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Lis N, Lamnisos D, Bograkou-Tzanetakou A, Hadjimbei E, Tzanetakou IP. Preterm Birth and Its Association with Maternal Diet, and Placental and Neonatal Telomere Length. Nutrients 2023; 15:4975. [PMID: 38068836 PMCID: PMC10708229 DOI: 10.3390/nu15234975] [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: 11/06/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
Preterm birth (PTB), a multi-causal syndrome, is one of the global epidemics. Maternal nutrition, but also neonatal and placental telomere length (TL), are among the factors affecting PTB risk. However, the exact relationship between these factors and the PTB outcome, remains obscure. The aim of this review was to investigate the association between PTB, maternal nutrition, and placental-infant TL. Observational studies were sought with the keywords: maternal nutrition, placental TL, newborn, TL, and PTB. No studies were found that included all of the keywords simultaneously, and thus, the keywords were searched in dyads, to reach assumptive conclusions. The findings show that maternal nutrition affects PTB risk, through its influence on maternal TL. On the other hand, maternal TL independently affects PTB risk, and at the same time PTB is a major determinant of offspring TL regulation. The strength of the associations, and the extent of the influence from covariates, remains to be elucidated in future research. Furthermore, the question of whether maternal TL is simply a biomarker of maternal nutritional status and PTB risk, or a causative factor of PTB, to date, remains to be answered.
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Affiliation(s)
- Nikoletta Lis
- Department of Health Sciences, European University Cyprus, Nicosia 2404, Cyprus; (N.L.); (D.L.)
- Maternity Clinic, Cork University Maternity Hospital, T12 YE02 Cork, Ireland
| | - Demetris Lamnisos
- Department of Health Sciences, European University Cyprus, Nicosia 2404, Cyprus; (N.L.); (D.L.)
| | | | - Elena Hadjimbei
- Department of Life Sciences, European University Cyprus, Nicosia 2404, Cyprus;
| | - Irene P. Tzanetakou
- Department of Life Sciences, European University Cyprus, Nicosia 2404, Cyprus;
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Glazier JD, Hayes DJL, Hussain S, D'Souza SW, Whitcombe J, Heazell AEP, Ashton N. The effect of Ramadan fasting during pregnancy on perinatal outcomes: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2018; 18:421. [PMID: 30359228 PMCID: PMC6202808 DOI: 10.1186/s12884-018-2048-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 10/09/2018] [Indexed: 01/26/2023] Open
Abstract
Background Although exempt, many pregnant Muslim women partake in the daily fast during daylight hours during the month of Ramadan. In other contexts an impoverished diet during pregnancy impacts on birth weight. The aim of this systematic review was to determine whether Ramadan fasting by pregnant women affects perinatal outcomes. Primary outcomes investigated were perinatal mortality, preterm birth and small for gestational age (SGA) infants. Secondary outcomes investigated were stillbirth, neonatal death, maternal death, hypertensive disorders of pregnancy, gestational diabetes, congenital abnormalities, serious neonatal morbidity, birth weight, preterm birth and placental weight. Methods Systematic review and meta-analysis of observational studies and randomised controlled trials was conducted in EMBASE, MEDLINE, CINAHL, Web of Science, Google Scholar, the Health Management Information Consortium and Applied Social Sciences Index and Abstracts. Studies from any year were eligible. Studies reporting predefined perinatal outcomes in pregnancies exposed to Ramadan fasting were included. Cohort studies with no comparator group or that considered fasting outside pregnancy were excluded, as were studies assuming fasting practice based solely upon family name. Quality of included studies was assessed using the ROBINS-I tool for assessing risk of bias in non-randomised studies. Analyses were performed in STATA. Results From 375 records, 22 studies of 31,374 pregnancies were included, of which 18,920 pregnancies were exposed to Ramadan fasting. Birth weight was reported in 21 studies and was not affected by maternal fasting (standardised mean difference [SMD] 0.03, 95% CI 0.00 to 0.05). Placental weight was significantly lower in fasting mothers (SMD -0.94, 95% CI -0.97 to -0.90), although this observation was dominated by a single large study. No data were presented for perinatal mortality. Ramadan fasting had no effect on preterm delivery (odds ratio 0.99, 95% CI 0.72 to 1.37) based on 5600 pregnancies (1193 exposed to Ramadan fasting). Conclusions Ramadan fasting does not adversely affect birth weight although there is insufficient evidence regarding potential effects on other perinatal outcomes. Further studies are needed to accurately determine whether Ramadan fasting is associated with adverse maternal or neonatal outcome. Electronic supplementary material The online version of this article (10.1186/s12884-018-2048-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jocelyn D Glazier
- Maternal and Fetal Health Research Centre, Division of Developmental Biology and Medicine, Faculty of Biology, Medicine and Health, University of Manchester, 5th Floor (Research), St Mary's Hospital, Oxford Road, Manchester, M13 9WL, UK
| | - Dexter J L Hayes
- Maternal and Fetal Health Research Centre, Division of Developmental Biology and Medicine, Faculty of Biology, Medicine and Health, University of Manchester, 5th Floor (Research), St Mary's Hospital, Oxford Road, Manchester, M13 9WL, UK
| | - Sabiha Hussain
- Maternal and Fetal Health Research Centre, Division of Developmental Biology and Medicine, Faculty of Biology, Medicine and Health, University of Manchester, 5th Floor (Research), St Mary's Hospital, Oxford Road, Manchester, M13 9WL, UK
| | - Stephen W D'Souza
- Maternal and Fetal Health Research Centre, Division of Developmental Biology and Medicine, Faculty of Biology, Medicine and Health, University of Manchester, 5th Floor (Research), St Mary's Hospital, Oxford Road, Manchester, M13 9WL, UK
| | - Joanne Whitcombe
- Trust Library, Central Manchester University Hospitals NHS Foundation Trust, Education South, Oxford Road, Manchester, M13 9WL, UK
| | - Alexander E P Heazell
- Maternal and Fetal Health Research Centre, Division of Developmental Biology and Medicine, Faculty of Biology, Medicine and Health, University of Manchester, 5th Floor (Research), St Mary's Hospital, Oxford Road, Manchester, M13 9WL, UK
| | - Nick Ashton
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester, 3rd Floor Core Technology Facility, 46 Grafton Street, Manchester, M13 9NT, UK.
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Chen X. Fetus, fasting, and festival: the persistent effects of in utero social shocks. Int J Health Policy Manag 2014; 3:165-9. [PMID: 25279378 DOI: 10.15171/ijhpm.2014.92] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 09/23/2014] [Indexed: 11/09/2022] Open
Abstract
The Fetal Origins Hypothesis (FOH), put forward in the epidemiological literature and later flourished in the economics literature, suggests that the time in utero is a critical period for human development. However, much attention has been paid to the consequences of fetal exposures to more extreme natural shocks, while less is known about fetal exposures to milder but more commonly experienced social shocks. Using two examples of under-nutrition due to mild social shocks, i.e. Ramadan fasting and festival overspending, this paper summarizes our current knowledge, especially the contribution from economics, and key challenges in exploring fetal exposures to milder social shocks. I also discuss the salient added value of identifying milder versus more extreme fetal shocks. Finally, implications are drawn on individual decisions and public policy to improve children's well-being before they are born or even before their mothers realize that they are pregnant.
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Affiliation(s)
- Xi Chen
- Faculty of Arts and Sciences, Yale University, New Haven, CT, USA
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