
- Amsterdam University Medical Center – location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Paul T. Seed
- Department of Women and Children’s Health, School of Life Course Sciences, King’s College London
| | - Elie Antoun
- Human Development and Health, Faculty of Medicine, University of Southampton, UK
| | - Keith M. Godfrey
- Human Development and Health, Faculty of Medicine, University of Southampton, UK
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Negusse T. Kitaba
- Human Development and Health, Faculty of Medicine, University of Southampton, UK
| | - Karen A. Lillycrop
- Centre for Biological Sciences, Faculty of Natural and Environmental Sciences, University of Southampton, Southampton, UK
| | - Kathryn V. Dalrymple
- Department of Women and Children’s Health, School of Life Course Sciences, King’s College London
| | - Agata Sobczyńska-Malefora
- Nutristasis Unit, Viapath, St. Thomas’ Hospital, London, UK
- Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - Rebecca C. Painter
- Department of Obstetrics and Gynaecology, Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Lucilla Poston
- Department of Women and Children’s Health, School of Life Course Sciences, King’s College London
| | - Sara L. White
- Department of Women and Children’s Health, School of Life Course Sciences, King’s College London
| | - Angela C. Flynn
- Department of Women and Children’s Health, School of Life Course Sciences, King’s College London
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Prenatal docosahexaenoic acid effect on maternal-infant DHA-equilibrium and fetal neurodevelopment: a randomized clinical trial. Pediatr Res 2022; 92:255-264. [PMID: 34552200 PMCID: PMC8456398 DOI: 10.1038/s41390-021-01742-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 08/03/2021] [Accepted: 09/05/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Maternal-infant equilibrium occurs when cord blood docosahexaenoic acid (DHA) is less than or equal to maternal DHA at delivery. Equilibrium may be an indicator of sufficient DHA for optimal fetal and infant neurodevelopment. The purpose of this study was to test the effect of maternal DHA supplementation on equilibrium status and fetal neurodevelopment. METHODS Women enrolled between 12 and 20 weeks gestation and were randomized to 200 or 800 mg DHA/day until delivery. Maternal red blood cell (RBC) phospholipids were measured at enrollment, 32 weeks, delivery, and in cord blood at delivery. Fetal neurodevelopment was measured at 32 and 36 weeks gestation. Intent-to-treat analyses were conducted to test differences in equilibrium status by group. Fetal outcomes were assessed by equilibrium status and group. RESULTS Three hundred women enrolled and 262 maternal-infant dyads provided blood samples at delivery. No maternal-infant dyads with maternal RBC-DHA ≤ 6.96% at delivery achieved equilibrium. The incidence of equilibrium was significantly higher in the 800 mg group. There was no effect of maternal group or equilibrium status on fetal neurodevelopment. CONCLUSION The significance of maternal-infant DHA equilibrium remains unknown. Ongoing research will test the effect of treatment group, equilibrium, and nutrient status on infant behavior and brain function. IMPACT Pregnant women who received a higher dose of docosahexaenoic acid (DHA) were more likely to achieve maternal-infant DHA equilibrium at delivery. Equilibrium status had no effect on fetal neurodevelopment in this sample. While DHA is crucial for early life neurodevelopment, the significance of achieving maternal-infant equilibrium above the lower threshold is uncertain. There is a lower threshold of maternal DHA status where maternal-infant DHA equilibrium never occurs. The lack of equilibrium associated with low maternal DHA status may indicate insufficient maternal status for optimal placental transfer.
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da Mota Santana J, Pereira M, Carvalho GQ, dos Santos DB, Oliveira AM. Long-Chain Polyunsaturated Fatty Acid Concentrations and Association with Weight Gain in Pregnancy. Nutrients 2021; 14:nu14010128. [PMID: 35011002 PMCID: PMC8746780 DOI: 10.3390/nu14010128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/20/2021] [Accepted: 12/25/2021] [Indexed: 12/02/2022] Open
Abstract
Lower concentrations of omega-3 (ω-3) and higher concentrations of omega-6 (ω-6) have been associated with excess weight in adults; however, the information on this relationship in pregnancy remains in its infancy. This study aimed to investigate the association between plasma levels of ω-3 and ω-6 long-chain polyunsaturated fatty acids (PUFAs) and weight gain during the gestational period. This is a prospective cohort study involving 185 pregnant women registered with the prenatal services of a municipality in the northeast of Brazil. The dosage of the serum concentration of fatty acids and the anthropometric measurements were carried out at the baseline, and the women’s weight information in the first, second, and third trimesters was collected from their pregnancy cards. Serum fatty acids were determined with the help of gas chromatography. The response variable of this study is the latent variable weight gain in pregnancy, derived from three variables: gestational weight in the first, second, and third trimesters. The main exposure was the plasma concentrations of PUFAs. Structural equation modeling was used for the data analysis. The mean age of the pregnant women was 26.74 years old (SD: 5.96 years). Most of the women had not completed high school (84%) and had a low income (70.86%). It was observed that the ω-3 PUFAs, represented by ALA plasm (alpha-linolenic acid), DHA (docosahexaenoic acid), and the EPA/ALA ratio (eicosapentaenoic acid to alpha-linolenic acid ratio), were negatively associated with the weight gain during pregnancy construct (−0.20, −0.12, and −0.14, respectively). Meanwhile, the PUFAs represented by the ratio between the ω-6 category acids ARA and LA (arachidonic acid and linoleic acid) had a direct and positive association (0.22) with that construct. Excess maternal weight gain was associated with ω-3 and ω-6 plasma levels. The women with the greatest gestational weight gain were the ones that presented the highest ARA/LA ratio (ω-6) and the lowest plasma concentrations of ALA, DHA, and EPA/ALA ratio (ω-3).
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Affiliation(s)
- Jerusa da Mota Santana
- Center of Health Sciences, Universidade Federal do Recôncavo da Bahia, Avenida Carlos Amaral, R. do Cajueiro, 1015, Santo Antonio de Jesus 44574-490, Brazil;
- Collective Health Institute, Universidade Federal da Bahia, Rua Basílio da Gama, s/n—Canela, Salvador 40110-040, Brazil;
- Correspondence: ; Tel.: +55-(75)-988537636
| | - Marcos Pereira
- Collective Health Institute, Universidade Federal da Bahia, Rua Basílio da Gama, s/n—Canela, Salvador 40110-040, Brazil;
| | - Gisele Queiroz Carvalho
- Campus Avançado de Governador Valadares, Universidade Federal de Juiz de Fora, Governador Valadares 35010-17, Brazil;
| | - Djanilson Barbosa dos Santos
- Center of Health Sciences, Universidade Federal do Recôncavo da Bahia, Avenida Carlos Amaral, R. do Cajueiro, 1015, Santo Antonio de Jesus 44574-490, Brazil;
| | - Ana Marlucia Oliveira
- Collective Health Institute, Universidade Federal da Bahia, Rua Basílio da Gama, s/n—Canela, Salvador 40110-040, Brazil;
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Tarui T, Rasool A, O'Tierney-Ginn P. How the placenta-brain lipid axis impacts the nutritional origin of child neurodevelopmental disorders: Focus on attention deficit hyperactivity disorder and autism spectrum disorder. Exp Neurol 2021; 347:113910. [PMID: 34742689 DOI: 10.1016/j.expneurol.2021.113910] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/19/2021] [Accepted: 10/31/2021] [Indexed: 12/01/2022]
Abstract
Dietary fish is a rich source of omega-3 (n-3) fatty acids, and as such, is believed to have played an important role in the evolution of the human brain and its advanced cognitive function. The long chain polyunsaturated fatty acids, particularly the n-3 docosahexanoic acid (DHA), are critical for proper neurological development and function. Both low plasma DHA and obesity in pregnancy are associated with neurodevelopmental disorders such as attention deficit and hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in childhood, and n-3 supplementation has been shown to improve symptoms, as reviewed herein. The mechanisms underlying the connection between maternal obesity, n-3 fatty acid levels and offspring's neurological outcomes are poorly understood, but we review the evidence for a mediating role of the placenta in this relationship. Despite promising data that n-3 fatty acid supplementation mitigates the effect of maternal obesity on placental lipid metabolism, few clinical trials or animal studies have considered the neurological outcomes of offspring of mothers with obesity supplemented with n-3 FA in pregnancy.
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Affiliation(s)
- Tomo Tarui
- Mother Infant Research Institute, Tufts Medical Center, Boston, MA, United States of America
| | - Aisha Rasool
- Mother Infant Research Institute, Tufts Medical Center, Boston, MA, United States of America
| | - Perrie O'Tierney-Ginn
- Mother Infant Research Institute, Tufts Medical Center, Boston, MA, United States of America.
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Weiler HA, Vanstone CA, Razaghi M, Gharibeh N, Patel S, Wei SQ, McNally D. Disparities in Vitamin D Status of Newborn Infants from a Diverse Sociodemographic Population in Montreal, Canada. J Nutr 2021; 152:255-268. [PMID: 34612495 PMCID: PMC8754562 DOI: 10.1093/jn/nxab344] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/02/2021] [Accepted: 09/17/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Vitamin D status at birth is reliant on maternal-fetal transfer of vitamin D during gestation. OBJECTIVES We aimed to examine the vitamin D status of newborn infants in a diverse population and to subsequently identify the modifiable correlates of vitamin D status. METHODS In this cross-sectional study, healthy mother-infant dyads (n = 1035) were recruited within 36 h after term delivery (March 2016-March 2019). Demographic and lifestyle factors were surveyed. Newborn serum 25-hydroxyvitamin D [25(OH)D] was measured (standardized chemiluminescence immunoassay) and categorized as deficient [serum 25(OH)D <30 nmol/L] or adequate (≥40 nmol/L). Serum 25(OH)D was compared among categories of maternal characteristics using ANOVA; each characteristic was tested in a separate model. Subgroups (use of multivitamins preconception and continued in pregnancy compared with during pregnancy only) were matched (n = 352/group) for maternal factors (ancestry, age, income, education, parity, and prepregnancy BMI) using propensity scores; logistic regression models were generated for odds of deficiency or adequacy. RESULTS Infants' mean serum 25(OH)D was 45.9 nmol/L (95% CI: 44.7, 47.0 nmol/L) (n = 1035), with 20.8% (95% CI: 18.3%, 23.2%) deficient and 60.7% (95% CI: 55.2%, 66.2%) adequate. Deficiency prevalence ranged from 14.6% of white infants to 41.7% of black infants. Serum 25(OH)D was higher (P < 0.0001) in infants of mothers with higher income, BMI < 25 kg/m2, exercise and sun exposure in pregnancy, and use of multivitamins preconception. In the matched-subgroup analysis, multivitamin supplementation preconception plus during pregnancy relative to only during pregnancy was associated with lower odds for vitamin D deficiency (ORadj: 0.55; 95% CI: 0.36, 0.86) and higher odds for adequate vitamin D status (ORadj: 1.47; 95% CI: 1.04, 2.07). CONCLUSIONS In this study most newborn infants had adequate vitamin D status, yet one-fifth were vitamin D deficient with disparities between population groups. Guidelines for a healthy pregnancy recommend maternal use of multivitamins preconception and continuing in pregnancy. An emphasis on preconception use may help to achieve adequate neonatal vitamin D status.This trial was registered at clinicaltrials.gov as NCT02563015.
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Affiliation(s)
| | - Catherine A Vanstone
- School of Human Nutrition, McGill University, Ste Anne de Bellevue, Québec, Canada
| | - Maryam Razaghi
- School of Human Nutrition, McGill University, Ste Anne de Bellevue, Québec, Canada
| | - Nathalie Gharibeh
- School of Human Nutrition, McGill University, Ste Anne de Bellevue, Québec, Canada
| | - Sharina Patel
- School of Human Nutrition, McGill University, Ste Anne de Bellevue, Québec, Canada
| | - Shu Q Wei
- Québec National Institute of Public Health, Montréal, Québec, Canada
| | - Dayre McNally
- Division of Critical Care, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
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10
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Gulecoglu Onem MG, Coker C, Baysal K, Altunyurt S, Keskinoglu P. The effects of pre-pregnancy obesity and gestational weight gain on maternal lipid profiles, fatty acids and insulin resistance. J Perinat Med 2021; 49:873-883. [PMID: 33887128 DOI: 10.1515/jpm-2020-0540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/19/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Pregnancy is associated with physiological alterations in insulin sensitivity and lipid metabolism. This study investigates the associations between pregestational body mass index (pBMI) and the rate of gestational weight gain (rGWG) in the second trimester with the biomarkers of lipid, fatty acids metabolism and insulin resistance. METHODS Sixty nine pregnant women followed. The body weights of the pregnant women were measured and blood samples were obtained at 11-14th and 24-28th weeks of pregnancy. Glucose, total cholesterol, triglyceride, HDL cholesterol, LDL cholesterol, insulin levels and fatty acids were measured. Rate of GWG (kg/week) and The Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) were calculated. The pregnant women were stratified according to their pBMI and the 2nd trimester rGWG. RESULTS The rate of GWG was significantly higher for the group with pBMI<25, compared to the group with pBMI≥25 (p=0.024). Triglyceride, total cholesterol, LDL and HDL cholesterol were significantly increased in the second trimester compared with the first trimester. Palmitic acid, oleic acid, linoleic acid, myristic acid, docosahexaenoic acid (DHA), arachidonic acid (AA), total omega-6 (n - 6) and omega-3 (n - 3) fatty acid levels and n - 6/n - 3 ratio were significantly higher in the second trimester. Glucose was significantly decreased and insulin was increased in the second trimester. In the overweight/obese group; HOMA-IR, insulin, AA, palmitoleic acid and stearic acid were found to be high in comparison to the group with low/normal pBMI. No parameters were associated with rGWG. CONCLUSIONS The changes in lipid parameters, free fatty acids, insulin and HOMA-IR in the second trimester were compatible with the changes in lipid metabolism and the development of insulin resistance. Pregestational BMI was shown to have a stronger influence on lipid profile, insulin resistance, and fatty acids than rGWG.
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Affiliation(s)
| | - Canan Coker
- Department of Medical Biochemistry, Medical Faculty Dokuz Eylul University, Izmir, Turkey
| | - Kemal Baysal
- Department of Medical Biochemistry, Medical Faculty Koc University, Istanbul, Turkey
| | - Sabahattin Altunyurt
- Department of Obstetrics and Gynecology, Medical Faculty Dokuz Eylul University, Izmir, Turkey
| | - Pembe Keskinoglu
- Department of Biostatistics and Medical Informatics, Medical Faculty Dokuz Eylul University, Izmir, Turkey
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11
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The effect of prepregnancy body mass index on maternal micronutrient status: a meta-analysis. Sci Rep 2021; 11:18100. [PMID: 34518612 PMCID: PMC8437962 DOI: 10.1038/s41598-021-97635-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/09/2021] [Indexed: 12/17/2022] Open
Abstract
The relationship between prepregnancy body mass index (BMI) and maternal micronutrient status is inconsistent and has not received sufficient attention. This meta-analysis aimed to evaluate the effect of prepregnancy BMI on micronutrient levels in pregnant women. PubMed, Embase, Web of Science, and the Cochrane Library were searched for articles that contained information on micronutrient levels and prepregnancy BMI. A random-effects model was used to determine the association between prepregnancy BMI and maternal micronutrient status. Sixty-one eligible articles were eventually included, with 83,554 participants. Vitamin B12, folate, vitamin D, iron and ferritin were the main micronutrients evaluated in our meta-analysis. Prepregnancy obesity and overweight may lead to an increased risk of micronutrient deficiency, including vitamin B12, folate and vitamin D deficiency, while prepregnancy obesity or overweight may have no significant association with ferritin deficiency. Additionally, the results of the dose-response analyses demonstrated a possible significant inverse correlation between prepregnancy BMI and levels of micronutrient, except for iron and ferritin. Compared with women with normal weight, women who were overweight or obese prepregnancy have lower micronutrient concentrations and are more likely to exhibit micronutrient deficiency during pregnancy, which is harmful to both mothers and neonates.
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12
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Longitudinal Plasma Metabolomics Profile in Pregnancy-A Study in an Ethnically Diverse U.S. Pregnancy Cohort. Nutrients 2021; 13:nu13093080. [PMID: 34578958 PMCID: PMC8471130 DOI: 10.3390/nu13093080] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/30/2021] [Accepted: 08/30/2021] [Indexed: 12/30/2022] Open
Abstract
Amino acids, fatty acids, and acylcarnitine metabolites play a pivotal role in maternal and fetal health, but profiles of these metabolites over pregnancy are not completely established. We described longitudinal trajectories of targeted amino acids, fatty acids, and acylcarnitines in pregnancy. We quantified 102 metabolites and combinations (37 fatty acids, 37 amino acids, and 28 acylcarnitines) in plasma samples from pregnant women in the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Fetal Growth Studies—Singletons cohort (n = 214 women at 10–14 and 15–26 weeks, 107 at 26–31 weeks, and 103 at 33–39 weeks). We used linear mixed models to estimate metabolite trajectories and examined variation by body mass index (BMI), race/ethnicity, and fetal sex. After excluding largely undetected metabolites, we analyzed 77 metabolites and combinations. Levels of 13 of 15 acylcarnitines, 7 of 25 amino acids, and 18 of 37 fatty acids significantly declined over gestation, while 8 of 25 amino acids and 10 of 37 fatty acids significantly increased. Several trajectories appeared to differ by BMI, race/ethnicity, and fetal sex although no tests for interactions remained significant after multiple testing correction. Future studies merit longitudinal measurements to capture metabolite changes in pregnancy, and larger samples to examine modifying effects of maternal and fetal characteristics.
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13
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Gázquez A, Giménez-Bañón MJ, Prieto-Sánchez MT, Martínez-Graciá C, Suárez C, Santaella-Pascual M, Galdo-Castiñeira L, Ballesteros-Meseguer C, Vioque J, Martínez-Villanueva M, Avilés-Plaza F, Noguera-Velasco JA, Morales E, García-Marcos L, Larqué E. Self-Reported DHA Supplementation during Pregnancy and Its Association with Obesity or Gestational Diabetes in Relation to DHA Concentration in Cord and Maternal Plasma: Results from NELA, a Prospective Mother-Offspring Cohort. Nutrients 2021; 13:843. [PMID: 33806689 PMCID: PMC8000695 DOI: 10.3390/nu13030843] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 02/26/2021] [Accepted: 02/28/2021] [Indexed: 12/19/2022] Open
Abstract
Maternal supplementation of docosahexaenoic acid (DHA) during pregnancy has been recommended due to its role in infant development, but its effect on materno-fetal DHA status is not well established. We evaluated the associations between DHA supplementation in pregnant women with obesity or gestational diabetes mellitus (GDM) and maternal and neonatal DHA status. Serum fatty acids (FA) were analyzed in 641 pregnant women (24 weeks of gestation) and in 345 venous and 166 arterial cord blood samples of participants of the NELA cohort. Obese women (n = 47) presented lower DHA in serum than those lean (n = 397) or overweight (n = 116) before pregnancy. Linoleic acid in arterial cord was elevated in obese women, which indicates lower fetal retention. Maternal DHA supplementation (200 mg/d) during pregnancy was associated with enhanced maternal and fetal DHA levels regardless of pre-pregnancy body mass index (BMI), although higher arterial DHA in overweight women indicated an attenuated response. Maternal DHA supplementation was not associated with cord venous DHA in neonates of mothers with GDM. The cord arteriovenous difference was similar for DHA between GDM and controls. In conclusion, maternal DHA supplementation during pregnancy enhanced fetal DHA status regardless of the pre-pregnancy BMI while GDM may reduce the effect of DHA supplementation in newborns.
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Affiliation(s)
- Antonio Gázquez
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), 30120 Murcia, Spain; (A.G.); (M.J.G.-B.); (M.T.P.-S.); (C.M.-G.); (C.S.); (M.S.-P.); (M.M.-V.); (F.A.-P.); (J.A.N.-V.); (E.M.); (L.G.-M.)
- Department of Physiology, University of Murcia, 30100 Murcia, Spain
| | - María J. Giménez-Bañón
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), 30120 Murcia, Spain; (A.G.); (M.J.G.-B.); (M.T.P.-S.); (C.M.-G.); (C.S.); (M.S.-P.); (M.M.-V.); (F.A.-P.); (J.A.N.-V.); (E.M.); (L.G.-M.)
- Department of Physiology, University of Murcia, 30100 Murcia, Spain
| | - María T. Prieto-Sánchez
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), 30120 Murcia, Spain; (A.G.); (M.J.G.-B.); (M.T.P.-S.); (C.M.-G.); (C.S.); (M.S.-P.); (M.M.-V.); (F.A.-P.); (J.A.N.-V.); (E.M.); (L.G.-M.)
- Obstetrics & Gynaecology Service, “Virgen de la Arrixaca” University Clinical Hospital, University of Murcia, 30120 Murcia, Spain; (L.G.-C.); (C.B.-M.)
| | - Carmen Martínez-Graciá
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), 30120 Murcia, Spain; (A.G.); (M.J.G.-B.); (M.T.P.-S.); (C.M.-G.); (C.S.); (M.S.-P.); (M.M.-V.); (F.A.-P.); (J.A.N.-V.); (E.M.); (L.G.-M.)
- Food Science and Technology Department, Faculty of Veterinary, University of Murcia, 30100 Murcia, Spain
| | - Clara Suárez
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), 30120 Murcia, Spain; (A.G.); (M.J.G.-B.); (M.T.P.-S.); (C.M.-G.); (C.S.); (M.S.-P.); (M.M.-V.); (F.A.-P.); (J.A.N.-V.); (E.M.); (L.G.-M.)
- Food Science and Technology Department, Faculty of Veterinary, University of Murcia, 30100 Murcia, Spain
| | - Marina Santaella-Pascual
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), 30120 Murcia, Spain; (A.G.); (M.J.G.-B.); (M.T.P.-S.); (C.M.-G.); (C.S.); (M.S.-P.); (M.M.-V.); (F.A.-P.); (J.A.N.-V.); (E.M.); (L.G.-M.)
- Food Science and Technology Department, Faculty of Veterinary, University of Murcia, 30100 Murcia, Spain
| | - Lina Galdo-Castiñeira
- Obstetrics & Gynaecology Service, “Virgen de la Arrixaca” University Clinical Hospital, University of Murcia, 30120 Murcia, Spain; (L.G.-C.); (C.B.-M.)
| | - Carmen Ballesteros-Meseguer
- Obstetrics & Gynaecology Service, “Virgen de la Arrixaca” University Clinical Hospital, University of Murcia, 30120 Murcia, Spain; (L.G.-C.); (C.B.-M.)
| | - Jesús Vioque
- Health and Biomedical Research Institute of Alicante (ISABIAL-UMH), 46020 Alicante, Spain;
- CIBER Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Miriam Martínez-Villanueva
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), 30120 Murcia, Spain; (A.G.); (M.J.G.-B.); (M.T.P.-S.); (C.M.-G.); (C.S.); (M.S.-P.); (M.M.-V.); (F.A.-P.); (J.A.N.-V.); (E.M.); (L.G.-M.)
- Molecular Therapy and Biomarkers Research Group, Clinical Analysis Service, University Clinical Hospital “Virgen de la Arrixaca”, University of Murcia, 30120 Murcia, Spain
| | - Francisco Avilés-Plaza
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), 30120 Murcia, Spain; (A.G.); (M.J.G.-B.); (M.T.P.-S.); (C.M.-G.); (C.S.); (M.S.-P.); (M.M.-V.); (F.A.-P.); (J.A.N.-V.); (E.M.); (L.G.-M.)
- Molecular Therapy and Biomarkers Research Group, Clinical Analysis Service, University Clinical Hospital “Virgen de la Arrixaca”, University of Murcia, 30120 Murcia, Spain
| | - José A. Noguera-Velasco
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), 30120 Murcia, Spain; (A.G.); (M.J.G.-B.); (M.T.P.-S.); (C.M.-G.); (C.S.); (M.S.-P.); (M.M.-V.); (F.A.-P.); (J.A.N.-V.); (E.M.); (L.G.-M.)
- Molecular Therapy and Biomarkers Research Group, Clinical Analysis Service, University Clinical Hospital “Virgen de la Arrixaca”, University of Murcia, 30120 Murcia, Spain
| | - Eva Morales
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), 30120 Murcia, Spain; (A.G.); (M.J.G.-B.); (M.T.P.-S.); (C.M.-G.); (C.S.); (M.S.-P.); (M.M.-V.); (F.A.-P.); (J.A.N.-V.); (E.M.); (L.G.-M.)
- Department of Public Health Sciences, University of Murcia, 30100 Murcia, Spain
| | - Luís García-Marcos
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), 30120 Murcia, Spain; (A.G.); (M.J.G.-B.); (M.T.P.-S.); (C.M.-G.); (C.S.); (M.S.-P.); (M.M.-V.); (F.A.-P.); (J.A.N.-V.); (E.M.); (L.G.-M.)
- Network of Asthma and Adverse and Allergic Reactions (ARADyAL), 28029 Madrid, Spain
| | - Elvira Larqué
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), 30120 Murcia, Spain; (A.G.); (M.J.G.-B.); (M.T.P.-S.); (C.M.-G.); (C.S.); (M.S.-P.); (M.M.-V.); (F.A.-P.); (J.A.N.-V.); (E.M.); (L.G.-M.)
- Department of Physiology, University of Murcia, 30100 Murcia, Spain
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Towards an Optimized Fetal DHA Accretion: Differences on Maternal DHA Supplementation Using Phospholipids vs. Triglycerides during Pregnancy in Different Models. Nutrients 2021; 13:nu13020511. [PMID: 33557158 PMCID: PMC7913957 DOI: 10.3390/nu13020511] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/15/2021] [Accepted: 02/01/2021] [Indexed: 01/10/2023] Open
Abstract
Docosahexaenoic acid (DHA) supplementation during pregnancy has been recommended by several health organizations due to its role in neural, visual, and cognitive development. There are several fat sources available on the market for the manufacture of these dietary supplements with DHA. These fat sources differ in the lipid structure in which DHA is esterified, mainly phospholipids (PL) and triglycerides (TG) molecules. The supplementation of DHA in the form of PL or TG during pregnancy can lead to controversial results depending on the animal model, physiological status and the fat sources utilized. The intestinal digestion, placental uptake, and fetal accretion of DHA may vary depending on the lipid source of DHA ingested by the mother. The form of DHA used in maternal supplementation that would provide an optimal DHA accretion for fetal brain development, based on the available data obtained most of them from different animal models, indicates no consistent differences in fetal accretion when DHA is provided as TG or PL. Other related lipid species are under evaluation, e.g., lyso-phospholipids, with promising results to improve DHA bioavailability although more studies are needed. In this review, the evidence on DHA bioavailability and accumulation in both maternal and fetal tissues after the administration of DHA supplementation during pregnancy in the form of PL or TG in different models is summarized.
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15
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Eastman AJ, Moore RE, Townsend SD, Gaddy JA, Aronoff DM. The Influence of Obesity and Associated Fatty Acids on Placental Inflammation. Clin Ther 2021; 43:265-278. [PMID: 33487441 DOI: 10.1016/j.clinthera.2020.12.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/24/2020] [Accepted: 12/31/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE Maternal obesity, affecting nearly 1 in 4 pregnancies, is associated with increased circulating saturated fatty acids, such as palmitate. These fatty acids are implicated in placental inflammation, which may in turn exacerbate both maternal-fetal tolerance and responses to pathogens, such as group B Streptococcus. In this review, we address the question, "How do obesity and associated fatty acids influence placental inflammation?" METHODS In this narrative review, we searched PubMed and Google Scholar using combinations of the key words placental inflammation or pregnancy and lipids, fatty acids, obesity, palmitate, or other closely related search terms. We also used references found within these articles that may have been absent from our original search queries. We analyzed methods and key results of these articles to compare and contrast their findings, which were occasionally at odds with each other. FINDINGS Although obesity can be studied as a whole, complex phenomena with in vivo mouse models and human samples from patients with obesity, in vitro modeling often relies on the treatment of cells or tissues with ≥1 fatty acids and occasionally other compounds (eg, glucose and insulin). We found that palmitate, most commonly used in vitro to recreate hallmarks of obesity, induces apoptosis, oxidative stress, mitochondrial dysfunction, autophagy defects, and inflammasome activation in many placental cell types. We compare this to in vivo models of obesity wherever possible. We found that obesity as a whole may have more complex regulation of these phenomena (apoptosis, oxidative stress, mitochondrial dysfunction, autophagy defects, and inflammasome activation) compared with in vitro models of fatty acid treatment (primarily palmitate) because of the presence of unsaturated fatty acids (ie, oleate), which may have anti-inflammatory effects. IMPLICATIONS The interaction of unsaturated fatty acids with saturated fatty acids may ameliorate many inflammatory effects of saturated fatty acids alone, which complicates interpretation of in vitro studies that focus on a particular fatty acid in isolation. This complication may explain why certain studies of obesity in vivo have differing outcomes from studies of specific fatty acids in vitro.
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Affiliation(s)
- Alison J Eastman
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rebecca E Moore
- Department of Chemistry, Vanderbilt University, Nashville, TN, USA
| | | | - Jennifer A Gaddy
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA; Tennessee Valley Healthcare Systems, Department of Veterans Affairs, Nashville, TN, USA
| | - David M Aronoff
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN, USA.
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16
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Al-Otaibi H, Hussein N, Mustafa H, Al-Mudaires N. Obesity, gestational weight gain, and polyunsaturated fatty acids profile in pregnant Saudi women. Bioinformation 2020; 16:493-500. [PMID: 32884215 PMCID: PMC7452740 DOI: 10.6026/97320630016493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 05/25/2020] [Accepted: 05/26/2020] [Indexed: 12/11/2022] Open
Abstract
Obesity and excessive gestational weight gain (GWG) are associated with a deficiency of essential fatty acids, affecting maternal health during and after pregnancy. Therefore, it
is of interest to identify the associations of pre-pregnancy body mass index (BMI) and GWG with lipid profiles in Saudi women after giving birth. Hence, a cross-sectional study of 238
pregnant women aged 20-40 years was conducted at the King Abdul Aziz Hospital, in Al-Ahsa Governorate-Saudi Arabia. Thus, socio-demographic and anthropometric data were collected
using a structured questionnaire. Poly-unsaturated fatty acids (PUFAs), saturated fatty acids (SFAs), and monounsaturated fatty acids (MUFAs) levels were assessed from blood samples
collected after the women gave birth. The participants generally consumed diets low in omega-3 and omega-6 PUFAs and high in SFAs and MUFAs. Among them, 51% had university degrees,
only 20.4% were employed, and 50% had pre-pregnancy overweight/obesity. Women with overweight/obesity had a higher omega-6 to omega-3 PUFA ratio than women with normal weight.
Overweight, obesity, and excessive GWG were not associated with higher levels of total n-3 PUFAs, docosahexaenoic acid, and α-linolenic acid but were associated with higher levels of
total n-6 PUFAs and linoleic acid. Women with obesity had significantly higher SFA and MUFA levels than women with normal weight, whereas women with excessive GWG were twice as likely
to have higher SFA levels than women with adequate GWG. We show that a higher pre-pregnancy BMI and excessive GWG were significantly associated with abnormal lipid profiles in Saudi
women after giving birth. We believe that future studies will help explore these associations in detail.
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Affiliation(s)
- Hala Al-Otaibi
- Department of Food Sciences and Nutrition, College of Agriculture and Food Sciences, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Nahed Hussein
- Faculty of Specific Education, Ain Shams University, Cairo, Egypt
| | - Hani Mustafa
- King Abdul Aziz Hospital, National Guard Health Affairs, Al-Ahsa, Saudi Arabia
| | - Norah Al-Mudaires
- Department of Physical Education, College of Education, King Faisal University, Al-Ahsa, Saudi Arabia
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Maternal Pre-Pregnancy Obesity Attenuates Response to Omega-3 Fatty Acids Supplementation During Pregnancy. Nutrients 2018; 10:nu10121908. [PMID: 30518052 PMCID: PMC6315963 DOI: 10.3390/nu10121908] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 11/27/2018] [Accepted: 11/27/2018] [Indexed: 12/12/2022] Open
Abstract
Maternal obesity is associated with adverse offspring outcomes. Inflammation and deficiency of anti-inflammatory nutrients like omega(n)-3 polyunsaturated fatty acids (PUFA) may contribute to these associations. Fetal supply of n-3 PUFA is dependent on maternal levels and studies have suggested that improved offspring outcomes are associated with higher maternal intake. However, little is known about how maternal obesity affects the response to n-3 supplementation during pregnancy. We sought to determine (1) the associations of obesity with PUFA concentrations and (2) if the systemic response to n-3 supplementation differs by body mass index (BMI). This was a secondary analysis of 556 participants (46% lean, 28% obese) in the Maternal-Fetal Medicine Units Network trial of n-3 (Docosahexaenoic acid (DHA) + Eicosapentaenoic acid (EPA)) supplementation, in which participants had 2g/day of n-3 (n = 278) or placebo (n = 278) from 19 to 22 weeks until delivery. At baseline, obese women had higher plasma n-6 arachidonic acid concentrations (β: 0.96% total fatty acids; 95% Confidence Interval (CI): 0.13, 1.79) and n-6/n-3 ratio (β: 0.26 unit; 95% CI: 0.05, 0.48) compared to lean women. In the adjusted analysis, women in all BMI groups had higher n-3 concentrations following supplementation, although obese women had attenuated changes (β = -2.04%, CI: -3.19, -0.90, interaction p = 0.000) compared to lean women, resulting in a 50% difference in the effect size. Similarly, obese women also had an attenuated reduction (β = 0.94 units, CI: 0.40, 1.47, interaction p = 0.046) in the n-6/n-3 ratio (marker of inflammatory status), which was 65% lower compared to lean women. Obesity is associated with higher inflammation and with an attenuated response to n-3 supplementation in pregnancy.
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Karami Z, Nekuei N, Kazemi A, Paknahad Z. Psychosocial Factors Related to Dietary Habits in Women Undergoing Preconception Care. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2018; 23:311-315. [PMID: 30034493 PMCID: PMC6034532 DOI: 10.4103/ijnmr.ijnmr_22_17] [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] [Indexed: 11/09/2022]
Abstract
Background: Correct health behaviors such as dietary habits before pregnancy ensure desired pregnancy outcomes. The aim of this study was to determine the relationship between psychosocial factors and dietary habits using social cognitive theory (SCT) in women undergoing preconception care (PCC). Materials and Methods: This cross-sectional study was conducted among 120 women from October to December 2015 in health centres in Isfahan, Iran. Using a researcher-made questionnaire, the researcher conducted stratified random sampling and convenience sampling for selecting health centres and participants, respectively. For data analysis, the researcher applied the Pearson, Spearman's, and linear regression test in SPSS software. Results: The results showed that perceived support from healthcare personnel and outcome expectations are not associated with any of the components of dietary habits. Access to healthy food was inversely correlated with incorrect dietary habits (β = −0.19, p = 0.039) and had a direct correlation with daily consumption of fruits (β = 0.27, p = 0.006). Perceived support from the spouse had a direct correlation with desired dietary habits (β = 0.27, p = 0.006). Self-efficacy was inversely correlated with incorrect dietary habits (β = −0.22, p = 0.011) and had a direct relationship with desired dietary habits (β = 0.25, p = 0.004). Conclusions: To improve the nutritional status of women prior to pregnancy, interventions must be focused on increasing women's access to healthy food and their self-efficacy in maintaining a healthy diet.
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Affiliation(s)
- Zahra Karami
- Students Research Centre, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nafisehsadat Nekuei
- Nursing and Midwifery Care Research Center, Midwifery and Reproductive Health Department, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Kazemi
- Nursing and Midwifery Care Research Center, Midwifery and Reproductive Health Department, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zamzam Paknahad
- Department of Clinical Nutrition, Faculty of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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Association between pre-pregnancy weight status and maternal micronutrient status in early pregnancy. Public Health Nutr 2018; 21:2046-2055. [PMID: 29560851 DOI: 10.1017/s1368980018000459] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Inadequate maternal micronutrient status during pregnancy can lead to short- and long-term health risks for mother and offspring. The present study investigated the association between pre-pregnancy weight status and micronutrient status during pregnancy. DESIGN Maternal blood samples were collected during early pregnancy (median 13, interquartile range 12-15 weeks) and were assayed for serum folate, ferritin, Fe and vitamin B12. Regression modelling was used to assess the association between pre-pregnancy underweight, normal weight, overweight and obesity, and micronutrient levels, as well as the odds for deficiencies. SETTING The Amsterdam Born Children and their Development (ABCD) study, the Netherlands. SUBJECTS Women with singleton pregnancies without diabetes (n 4243). RESULTS After adjustment for covariates, overweight women and obese women had lower (β; 95 % CI) folate (-1·2; -2·2, -0·2 and -2·3; -4·0, -0·7 nmol/l, respectively) and Fe (-1·7; -2·3, -1·1 and -3·6; -4·7, -2·6 μmol/l, respectively) levels than women with normal weight. Furthermore, overweight women had 6 % (95 % CI -9, -3 %) and obese women had 15 % (-19, -10 %), lower vitamin B12 levels, and obese women had 19 % (6, 32 %) higher ferritin levels, than normal-weight women. Obese women had higher odds (OR; 95 % CI) for folate deficiency (2·03; 1·35, 3·06), Fe deficiency (3·26; 2·09, 5·08) and vitamin B12 deficiency (2·05; 1·41, 2·99) than women with normal weight. Underweight was not associated with micronutrient status. CONCLUSIONS During early pregnancy, women with pre-pregnancy overweight and obesity had lower serum folate, Fe and vitamin B12 status. This resulted in increased risk of serum folate, Fe and vitamin B12 deficiencies in women with obesity.
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Smid MC, Stuebe AM, Manuck TA, Sen S. Maternal obesity, fish intake, and recurrent spontaneous preterm birth. J Matern Fetal Neonatal Med 2018; 32:2486-2492. [PMID: 29415593 DOI: 10.1080/14767058.2018.1439008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Moderate fish intake in early pregnancy is associated with decreased risk of preterm birth (PTB). Obesity during pregnancy is characterized by inflammation and insufficiency of essential fatty acids. The objective of this study was to measure the association between fish intake during pregnancy and risk of recurrent spontaneous (s) PTB among lean, overweight, and obese women. DESIGN This is secondary analysis of a randomized controlled trial of omega-3 fatty acid supplementation for recurrent PTB prevention, 2005-2006. The primary exposure was fish intake at time of enrollment (16-22.9-week gestation). The primary outcomes were sPTB <37 weeks and sPTB <35 weeks. Maternal prepregnancy body mass index was treated as an effect modifier. SUBJECTS Eight hundred and fifty-two women were included, 47% were lean, 25% overweight, and 28% obese. RESULTS In this cohort, among lean, but not overweight or obese women, ≥1 serving of fish per week was associated with decreased frequency of sPTB <37 weeks compared with <1 serving of fish per week (45.1% versus 27.5%, p = .001) and spontaneous PTB <35 (21.4% versus 11.6%, p = .01). In adjusted models, as fish intake increased, the predicted probability of sPTB decreased in lean women but increased in overweight and obese women (p for interaction < .10). CONCLUSION Fish intake was associated with lower probability of sPTB in lean women and higher probability in obese women. These findings warrant further investigation to understand the dietary or metabolic factors associated with obesity that may modulate benefit of fish intake during pregnancy.
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Affiliation(s)
- Marcela C Smid
- a Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology , University of Utah School of Medicine , Salt Lake City , UT , USA.,b Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology , University of North Carolina School of Medicine , Chapel Hill , NC , USA
| | - Alison M Stuebe
- b Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology , University of North Carolina School of Medicine , Chapel Hill , NC , USA.,c Department of Maternal and Child Health , Gillings School of Global Public Health , Chapel Hill , NC , USA
| | - Tracy A Manuck
- b Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology , University of North Carolina School of Medicine , Chapel Hill , NC , USA
| | - Sarbattama Sen
- d Department of Pediatric Newborn Medicine , Brigham and Women's Hospital , Boston , MA , USA
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Cruz S, Matos A, da Cruz SP, Pereira S, Saboya C, Ramalho A. Relationship between the Nutritional Status of Vitamin A per Trimester of Pregnancy with Maternal Anthropometry and Anemia after Roux-en-Y Gastric Bypass. Nutrients 2017; 9:E989. [PMID: 28885564 PMCID: PMC5622749 DOI: 10.3390/nu9090989] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 08/25/2017] [Accepted: 09/04/2017] [Indexed: 01/03/2023] Open
Abstract
The aim of this study was to compare the nutritional status of vitamin A per trimester of pregnancy, as well as to assess its influence on pre-pregnancy BMI, total gestational weight gain (TGWG) and presence of anemia in women who had previously undergone Roux-en-Y gastric bypass (RYGB). An analytical, longitudinal and retrospective study comprising 30 pregnant women who had previously undergone RYGB was undertaken. In all trimesters of pregnancy, the serum concentrations of retinol, β-carotene, stages of vitamin A deficiency (VAD), night blindness (NB), anemia and anthropometric variables were assessed. VAD in pregnancy affected 90% of women, 86.7% developed NB and 82.8% had mild VAD. TGWG above/below the recommended range was related to the low serum concentrations of β-carotene (p = 0.045) in the second trimester and women with TGWG above the recommended range showed 100% of inadequacy of this nutrient in the third trimester. Among the pregnant women with anemia, 90.9% had VAD and 86.4% had NB. This study highlights the importance of monitoring the nutritional status of vitamin A in prenatal care, due to its relationship with TGWG and the high percentage of VAD and NB found since the beginning of pregnancy. It also reaffirms the use of the cut-off <1.05 μmol/L for determining VAD.
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Affiliation(s)
- Sabrina Cruz
- School of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21.941-902, Brazil.
- Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ), Rio de Janeiro 21.941-902, Brazil.
| | - Andréa Matos
- School of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21.941-902, Brazil.
- Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ), Rio de Janeiro 21.941-902, Brazil.
- Fluminense Federal University (UFF), Rio de Janeiro 24.020-150, Brazil.
| | - Suelem Pereira da Cruz
- School of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21.941-902, Brazil.
- Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ), Rio de Janeiro 21.941-902, Brazil.
| | - Silvia Pereira
- School of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21.941-902, Brazil.
- Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ), Rio de Janeiro 21.941-902, Brazil.
- Multidisciplinary Center for Bariatric and Metabolic Surgery, Rio de Janeiro 22280-020, Brazil.
| | - Carlos Saboya
- Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ), Rio de Janeiro 21.941-902, Brazil.
- Multidisciplinary Center for Bariatric and Metabolic Surgery, Rio de Janeiro 22280-020, Brazil.
- Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), São Paulo 04.021-001, Brazil.
| | - Andréa Ramalho
- Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ), Rio de Janeiro 21.941-902, Brazil.
- Fundação Oswaldo Cruz (ENSP/FIOCRUZ), Rio de Janeiro 21040-900, Brazil.
- Department of Social and Applied Nutrition of the Institute of Nutrition, UFRJ, Rio de Janeiro 21.941-902, Brazil.
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Bjørke-Monsen AL, Ulvik A, Nilsen RM, Midttun Ø, Roth C, Magnus P, Stoltenberg C, Vollset SE, Reichborn-Kjennerud T, Ueland PM. Impact of Pre-Pregnancy BMI on B Vitamin and Inflammatory Status in Early Pregnancy: An Observational Cohort Study. Nutrients 2016; 8:nu8120776. [PMID: 27916904 PMCID: PMC5188431 DOI: 10.3390/nu8120776] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 11/25/2016] [Accepted: 11/28/2016] [Indexed: 12/13/2022] Open
Abstract
Maternal nutrition and inflammation have been suggested as mediators in the development of various adverse pregnancy outcomes associated with maternal obesity. We have investigated the relation between pre-pregnancy BMI, B vitamin status, and inflammatory markers in a group of healthy pregnant women. Cobalamin, folate, pyridoxal 5′-phosphate, and riboflavin; and the metabolic markers homocysteine, methylmalonic acid, and 3-hydroxykynurenine/xanthurenic acid ratio (HK/XA); and markers of cellular inflammation, neopterin and kynurenine/tryptophan ratio (KTR) were determined in pregnancy week 18 and related to pre-pregnancy body mass index (BMI), in 2797 women from the Norwegian Mother and Child Cohort Study (MoBa). Pre-pregnancy BMI was inversely related to folate, cobalamin, pyridoxal 5′-phosphate (PLP), and riboflavin (p < 0.001), and associated with increased neopterin and KTR levels (p < 0.001). Inflammation seemed to be an independent predictor of low vitamin B6 status, as verified by low PLP and high HK/XA ratio. A high pre-pregnancy BMI is a risk factor for low B vitamin status and increased cellular inflammation. As an optimal micronutrient status is vital for normal fetal development, the observed lower B vitamin levels may contribute to adverse pregnancy outcomes associated with maternal obesity and B vitamin status should be assessed in women with high BMI before they get pregnant.
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Affiliation(s)
| | | | - Roy M Nilsen
- Centre for Clinical Research, Haukeland University Hospital, 5021 Bergen, Norway.
| | | | - Christine Roth
- The Norwegian Institute of Public Health, 0403 Oslo, Norway.
- Imprints Center for Genetic and Environmental Life Course Studies, Mailman School of Public Health and New York State Psychiatric Institute, Columbia University, New York, NY 10027, USA.
| | - Per Magnus
- The Norwegian Institute of Public Health, 0403 Oslo, Norway.
| | - Camilla Stoltenberg
- The Norwegian Institute of Public Health, 0403 Oslo, Norway.
- Department of Public Health and Primary Health Care, University of Bergen, 5007 Bergen, Norway.
| | - Stein Emil Vollset
- The Norwegian Institute of Public Health, 0403 Oslo, Norway.
- Department of Public Health and Primary Health Care, University of Bergen, 5007 Bergen, Norway.
| | - Ted Reichborn-Kjennerud
- The Norwegian Institute of Public Health, 0403 Oslo, Norway.
- Institute of Clinical Medicine, University of Oslo, 0313 Oslo, Norway.
| | - Per Magne Ueland
- Laboratory of Clinical Biochemistry, Haukeland University Hospital, 5021 Bergen, Norway.
- Department of Clinical Science, University of Bergen, 5007 Bergen, Norway.
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Ryckman KK, Donovan BM, Fleener DK, Bedell B, Borowski KS. Pregnancy-Related Changes of Amino Acid and Acylcarnitine Concentrations: The Impact of Obesity. AJP Rep 2016; 6:e329-36. [PMID: 27672481 PMCID: PMC5031496 DOI: 10.1055/s-0036-1592414] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Objective Our primary objective was to assess the difference in amino and fatty acid biomarkers throughout pregnancy in women with and without obesity. Interactions between biomarkers and obesity status for associations with maternal and fetal metabolic measures were secondarily analyzed. Methods Overall 39 women (15 cases, 24 controls) were enrolled in this study during their 15- to 20-weeks' visit at the University of Iowa Hospitals and Clinics. We analyzed 32 amino acid and acylcarnitine concentrations with tandem mass spectrometry for differences throughout pregnancy as well as among women with and without obesity (body mass index [BMI] ≥ 35, BMI < 25). Results There were substantial changes in amino acids and acylcarnitine metabolites between the second and third trimesters (nonfasting state) of pregnancy that were significant after correcting for multiple testing (p < 0.002). Examining differences by maternal obesity, C8:1 (second trimester) and C2, C4-OH, C18:1 (third trimester) were higher in women with obesity compared with women without obesity. Several metabolites were marginally (0.002 < p < 0.05) correlated with birth weight, maternal glucose, and maternal weight gain stratified by obesity status and trimester. Conclusions Understanding maternal metabolism throughout pregnancy and the influence of obesity is a critical step in identifying potential mechanisms that may contribute to adverse outcomes in pregnancies complicated by obesity.
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Affiliation(s)
- Kelli K Ryckman
- Department of Epidemiology, University of Iowa, Iowa City, Iowa
| | | | - Diedre K Fleener
- Department of Obstetrics and Gynecology, University of Iowa, Iowa City, Iowa
| | - Bruce Bedell
- Department of Pediatrics, University of Iowa, Iowa City, Iowa
| | - Kristi S Borowski
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota
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Shin D, Lee KW, Song WO. Pre-Pregnancy Weight Status Is Associated with Diet Quality and Nutritional Biomarkers during Pregnancy. Nutrients 2016; 8:162. [PMID: 26978398 PMCID: PMC4808890 DOI: 10.3390/nu8030162] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 03/01/2016] [Accepted: 03/09/2016] [Indexed: 11/21/2022] Open
Abstract
Although the positive association between pre-pregnancy overweight and obesity with excessive gestational weight gain is well known, it is not clear how pre-pregnancy weight status is associated with gestational weight gain through maternal diet during pregnancy. This study aimed to examine the relationship between pre-pregnancy weight status and diet quality and maternal nutritional biomarkers during pregnancy. Our study included 795 U.S. pregnant women from the National Health and Nutrition Examination Survey, 2003–2012. Pre-pregnancy body mass index (BMI) was calculated based on self-reported pre-pregnancy weight and height. The cutoff points of <18.5 (underweight), 18.5–24.9 (normal), 25.0–29.9 (overweight), and 30 kg/m2 (obese) were used to categorize pregnant women’s weight status. Diet quality during pregnancy was assessed by the Healthy Eating Index (HEI)-2010 based on a 24-h recall. Multivariable logistic regressions were used to estimate the odds ratios (OR) and 95% confidence intervals (CI). For all pregnant women included in this study, the mean HEI-2010 (±standard error of the mean (SEM)) was 50.7 (±0.9). Women with obese pre-pregnancy BMI demonstrated significantly lower HEI-2010 compared to those with underweight and normal pre-pregnancy BMI, respectively. In an unadjusted model, women with pre-pregnancy obesity BMI had increased odds for being in the lowest tertile of HEI-2010 (33.4 ± 0.5) compared to those with underweight pre-pregnancy BMI (OR 5.0; 95% CI 2.2–11.4). The inverse association between pre-pregnancy overweight and obesity status and diet quality during pregnancy persisted even after we controlled for physical activity levels (adjusted OR (AOR) 3.8; 95% CI 1.2–11.7, AOR 5.4; 95% CI 2.0–14.5, respectively). Serum folate concentration (ng/mL) was significantly higher in underweight women compared to overweight women (23.4 ± 1.7 vs. 17.0 ± 0.8, p < 0.05). Serum iron concentration (ng/dL) was significantly higher in normal weight women compared to overweight women (86.2 ± 5.0 vs. 68.9 ± 3.0, p < 0.05). An inverse association was found between pre-pregnancy weight status and diet quality and maternal nutritional biomarkers during pregnancy. Poor diet quality as measured by HEI-2010 was shown among overweight and obese women. Nutrition education and interventions need to be targeted to those women entering pregnancy as overweight and obese.
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Affiliation(s)
- Dayeon Shin
- Department of Food Science and Human Nutrition, Michigan State University, 469 Wilson Road, G. Malcolm Trout FSHN Building, East Lansing, MI 48824, USA.
| | - Kyung Won Lee
- Department of Food Science and Human Nutrition, Michigan State University, 469 Wilson Road, G. Malcolm Trout FSHN Building, East Lansing, MI 48824, USA.
| | - Won O Song
- Department of Food Science and Human Nutrition, Michigan State University, 469 Wilson Road, G. Malcolm Trout FSHN Building, East Lansing, MI 48824, USA.
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25
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Vidakovic AJ, Jaddoe VWV, Gishti O, Felix JF, Williams MA, Hofman A, Demmelmair H, Koletzko B, Tiemeier H, Gaillard R. Body mass index, gestational weight gain and fatty acid concentrations during pregnancy: the Generation R Study. Eur J Epidemiol 2015; 30:1175-85. [PMID: 26666541 PMCID: PMC4684831 DOI: 10.1007/s10654-015-0106-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 11/27/2015] [Indexed: 12/25/2022]
Abstract
Obesity during pregnancy may be correlated with an adverse nutritional status affecting pregnancy and offspring outcomes. We examined the associations of prepregnancy body mass index and gestational weight gain with plasma fatty acid concentrations in mid-pregnancy. This study was embedded in a population-based prospective cohort study among 5636 women. We obtained prepregnancy body mass index and maximum weight gain during pregnancy by questionnaires. We measured concentrations of saturated fatty acid (SFA), monounsaturated fatty acid (MUFA), n-3 polyunsaturated fatty acid (n-3 PUFA) and n-6 polyunsaturated fatty acid (n-6 PUFA) at a median gestational age of 20.5 (95 % range 17.1–24.9) weeks. We used multivariate linear regression models. As compared to normal weight women, obese women had higher total SFA concentrations [difference: 0.10 standard deviation (SD) (95 % Confidence Interval (CI) 0, 0.19)] and lower total n-3 PUFA concentrations [difference: − 0.11 SD (95 % CI − 0.20, − 0.02)]. As compared to women with sufficient gestational weight gain, those with excessive gestational weight gain had higher SFA concentrations [difference: 0.16 SD (95 % CI 0.08, 0.25)], MUFA concentrations [difference: 0.16 SD (95 % CI 0.08, 0.24)] and n-6 PUFA concentrations [difference: 0.12 SD (95 % CI 0.04, 0.21)]. These results were not materially affected by adjustment for maternal characteristics. Our results suggest that obesity and excessive weight gain during pregnancy are associated with an adverse fatty acids profile. Further studies are needed to assess causality and direction of the observed associations.
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Affiliation(s)
- Aleksandra Jelena Vidakovic
- The Generation R Study Group (Na29-15), Erasmus MC, University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group (Na29-15), Erasmus MC, University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands. .,Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands. .,Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
| | - Olta Gishti
- The Generation R Study Group (Na29-15), Erasmus MC, University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Janine F Felix
- The Generation R Study Group (Na29-15), Erasmus MC, University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | | | - Albert Hofman
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Hans Demmelmair
- Division of Metabolic Medicine, Department of Pediatrics, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University of Munich Medical Center, Munich, Germany
| | - Berthold Koletzko
- Division of Metabolic Medicine, Department of Pediatrics, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University of Munich Medical Center, Munich, Germany
| | - Henning Tiemeier
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Romy Gaillard
- The Generation R Study Group (Na29-15), Erasmus MC, University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands. .,Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands. .,Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
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Marques AH, Bjørke-Monsen AL, Teixeira AL, Silverman MN. Maternal stress, nutrition and physical activity: Impact on immune function, CNS development and psychopathology. Brain Res 2014; 1617:28-46. [PMID: 25451133 DOI: 10.1016/j.brainres.2014.10.051] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 10/20/2014] [Accepted: 10/25/2014] [Indexed: 12/14/2022]
Abstract
Evidence suggests that maternal and fetal immune dysfunction may impact fetal brain development and could play a role in neurodevelopmental disorders, although the definitive pathophysiological mechanisms are still not completely understood. Stress, malnutrition and physical inactivity are three maternal behavioral lifestyle factors that can influence immune and central nervous system (CNS) functions in both the mother and fetus, and may therefore, increase risk for neurodevelopmental/psychiatric disorders. First, we will briefly review some aspects of maternal-fetal immune system interactions and development of immune tolerance. Second, we will discuss the bidirectional communication between the immune system and CNS and the pathways by which immune dysfunction could contribute to neurodevelopmental disorders. Third, we will discuss the effects of prenatal stress and malnutrition (over and undernutrition) on perinatal programming of the CNS and immune system, and how this might influence neurodevelopment. Finally, we will discuss the beneficial impact of physical fitness during pregnancy on the maternal-fetal unit and infant and how regular physical activity and exercise can be an effective buffer against stress- and inflammatory-related disorders. Although regular physical activity has been shown to promote neuroplasticity and an anti-inflammatory state in the adult, there is a paucity of studies evaluating its impact on CNS and immune function during pregnancy. Implementing stress reduction, proper nutrition and ample physical activity during pregnancy and the childbearing period may be an efficient strategy to counteract the impact of maternal stress and malnutrition/obesity on the developing fetus. Such behavioral interventions could have an impact on early development of the CNS and immune system and contribute to the prevention of neurodevelopmental and psychiatric disorders. Further research is needed to elucidate this relationship and the underlying mechanisms of protection. This article is part of a Special Issue entitled SI: Neuroimmunology in Health And Disease.
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Affiliation(s)
- Andrea Horvath Marques
- Obsessive--Compulsive Spectrum Disorders Program, Department & Institute of Psychiatry, University of São Paulo, Medical School, São Paulo, Brazil.
| | | | - Antônio L Teixeira
- School of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Marni N Silverman
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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