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Nayyar D, Said JM, McCarthy H, Hryciw DH, O'Keefe L, McAinch AJ. Effect of a High Linoleic Acid Diet on Pregnant Women and Their Offspring. Nutrients 2024; 16:3019. [PMID: 39275331 PMCID: PMC11397513 DOI: 10.3390/nu16173019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2024] [Revised: 09/01/2024] [Accepted: 09/04/2024] [Indexed: 09/16/2024] Open
Abstract
Nutritional intake during pregnancy can affect gestational length, fetal development, and impact postnatal growth and health in offspring. Perturbations in maternal nutrition with either an excess or deficiency in nutrients during pregnancy may have harmful effects on the offspring's development and increase the risk of developing chronic diseases later in life. In pregnancy, nutrients transfer from the mother to the fetus via the placenta. Essential fatty acids, linoleic acid (LA) and alpha linoleic acid (ALA), can only be obtained in the diet. In Western countries, the ratio of LA and ALA in the diet has increased dramatically in recent decades. Some animal and human studies have found a correlation between maternal intake of LA and birth weight; however, the association varies. In contrast, some human studies have demonstrated inconclusive findings regarding the correlation between cord blood levels of LA and birth outcomes. In addition, high dietary LA intake in animal studies in pregnancy increased the production of inflammatory markers such as prostaglandins, leukotrienes, cytokines, and tumour necrosis factor-alpha. This review aims to highlight the effect of high dietary LA intake during pregnancy on birth outcomes, obesity, maternal inflammatory markers, and the transfer of fatty acids across the placenta.
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Affiliation(s)
- Deepti Nayyar
- Institute for Health and Sport, Victoria University, P.O. Box 14428, Melbourne, VIC 8001, Australia
| | - Joanne M Said
- Department of Maternal Fetal Medicine, Joan Kirner Women's & Children's Sunshine Hospital, Western Health, St Albans, VIC 3021, Australia
- Department of Obstetrics, Gynaecology and Newborn Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Helen McCarthy
- Institute for Health and Sport, Victoria University, P.O. Box 14428, Melbourne, VIC 8001, Australia
| | - Deanne H Hryciw
- Institute for Health and Sport, Victoria University, P.O. Box 14428, Melbourne, VIC 8001, Australia
- School of Environment and Science, Griffith University, Nathan, QLD 4111, Australia
- Griffith Institute for Drug Discovery, Griffith University, Nathan, QLD 4111, Australia
| | - Lannie O'Keefe
- Institute for Health and Sport, Victoria University, P.O. Box 14428, Melbourne, VIC 8001, Australia
| | - Andrew J McAinch
- Institute for Health and Sport, Victoria University, P.O. Box 14428, Melbourne, VIC 8001, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Victoria University, P.O. Box 14428, Melbourne, VIC 8001, Australia
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Masina M, Medithi S, Muley A. Impact of Maternal Essential Fatty Acid Intake on the Birth Weight of Infants. JOURNAL OF MOTHER AND CHILD 2023; 27:147-157. [PMID: 37843970 PMCID: PMC10578463 DOI: 10.34763/jmotherandchild.20232701.d-22-00052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 06/05/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Increased uptake of essential fatty acids during pregnancy through seafood and supplementation has been shown to positively correlate with gestational age and increased infant birth weight. We aimed to evaluate the effect of maternal dietary intake of essential fatty acids, supplementation on gestational period and infant birth weight. MATERIALS A literature search with the help of various databases such as PubMed, Google Scholar, Web of Science and Scopus was conducted. METHODS Original research articles and intervention-based studies, which involve an association between dietary intake and supplementation of essential fatty acids during full-term pregnancy on human infant birth outcomes and published from 2011 to 2021, were included. RESULTS In total, there were 21 intervention-based studies, including full-term pregnant women with or without existing comorbidities, which compared essential fatty acids in the form of dietary sources and supplementation with dietary counseling and with or without placebo. The intervention trials included in this review were conducted in developed and developing countries. Half of the pregnant women who enrolled in the study had comorbidities such as diabetes and hypertension, which might increase their risk of adverse maternal and infant birth outcomes. Most of the studies included in the review have reported a positive association between improvised dietary and supplementation intake of essential fatty acids with increased length of gestation, infant birth weight and other parameters such as head circumference, infant birth length and growth velocity. CONCLUSION Positive correlations were found between increased consumption of essential fatty acids in food sources and supplements with improvised infant birth weight and gestational period.
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Affiliation(s)
- Manojna Masina
- Symbiosis Institute of Health Sciences (SIHS), Symbiosis International (Deemed University), Pune, Maharashtra, India
| | - Srujana Medithi
- Symbiosis Institute of Health Sciences (SIHS), Symbiosis International (Deemed University), Pune, Maharashtra, India
| | - Arti Muley
- Symbiosis Institute of Health Sciences (SIHS), Symbiosis International (Deemed University), Pune, Maharashtra, India
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Koemel NA, Senior AM, Dissanayake HU, Ross J, McMullan RL, Kong Y, Phang M, Hyett J, Raubenheimer D, Gordon A, Simpson SJ, Skilton MR. Maternal dietary fatty acid composition and newborn epigenetic aging-a geometric framework approach. Am J Clin Nutr 2022; 115:118-127. [PMID: 34591100 DOI: 10.1093/ajcn/nqab318] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 09/17/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Maternal nutrition is associated with epigenetic and cardiometabolic risk factors in offspring. Research in humans has primarily focused on assessing the impact of individual nutrients. OBJECTIVES We sought to assess the collective impact of maternal dietary MUFAs, PUFAs, and SFAs on epigenetic aging and cardiometabolic risk markers in healthy newborn infants using a geometric framework approach. METHODS Body fatness (n = 162), aortic intima-media thickness (aIMT; n = 131), heart rate variability (n = 118), and epigenetic age acceleration (n = 124) were assessed in newborn infants. Maternal dietary intake was cross-sectionally assessed in the immediate postpartum period via a validated 80-item self-administered FFQ. Generalized additive models were used to explore interactive associations of nutrient intake, with results visualized as response surfaces. RESULTS After adjustment for total energy intake, maternal age, gestational age, and sex there was a 3-way interactive association of MUFAs, PUFAs, and SFAs (P = 0.001) with newborn epigenetic aging. This suggests that the nature of each fat class association depends upon one another. Response surfaces revealed MUFAs were positively associated with newborn epigenetic age acceleration only at proportionately lower intakes of SFAs or PUFAs. We also demonstrate a potential beneficial association of omega-3 (n-3) PUFAs with newborn epigenetic age acceleration (P = 0.008). There was no significant association of fat class with newborn aIMT, heart rate variability, or body fatness. CONCLUSIONS In this study, we demonstrated an association between maternal dietary fat class composition and epigenetic aging in newborns. Future research should consider other characteristics such as the source of maternal dietary fatty acids.
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Affiliation(s)
- Nicholas A Koemel
- Charles Perkins Centre, The University of Sydney, Sydney, Australia.,Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, The University of Sydney, Sydney, Australia.,Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Alistair M Senior
- Charles Perkins Centre, The University of Sydney, Sydney, Australia.,Sydney Medical School, The University of Sydney, Sydney, Australia.,School of Life and Environmental Sciences, The University of Sydney, Sydney, Australia
| | - Hasthi U Dissanayake
- Charles Perkins Centre, The University of Sydney, Sydney, Australia.,Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, The University of Sydney, Sydney, Australia.,Sydney Medical School, The University of Sydney, Sydney, Australia.,Sleep Research Group, The University of Sydney, Sydney, Australia
| | - Jason Ross
- CSIRO Health and Biosecurity, Sydney, Australia
| | - Rowena L McMullan
- Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, The University of Sydney, Sydney, Australia.,Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Yang Kong
- Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, The University of Sydney, Sydney, Australia.,Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Melinda Phang
- Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, The University of Sydney, Sydney, Australia.,Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Jon Hyett
- Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, Australia
| | - David Raubenheimer
- Charles Perkins Centre, The University of Sydney, Sydney, Australia.,School of Life and Environmental Sciences, The University of Sydney, Sydney, Australia
| | - Adrienne Gordon
- Charles Perkins Centre, The University of Sydney, Sydney, Australia.,Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, The University of Sydney, Sydney, Australia.,Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, Australia
| | - Stephen J Simpson
- Charles Perkins Centre, The University of Sydney, Sydney, Australia.,School of Life and Environmental Sciences, The University of Sydney, Sydney, Australia
| | - Michael R Skilton
- Charles Perkins Centre, The University of Sydney, Sydney, Australia.,Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, The University of Sydney, Sydney, Australia.,Sydney Medical School, The University of Sydney, Sydney, Australia.,Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, Australia
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Wang T, Grech A, Dissanayake HU, Boylan S, Skilton MR. Modeling the Effect of Environmentally Sustainable Food Swaps on Nutrient Intake in Pregnant Women. Nutrients 2021; 13:3355. [PMID: 34684355 PMCID: PMC8537316 DOI: 10.3390/nu13103355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 11/16/2022] Open
Abstract
Food production greatly contributes to greenhouse gas emissions (GHG), but there remain concerns that consuming environmentally sustainable foods can increase the likelihood of nutritional deficiencies during pregnancy. We identified commonly consumed foods of pregnant women and determined the effect of their replacement with environmentally sustainable alternatives on nutrient intake and measures of environmental sustainability. Dietary intake data from 171 pregnant women was assessed and foods that contributed the most to energy and protein intake were identified. Of these, foods producing the highest GHG emissions were matched with proposed environmentally sustainable alternatives, and their impact on nutrient provision determined. Meats, grains, and dairy products were identified as important sources of energy and protein. With the highest GHG emissions, beef was selected as the reference food. Proposed alternatives included chicken, eggs, fish, tofu, legumes, and nuts. The most pronounced reductions in CO2 emissions were from replacing beef with tofu, legumes, and nuts. Replacing one serve per week of beef with an isocaloric serve of firm tofu during pregnancy could reduce GHG emissions by 372 kg CO2 eq and increase folate (+28.1 µg/serve) and fiber (+3.3 g/serve) intake without compromising iron (+1.1 mg/serve) intake. Small dietary substitutions with environmentally sustainable alternatives can substantially reduce environmental impact without compromising nutrient adequacy.
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Affiliation(s)
- Tian Wang
- Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, NSW 2006, Australia;
- Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia; (A.G.); (H.U.D.); (S.B.)
| | - Allison Grech
- Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia; (A.G.); (H.U.D.); (S.B.)
| | - Hasthi U. Dissanayake
- Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia; (A.G.); (H.U.D.); (S.B.)
| | - Sinead Boylan
- Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia; (A.G.); (H.U.D.); (S.B.)
- School of Life and Environmental Sciences, The University of Sydney, Sydney, NSW 2006, Australia
| | - Michael R. Skilton
- Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, NSW 2006, Australia;
- Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia; (A.G.); (H.U.D.); (S.B.)
- Sydney Institute for Women, Children and Their Families, Sydney Local Health District, Camperdown, NSW 2050, Australia
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Souza RCVE, Miranda C, Ferreira LB, Dos Santos LC. The Influence of Nutrients Intake during Pregnancy on Baby's Birth Weight: A Systematic Review. J Trop Pediatr 2021; 67:6290306. [PMID: 34059907 DOI: 10.1093/tropej/fmab034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVE Maternal food intake during pregnancy can substantially interfere in the baby's anthropometric measurements at birth. Our objective was to perform a systematic review that investigate the influence of nutrient intake via food during pregnancy on the baby's anthropometric measurements at birth. METHODS A search was performed without time limits on CINAHL, Embase, PubMed, Scopus and Web of Science databases and manual on studies references. All nutrients and baby's anthropometric measurements at birth were included as descriptors. RESULTS Thirty articles were included, the majority of prospective cohort studies, with 15.39 (2.36) quality points (maximum value: 22). Thirty-six results of associations were found, of which 17 studies had direct associations between nutrient intake and birth outcomes. Inverse associations were identified in 8 studies and 11 articles showed no significant associations in all analyses. Maternal food intake of vitamin C, calcium and magnesium during pregnancy seems to have a positive influence on the baby's birth weight, while carbohydrates intake have an inverse association with the same outcome. CONCLUSION It is suggested that vitamin C, calcium, magnesium and carbohydrates influence on baby's birth weight. So, these specific nutrients need more attention to the consumption, in addition to carried out new studies, with robust methodologies for measuring maternal food consumption and considering the several factors that can interfere in this assessment. REGISTRATION This review has been registered to the PROSPERO (International prospective register of systematic reviews) (ID: CRD42020167889).
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Affiliation(s)
| | - Cristianny Miranda
- Department of Nutrition, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Larissa Bueno Ferreira
- Department of Nutrition, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Luana Caroline Dos Santos
- Department of Nutrition, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Mckenzie KM, Nasir R, Kong Y, Dissanayake HU, McMullan R, Gordon A, Meroni A, Phang M, Skilton MR. Maternal Dietary Carbohydrate Intake and Newborn Aortic Wall Thickness. Nutrients 2021; 13:1382. [PMID: 33924014 PMCID: PMC8073292 DOI: 10.3390/nu13041382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/02/2021] [Accepted: 04/15/2021] [Indexed: 11/16/2022] Open
Abstract
Evidence from animal models indicates that maternal diet during pregnancy affects offspring cardiometabolic health. Improving carbohydrate quality during high-risk pregnancies reduces aortic intima-medial thickness; a marker for early atherosclerosis; in the infant offspring. We sought to determine whether maternal carbohydrate quantity and quality are associated with newborn aortic intima-medial thickness in healthy pregnancies. Maternal diet throughout pregnancy was evaluated in 139 mother-child dyads using a validated food frequency questionnaire. Carbohydrate intake was expressed as quantity (% total energy), quality (fibre, glycaemic index), and glycaemic burden (glycaemic load). Aortic intima-medial thickness was measured by high-frequency ultrasound of the neonatal abdominal aorta. Neither quantity nor quality of maternal carbohydrate intake during pregnancy was associated with meaningful differences in offspring maximum aortic intima-medial thickness with the exception of fibre intake in women with overweight or obesity which was inversely associated (-8 μm [95% CI -14, -1] per g fibre, p = 0.04). In healthy pregnancy, the quantity and quality of maternal carbohydrate intake is likely not a meaningful modifiable lifestyle factor for influencing offspring vascular health. The effect of carbohydrate quality may only be evident in high-risk pregnancies, consistent with previous findings. These findings may be confirmed in prospective dietary trials in pregnancy.
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Affiliation(s)
- Kirsty M. Mckenzie
- Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia; (K.M.M.); (R.N.); (Y.K.); (H.U.D.); (R.M.); (A.M.); (M.P.)
- Sydney Medical School, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia;
| | - Reeja Nasir
- Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia; (K.M.M.); (R.N.); (Y.K.); (H.U.D.); (R.M.); (A.M.); (M.P.)
- Sydney Medical School, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia;
| | - Yang Kong
- Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia; (K.M.M.); (R.N.); (Y.K.); (H.U.D.); (R.M.); (A.M.); (M.P.)
- Sydney Medical School, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia;
| | - Hasthi U. Dissanayake
- Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia; (K.M.M.); (R.N.); (Y.K.); (H.U.D.); (R.M.); (A.M.); (M.P.)
- Sydney Medical School, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia;
| | - Rowena McMullan
- Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia; (K.M.M.); (R.N.); (Y.K.); (H.U.D.); (R.M.); (A.M.); (M.P.)
- Sydney Medical School, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia;
- Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia
| | - Adrienne Gordon
- Sydney Medical School, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia;
- Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia
- Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, NSW 2000, Australia
| | - Alice Meroni
- Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia; (K.M.M.); (R.N.); (Y.K.); (H.U.D.); (R.M.); (A.M.); (M.P.)
| | - Melinda Phang
- Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia; (K.M.M.); (R.N.); (Y.K.); (H.U.D.); (R.M.); (A.M.); (M.P.)
| | - Michael R. Skilton
- Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia; (K.M.M.); (R.N.); (Y.K.); (H.U.D.); (R.M.); (A.M.); (M.P.)
- Sydney Medical School, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia;
- Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, NSW 2000, Australia
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Phang M, Ross J, Raythatha JH, Dissanayake HU, McMullan RL, Kong Y, Hyett J, Gordon A, Molloy P, Skilton MR. Epigenetic aging in newborns: role of maternal diet. Am J Clin Nutr 2020; 111:555-561. [PMID: 31942922 DOI: 10.1093/ajcn/nqz326] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 12/09/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Epigenetic aging is associated with higher risk of cardiovascular disease, cancer, and all-cause mortality and may be a mechanistic link between early-life exposures, such as maternal dietary characteristics during pregnancy, and risk of adult disease. OBJECTIVES We sought to determine the early-life risk factors for newborn epigenetic aging, specifically maternal dietary macronutrient intake, and whether epigenetic aging is associated with cardiovascular health markers in the newborn. METHODS Epigenetic age acceleration of 169 newborns was measured from saliva using the Horvath age calculator. Maternal diet during pregnancy was assessed using food-frequency questionnaires. RESULTS Newborns with positive age acceleration were more likely to be female and have greater body fatness. Maternal intakes of saturated fat [6.2 wk epigenetic age acceleration (95% CI: 1.0, 11.3) per 5% of energy; P = 0.02] and monounsaturated fat [12.4 wk (95% CI: 4.2, 20.5) per 5% of energy; P = 0.003] were associated with higher epigenetic age acceleration in the newborn. The strongest association of individual fatty acids were for palmitoleic acid (25.3 wk; 95% CI: 11.4, 39.2; P = 0.0004), oleic acid (2.2 wk; 95% CI: 0.8, 3.6; P = 0.002), and palmitic acid (2.9 wk; 95% CI: 1.0, 4.9; P = 0.004) per 1% of energy intake. Vitamin D supplementation was associated with lower epigenetic age acceleration (-8.1 wk; 95% CI: -14.5, -1.7; P = 0.01). Epigenetic age acceleration was associated with aortic intima-media thickness in preterm infants [1.0 µm (95% CI: 0.2, 1.8) per week of epigenetic age acceleration; P = 0.01], but not among those born at term (P = 0.78). Epigenetic age acceleration was not associated with heart rate variability in either preterm or term born infants (both P > 0.2). CONCLUSIONS This study provides evidence of maternal dietary characteristics that are associated with epigenetic aging in the offspring. Prospective intervention studies are required to determine whether such associations are causal.
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Affiliation(s)
- Melinda Phang
- Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, University of Sydney, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
| | - Jason Ross
- CSIRO Health and Biosecurity, Sydney, Australia
| | - Jineel H Raythatha
- Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, University of Sydney, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
| | - Hasthi U Dissanayake
- Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, University of Sydney, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia.,Sleep Research Group, University of Sydney, Sydney, Australia
| | - Rowena L McMullan
- Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, University of Sydney, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia.,Royal Prince Alfred Hospital, Sydney, Australia
| | - Yang Kong
- Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, University of Sydney, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
| | - Jon Hyett
- Royal Prince Alfred Hospital, Sydney, Australia
| | - Adrienne Gordon
- Sydney Medical School, University of Sydney, Sydney, Australia.,Royal Prince Alfred Hospital, Sydney, Australia
| | | | - Michael R Skilton
- Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, University of Sydney, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
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Nkhoma M, Ashorn P, Ashorn U, Dewey KG, Gondwe A, Maleta K. Lipid based nutrient supplements during pregnancy may improve foetal growth in HIV infected women - A cohort study. PLoS One 2019; 14:e0215760. [PMID: 31048878 PMCID: PMC6497372 DOI: 10.1371/journal.pone.0215760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 04/07/2019] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES Both maternal HIV infection and antiretroviral therapy are associated with adverse birth outcomes. The role of antenatal nutrient supplements with regard to adverse birth outcomes in HIV infected women exposed to antiretroviral therapy is not well known. We assessed the association between HIV and birth outcomes and explored whether antenatal lipid-based nutrient supplements (LNS) modulated this association. METHODS We analysed a nested cohort of pregnant Malawian women who received daily LNS, multiple micronutrients (MMN) or iron and folic acid (IFA). Birth weight, length-for-age z-score (LAZ) and weight-for-age z-score (WAZ) were analysed as continuous outcomes and proportion of stunting and small-for-gestational age (SGA) as dichotomous outcomes. RESULTS 134 HIV infected (46 LNS, 39 MMN, 49 IFA) and 833 HIV uninfected (271 LNS, 287 MMN, 275 IFA) women were included. Maternal HIV infection was associated with a lower mean birth weight (-129g (-209, -48), P = 0.002); LAZ (-0.34 (-0.54, -0.13), P = 0.002) and WAZ (-0.21 (-0.40, -0.02), P = 0.041) and a higher risk of stunting (RR (95% confidence interval), 1.87 (1.24, 2.83), P = 0.003) and SGA (1.66 (1.21, 2.26), P = 0.001) in the newborn. If the women received LNS, HIV was not associated with LAZ (mean difference (95%); -0.02 (-0.35, 0.31), P = 0.918) or newborn stunting (RR (95% CI), 0.84 (0.34, 2.03), P = 0.691). However HIV tended to be associated with LAZ if the women received MMN (-0.42 (-0.80, -0.03), P = 0.053); and was significantly associated with LAZ if the women received IFA (-0.52 (-0.89, -0.14), P = 0.021) and with newborn stunting if they received MMN (2.40 (1.15, 4.98), P = 0.029) or IFA (2.40 (1.26, 4.59), P = 0.024). CONCLUSIONS Further research to investigate the impact of LNS on various aspects of foetal growth in HIV infected women is warranted.
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Affiliation(s)
- Minyanga Nkhoma
- Centre for Child Health Research, Faculty of Medicine and Health Technology, Tampere, University, Tampere, Finland
| | - Per Ashorn
- Centre for Child Health Research, Faculty of Medicine and Health Technology, Tampere, University, Tampere, Finland
- Department of Paediatrics, Tampere University Hospital, Tampere, Finland
| | - Ulla Ashorn
- Centre for Child Health Research, Faculty of Medicine and Health Technology, Tampere, University, Tampere, Finland
| | - Kathryn G. Dewey
- Department of Nutrition, University of California Davis, Davis, California, United States of America
| | - Austrida Gondwe
- Centre for Child Health Research, Faculty of Medicine and Health Technology, Tampere, University, Tampere, Finland
| | - Kenneth Maleta
- School of Public Health and Family Medicine, University of Malawi College of Medicine, Blantyre, Malawi
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