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Alibrandi A, Zirilli A, Le Donne M, Giannetto C, Lanfranchi M, De Pascale A, Politi C, Incognito GG, Ercoli A, Granese R. Association between Fish Consumption during Pregnancy and Maternal and Neonatal Outcomes: A Statistical Study in Southern Italy. J Clin Med 2024; 13:2131. [PMID: 38610896 PMCID: PMC11012849 DOI: 10.3390/jcm13072131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/21/2024] [Accepted: 03/24/2024] [Indexed: 04/14/2024] Open
Abstract
Background: This research aimed to evaluate the association between the monthly consumption of fish (differentiated by type) and both gestational and neonatal outcomes. Methods: Women who were admitted for delivery in the last 6 months of 2023 were prospectively included and divided according to type of fish consumed (based on DHA and mercury content) and frequency of consumption. Neonatal outcomes included weight, length, head circumference, and 1st and 5th minute Apgar scores. Maternal outcomes were threats of abortion, preterm birth, gestational diabetes and hypertension, cesarean section, and differential body mass index (BMI). Results: Small-size oily fish with high DHA and low mercury content (type B fish) consumption was positively associated with neonatal weight and head circumference, and less weight gain in pregnancy. It was also significantly associated with lower incidences of gestational diabetes and hypertension, and cesarean section. Correlation between differential BMI and monthly consumption of fish resulted in statistical significance, especially in type B fish consumers. Conclusions: The consumption of type B fish was significantly associated with increased neonatal weight and head circumference and better maternal outcomes.
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Affiliation(s)
- Angela Alibrandi
- Department of Economics, University of Messina, 98100 Messina, Italy; (A.A.); (A.Z.); (C.G.); (M.L.); (A.D.P.)
| | - Agata Zirilli
- Department of Economics, University of Messina, 98100 Messina, Italy; (A.A.); (A.Z.); (C.G.); (M.L.); (A.D.P.)
| | - Maria Le Donne
- Unit of Gynecology and Obstetrics, Department of Human Pathology of Adults and Developmental Age, “G. Martino” University Hospital, 98100 Messina, Italy; (M.L.D.); (C.P.); (A.E.)
| | - Carlo Giannetto
- Department of Economics, University of Messina, 98100 Messina, Italy; (A.A.); (A.Z.); (C.G.); (M.L.); (A.D.P.)
| | - Maurizio Lanfranchi
- Department of Economics, University of Messina, 98100 Messina, Italy; (A.A.); (A.Z.); (C.G.); (M.L.); (A.D.P.)
| | - Angelina De Pascale
- Department of Economics, University of Messina, 98100 Messina, Italy; (A.A.); (A.Z.); (C.G.); (M.L.); (A.D.P.)
| | - Chiara Politi
- Unit of Gynecology and Obstetrics, Department of Human Pathology of Adults and Developmental Age, “G. Martino” University Hospital, 98100 Messina, Italy; (M.L.D.); (C.P.); (A.E.)
| | - Giosuè Giordano Incognito
- Department of General Surgery and Medical Surgical Specialties, University of Catania, 95123 Catania, Italy;
| | - Alfredo Ercoli
- Unit of Gynecology and Obstetrics, Department of Human Pathology of Adults and Developmental Age, “G. Martino” University Hospital, 98100 Messina, Italy; (M.L.D.); (C.P.); (A.E.)
| | - Roberta Granese
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, “G. Martino” University Hospital, 98100 Messina, Italy
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2
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Talebi S, Zeraattalab-Motlagh S, Rahimlou M, Sadeghi E, Rashedi MH, Ghoreishy SM, Mohammadi H. Dietary fat intake with risk of gestational diabetes mellitus and preeclampsia: a systematic review and meta-analysis of prospective cohort studies. Nutr Rev 2024:nuae033. [PMID: 38568994 DOI: 10.1093/nutrit/nuae033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
CONTEXT Gestational diabetes mellitus (GDM) and preeclampsia (PE) are commonly observed medical complications in pregnancy. Dietary total fat and fatty acids associated with GDM and PE risk have been examined in several epidemiological studies. In some instances, systematic reviews and meta-analyses might provide more accurate dietary recommendations. OBJECTIVES This systematic review and dose-response meta-analysis was conducted to investigate the association between dietary total fat and fatty acids and the risk of GDM and PE. DATA SOURCES Research on dietary fat intake and the risk of GDM and PE was conducted through systematic searches of the PubMed, Scopus, and Web of Science databases for articles published up to August 19, 2023. An investigation of associations between dietary intake of total fat and fatty acids and the risk of GDM and PE was performed using prospective cohort study designs. RESULTS Twenty-one prospective cohort studies were considered eligible. Findings indicated that higher intakes of total fat (relative risk [RR], 1.08; 95% confidence interval [CI], 1.02-1.14), animal fat (RR, 1.56; 95%CI, 1.34-1.89), vegetable fat (RR, 1.23; 95%CI, 1.05-1.45), dietary cholesterol (RR, 1.48; 95%CI, 1.10-2.00), and omega-3 fatty acid (RR, 1.11; 95%CI, 1.02-1.20) are associated with a greater risk of GDM. However, no significant association was found between dietary total fat and fatty acids and the risk of PE. Dose-response meta-analyses suggested every 10% increment in total energy intake from total fat, 5% from animal fat, 5% from vegetable fat, and 100 mg from cholesterol was related to 15%, 12%, 7%, 14%, and 20% higher GDM risk, respectively. CONCLUSIONS Overall, total fat, animal fat, vegetable fat, dietary cholesterol, and omega-3 fatty acid consumption are associated with a small but statistically significant increase in GDM risk. PROTOCOL REGISTRATION PROSPERO (CRD42023466844).
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Affiliation(s)
- Sepide Talebi
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mehran Rahimlou
- Department of Nutrition, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Erfan Sadeghi
- Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Minoo Hasan Rashedi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Mojtaba Ghoreishy
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
- Student Research Committee, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Hamed Mohammadi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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Pavlidou E, Papadopoulou SK, Alexatou O, Tsourouflis G, Antasouras G, Louka A, Chatziprodromidou IP, Mentzelou M, Sampani A, Chrysafi M, Apostolou T, Dakanalis A, Papadopoulou VG, Giaginis C. Association of Gestational Hypertension with Sociodemographic and Anthropometric Factors, Perinatal Outcomes, Breastfeeding Practices, and Mediterranean Diet Adherence: A Cross-Sectional Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2103. [PMID: 38138206 PMCID: PMC10744616 DOI: 10.3390/medicina59122103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/23/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: Gestational hypertension has been associated with several pregnancy short-term and long-term complications, affecting both the mother and her infant's health. The present study aims to assess the potential association of gestational hypertension with sociodemographic and anthropometry factors, perinatal outcomes, breastfeeding habits, and Mediterranean diet (MD) compliance. Materials and Methods: This is a cross-sectional study conducted on 5271 mothers that was carried out after delivery. The anthropometry characteristics and perinatal outcomes were retrieved from the mothers' medical records. Sociodemographic characteristics, MD adherence, and breastfeeding habits were assessed via one-to-one interviews of the assigned women with qualified staff. Results: Maternal older age, being employed, family history of gestational hypertension, overweight/obesity before gestation, and abnormal gestational weight gain (GWG) independently increased the risk of developing gestational hypertension. Moreover, gestational hypertension was independently related with a greater incidence of abnormal childbirth body weight and preterm birth, not exclusively breastfeeding, and lower levels of MD adherence. Conclusions: This study highlights the importance of informing future mothers about the risk factors of gestational hypertension, underlining also that a healthy lifestyle, which simultaneously includes a healthy nutritional pattern such as MD, may decrease the risk of developing gestational hypertension and the subsequent pregnancy complications.
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Affiliation(s)
- Eleni Pavlidou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Lemnos, Greece; (E.P.); (O.A.); (G.A.); (A.L.); (M.M.); (M.C.)
| | - Sousana K. Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece; (S.K.P.); (V.G.P.)
| | - Olga Alexatou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Lemnos, Greece; (E.P.); (O.A.); (G.A.); (A.L.); (M.M.); (M.C.)
| | - Gerasimos Tsourouflis
- Second Department of Propedeutic Surgery, Medical School, University of Athens, 11527 Athens, Greece;
| | - Georgios Antasouras
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Lemnos, Greece; (E.P.); (O.A.); (G.A.); (A.L.); (M.M.); (M.C.)
| | - Aikaterini Louka
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Lemnos, Greece; (E.P.); (O.A.); (G.A.); (A.L.); (M.M.); (M.C.)
| | | | - Maria Mentzelou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Lemnos, Greece; (E.P.); (O.A.); (G.A.); (A.L.); (M.M.); (M.C.)
| | - Anastasia Sampani
- First Department of Pathology, Medical School, University of Athens, 11527 Athens, Greece;
| | - Maria Chrysafi
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Lemnos, Greece; (E.P.); (O.A.); (G.A.); (A.L.); (M.M.); (M.C.)
| | - Thomas Apostolou
- Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece;
| | - Antonios Dakanalis
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy;
- Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
| | - Vasiliki G. Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece; (S.K.P.); (V.G.P.)
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Lemnos, Greece; (E.P.); (O.A.); (G.A.); (A.L.); (M.M.); (M.C.)
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4
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Herrera E, Ortega-Senovilla H. Dietary Implications of Polyunsaturated Fatty Acids during Pregnancy and in Neonates. Life (Basel) 2023; 13:1656. [PMID: 37629513 PMCID: PMC10455977 DOI: 10.3390/life13081656] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/24/2023] [Accepted: 07/27/2023] [Indexed: 08/27/2023] Open
Abstract
Certain limitations exist for animals to modify fatty acid changes. Besides the role of arachidonic acid (AA), docosahexaenoic acid (DHA) and other 20-carbon long-chain polyunsaturated fatty acids (LCPUFAs) for the synthesis of inflammatory mediators as eicosanoids, different LCPUFAs have many other effects, including their abilities to regulate gene expression and downstream events. LCPUFAs are susceptible to autoxidation, which is prevented by the action of antioxidants in the form of enzymes like superoxide dismutases, catalases and peroxidases, as well as antioxidant compounds that protect against oxidation or repair the damage caused. Under normal conditions, the fetus needs both essential fatty acids (EFAs) and LCPUFAs, which are obtained from its mother by placental transfer. In early pregnancy, dietary derived fatty acids are accumulated in maternal adipose tissue. However, during late pregnancy, corresponding to the period of the highest fetal growth, maternal adipose tissue becomes catabolic and LCPUFAs are released into the circulation by adipose lipolytic activity. The released LCPUFAs are taken up by maternal liver to be esterified and released back to the circulation as triacylglycerides (TAGs) in very-low-density lipoprotein (VLDL) that become available to the placenta to be transferred to the fetus in the form of non-esterified fatty acids (NEFAs). An enhanced adipose tissue lipolysis is maintained around parturition and esterified LCPUFAs are diverted to mammary glands thanks to an increased activity of lipoprotein lipase for milk production. Throughout this process, LCPUFAs become available to the newborn during suckling. The important role of both DHA and AA for the development of the nervous system and for growth has motivated their dietary supplement during different postnatal stages. This has been especially important in preterm infants both because under normal conditions, the fetus acquires most of these fatty acids during late pregnancy, and because the immaturity of the enzyme systems for the synthesis of AA and DHA from their respective EFAs.
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Affiliation(s)
- Emilio Herrera
- Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, 28660 Madrid, Spain
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Chen B, Dong S. Mercury Contamination in Fish and Its Effects on the Health of Pregnant Women and Their Fetuses, and Guidance for Fish Consumption-A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15929. [PMID: 36498005 PMCID: PMC9739465 DOI: 10.3390/ijerph192315929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/25/2022] [Accepted: 11/25/2022] [Indexed: 06/17/2023]
Abstract
As a principal source of long-chain omega-3 fatty acids (3FAs), which provide vital health benefits, fish consumption also comes with the additional benefit of being rich in diverse nutrients (e.g., vitamins and selenium, high in proteins and low in saturated fats, etc.). The consumption of fish and other seafood products has been significantly promoted universally, given that fish is an important part of a healthy diet. However, many documents indicate that fish may also be a potential source of exposure to chemical pollutants, especially mercury (Hg) (one of the top ten chemicals or groups of chemicals of concern worldwide), and this is a grave concern for many consumers, especially pregnant women, as this could affect their fetuses. In this review, the definition of Hg and its forms and mode of entrance into fish are introduced in detail and, moreover, the bio-accumulation of Hg in fish and its toxicity and action mechanisms on fish and humans, especially considering the health of pregnant women and their fetuses after the daily intake of fish, are also reviewed. Finally, some feasible and constructive suggestions and guidelines are recommended for the specific group of pregnant women for the consumption of balanced and appropriate fish diets in a rational manner.
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Affiliation(s)
- Bojian Chen
- Food Science and Engineering, Haide College, Ocean University of China, Qingdao 266100, China
| | - Shiyuan Dong
- College of Food Science and Technology, Ocean University of China, Qingdao 266003, China
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6
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Kinshella MLW, Omar S, Scherbinsky K, Vidler M, Magee LA, von Dadelszen P, Moore SE, Elango R. Maternal nutritional risk factors for pre-eclampsia incidence: findings from a narrative scoping review. Reprod Health 2022; 19:188. [PMID: 36064716 PMCID: PMC9442926 DOI: 10.1186/s12978-022-01485-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 07/21/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Pre-eclampsia is a leading cause of maternal mortality and morbidity that involves pregnancy-related stressors on the maternal cardiovascular and metabolic systems. As nutrition is important to support optimal development of the placenta and for the developing fetus, maternal diets may play a role in preventing pre-eclampsia. The purpose of this scoping review is to map the maternal nutritional deficiencies and imbalances associated with pre-eclampsia incidence and discuss evidence consistency and linkages with current understandings of the etiology of pre-eclampsia. METHODS A narrative scoping review was conducted to provide a descriptive account of available research, summarize research findings and identify gaps in the evidence base. Relevant observational studies and reviews of observational studies were identified in an iterative two-stage process first involving electronic database searches then more sensitive searches as familiarity with the literature increased. Results were considered in terms of their consistency of evidence, effect sizes and biological plausibility. RESULTS The review found evidence for associations between nutritional inadequacies and a greater risk of pre-eclampsia. These associations were most likely mediated through oxidative stress, inflammation, maternal endothelial dysfunction and blood pressure in the pathophysiology of pre-eclampsia. Maternal nutritional risk factors for pre-eclampsia incidence with the strongest consistency, effect and biological plausibility include vitamin C and its potential relationship with iron status, vitamin D (both on its own and combined with calcium and magnesium), and healthy dietary patterns featuring high consumption of fruits, vegetables, whole grains, fish, seafood and monounsaturated vegetable oils. Foods high in added sugar, such as sugary drinks, were associated with increased risk of pre-eclampsia incidence. CONCLUSION A growing body of literature highlights the involvement of maternal dietary factors in the development of pre-eclampsia. Our review findings support the need for further investigation into potential interactions between dietary factors and consideration of nutritional homeostasis and healthy dietary patterns. Further research is recommended to explore gestational age, potential non-linear relationships, dietary diversity and social, cultural contexts of food and meals.
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Affiliation(s)
- Mai-Lei Woo Kinshella
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada
| | - Shazmeen Omar
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada
| | - Kerri Scherbinsky
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada
- Department of Pediatrics, Rm170, BC Children's and Women's Hospital, University of British Columbia, 950 West 28th Avenue, Vancouver, Canada
| | - Marianne Vidler
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada
| | - Laura A Magee
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada
- Department of Women & Children's Health, King's College London, London, UK
| | - Peter von Dadelszen
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada
- Department of Women & Children's Health, King's College London, London, UK
| | - Sophie E Moore
- Department of Women & Children's Health, King's College London, London, UK
- MRC Unit The Gambia at the London, School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Rajavel Elango
- Department of Pediatrics, Rm170, BC Children's and Women's Hospital, University of British Columbia, 950 West 28th Avenue, Vancouver, Canada.
- School of Population and Public Health, University of British Columbia, Vancouver, Canada.
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7
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Arvizu M, Minguez-Alarcon L, Wang S, Mitsunami M, Stuart JJ, Rich-Edwards JW, Rosner B, Chavarro JE. Pre-pregnancy fat intake in relation to hypertensive disorders of pregnancy. Am J Clin Nutr 2022; 116:750-758. [PMID: 35575613 PMCID: PMC9437979 DOI: 10.1093/ajcn/nqac145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/16/2022] [Accepted: 05/12/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Many studies have linked intakes of fat and of specific fatty acids during pregnancy with preeclampsia; however, information on the association of intake before pregnancy with hypertensive disorders of pregnancy (HDP) is scant. OBJECTIVES We evaluated the associations of intakes of major and specific types of fat before pregnancy with the risks of HDP, including preeclampsia and gestational hypertension (GHTN). METHODS We followed 11,535 women without chronic disease participating in the Nurses' Health Study II from 1991 and 2009. Pre-pregnancy dietary fat was assessed by an FFQ. Intakes of total fat, saturated fat, trans fatty acid (TFA), MUFAs, PUFAs, and fat subtypes (omega-3 and omega-6) were categorized into quintiles of intake. HDP were self-reported. The RRs (95% CIs) of HDP were estimated by log-binomial generalized estimating equation regression models, with an exchangeable correlation matrix to account for repeated pregnancies while adjusting for potential confounders. RESULTS During 19 years of follow-up, there were 495 cases of preeclampsia (2.9%) and 561 (3.3%) cases of GHTN in 16,892 singleton pregnancies. The mean age at pregnancy was 34.6 years (SD, 3.9 years). Among major fat types, only pre-pregnancy TFA was related to a higher risk of HDP (RR, 1.32; 95% CI: 1.05-1.66), and only for preeclampsia (RR, 1.50; 95% CI: 1.07-2.10) but not for GHTN (RR, 1.21; 95% CI: 0.87-1.70). Among specific types of PUFAs, intake of arachidonic acid was positively related with GHTN (RR, 1.43; 95% CI: 1.00-2.04) but not preeclampsia (RR, 1.08; 95% CI: 0.75-1.57). In analyses restricted to pregnancies 1 year after the diet assessment, women with the highest intake of long-chain omega-3 fatty acids had a 31% lower risk of HDP (95% CI: 3%-51%), which was driven by preeclampsia (RR, 0.55; 95% CI: 0.33-0.92). CONCLUSIONS Pre-pregnancy intakes of total fat, saturated fat, and MUFA were unrelated to HDP, whereas TFA was positively related to HDP. These findings highlight the importance of ongoing efforts to eliminate TFA from the global food supply.
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Affiliation(s)
- Mariel Arvizu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Lidia Minguez-Alarcon
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Siwen Wang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Makiko Mitsunami
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jennifer J Stuart
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Janet W Rich-Edwards
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Bernard Rosner
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jorge E Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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8
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Simmonds LA, Sullivan TR, Skubisz M, Middleton PF, Best KP, Yelland LN, Quinlivan J, Zhou SJ, Liu G, McPhee AJ, Gibson RA, Makrides M. Omega-3 fatty acid supplementation in pregnancy-baseline omega-3 status and early preterm birth: exploratory analysis of a randomised controlled trial. BJOG 2020; 127:975-981. [PMID: 32034969 DOI: 10.1111/1471-0528.16168] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To identify a polyunsaturated fatty acid (PUFA) biomarker able to detect which women with singleton pregnancies are most likely to benefit from omega-3 supplementation to reduce their risk of early preterm birth. DESIGN Exploratory analysis of a randomised controlled trial. SETTING Six Australian hospitals. POPULATION Women with a singleton pregnancy enrolled in the ORIP trial. METHODS Using maternal capillary whole blood collected ~14 weeks' gestation, the fatty acids in total blood lipids were quantified using gas chromatography. Interaction tests examined whether baseline PUFA status modified the effect of omega-3 supplementation on birth outcomes. MAIN OUTCOME MEASURE Early preterm birth (<34 weeks' gestation). RESULTS A low total omega-3 PUFA status in early pregnancy was associated with a higher risk of early preterm birth. Among women with a total omega-3 status ≤4.1% of total fatty acids, omega-3 supplementation substantially reduced the risk of early preterm birth compared with control (0.73 versus 3.16%; relative risk = 0.23, 95% confidence interval [CI] 0.07-0.79). Conversely, women with higher total omega-3 status in early pregnancy were at lower risk of early preterm birth. Supplementing women with a baseline status above 4.9% increased early preterm birth (2.20 versus 0.97%; relative risk = 2.27, 95% CI 1.13-4.58). CONCLUSIONS Women with singleton pregnancies and low total omega-3 PUFA status early in pregnancy have an increased risk of early preterm birth and are most likely to benefit from omega-3 supplementation to reduce this risk. Women with higher total omega-3 status are at lower risk and additional omega-3 supplementation may increase their risk. TWEETABLE ABSTRACT Low total omega-3 fat status helps identify which women benefit from extra omega-3 to reduce early prematurity.
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Affiliation(s)
- L A Simmonds
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - T R Sullivan
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - M Skubisz
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.,Department of Obstetrics and Gynaecology, Women's and Children's Hospital, North Adelaide, SA, Australia
| | - P F Middleton
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.,School of Medicine, The University of Adelaide, Adelaide, SA, Australia
| | - K P Best
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.,School of Medicine, The University of Adelaide, Adelaide, SA, Australia
| | - L N Yelland
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.,School of Public Health, The University of Adelaide, Adelaide, SA, Australia
| | - J Quinlivan
- The Institute of Health Research, University of Notre Dame, Fremantle, WA, Australia
| | - S J Zhou
- The School of Agriculture, Food and Wine, The University of Adelaide, Adelaide, SA, Australia
| | - G Liu
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.,The School of Agriculture, Food and Wine, The University of Adelaide, Adelaide, SA, Australia
| | - A J McPhee
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.,Neonatal Services, Women's and Children's Hospital, North Adelaide, SA, Australia
| | - R A Gibson
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.,The School of Agriculture, Food and Wine, The University of Adelaide, Adelaide, SA, Australia
| | - M Makrides
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.,School of Medicine, The University of Adelaide, Adelaide, SA, Australia
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9
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Burchakov DI, Kuznetsova IV, Uspenskaya YB. Omega-3 Long-Chain Polyunsaturated Fatty Acids and Preeclampsia: Trials Say "No," but Is It the Final Word? Nutrients 2017; 9:E1364. [PMID: 29244779 PMCID: PMC5748814 DOI: 10.3390/nu9121364] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 11/30/2017] [Accepted: 12/01/2017] [Indexed: 02/04/2023] Open
Abstract
Preeclampsia is a dangerous disorder of pregnancy, defined as hypertension with proteinuria. Its nature remains elusive, and measures of prevention and treatment are limited. Observational studies have suggested that preeclampsia is associated with low intake of omega-3 long-chain polyunsaturated fatty acids (LCPUFA). In recent decades, researchers studied LCPUFA supplementation as a measure to prevent preeclampsia. Most of these trials and later systematic reviews yielded negative results. However, these trials had several important limitations associated with heterogeneity and other issues. Recent research suggests that preeclampsia trials should take into consideration the gender of the fetus (and thus sexual dimorphism of placenta), the positive effect of smoking on preeclampsia prevalence, and the possibility that high doses of LCPUFA mid-term or later may promote the disorder instead of keeping it at bay. In this review, we discuss these issues and future prospects for LCPUFA in preeclampsia research.
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Affiliation(s)
- Denis I Burchakov
- Clinic of Obstetrics and Gynecology n.a. V.F. Snegirev, Department of Obstetrics and Gynecology No. 1, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8-2 Trubetskaya st., 119991 Moscow, Russia.
| | - Irina V Kuznetsova
- Clinic of Obstetrics and Gynecology n.a. V.F. Snegirev, Department of Obstetrics and Gynecology No. 1, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8-2 Trubetskaya st., 119991 Moscow, Russia.
| | - Yuliya B Uspenskaya
- Clinic of Obstetrics and Gynecology n.a. V.F. Snegirev, Department of Obstetrics and Gynecology No. 1, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8-2 Trubetskaya st., 119991 Moscow, Russia.
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Umesawa M, Kobashi G. Epidemiology of hypertensive disorders in pregnancy: prevalence, risk factors, predictors and prognosis. Hypertens Res 2016; 40:213-220. [PMID: 27682655 DOI: 10.1038/hr.2016.126] [Citation(s) in RCA: 294] [Impact Index Per Article: 36.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 07/24/2016] [Accepted: 08/02/2016] [Indexed: 02/08/2023]
Abstract
Hypertensive disorders in pregnancy (HDP) represent some of the most important problems faced by public health because HDP is a major cause of maternal and prenatal morbidity and mortality. Several epidemiological studies have been performed to determine the prevalence and risk factors of HDP as well as its subtypes. The prevalences of HDP, gestational hypertension and preeclampsia are 5.2-8.2%, 1.8-4.4% and 0.2-9.2%, respectively. Body mass index, anemia and lower education appear to be modifiable risk factors for HDP. Maternal age, primiparous, multiple pregnancy, HDP in previous pregnancy, gestational diabetes mellitus, preexisting hypertension, preexisting type 2 diabetes mellitus, preexisting urinary tract infection and a family history of hypertension, type 2 diabetes mellitus and preeclampsia appear to be nonmodifiable risk factors. Genetic variants including a single-nucleotide polymorphism in the angiotensinogen gene have also been reported to be nonmodifiable risk factors. Epidemiological studies have recently examined the associations between a history of HDP and its subtypes and future risks of other diseases. These studies have reported associations between a history of HDP and a risk of coronary heart disease, heart failure, dysrhythmia, stroke, hypertension, diabetes mellitus, end-stage renal dysfunction and cardiomyopathy. HDP is not associated with the future incidence of total cancer. In conclusion, HDP is not a rare complication of pregnancy and the influence of HDP remains for an extended duration. Physicians should consider the effects of HDP when treating chronic diseases in women.
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Affiliation(s)
- Mitsumasa Umesawa
- Department of Public Health, Dokkyo Medical University, School of Medicine, Tochigi, Japan
| | - Gen Kobashi
- Department of Public Health, Dokkyo Medical University, School of Medicine, Tochigi, Japan
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11
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The Impact of Macronutrients on Retinal Microvasculature among Singapore Pregnant Women during the Mid-Late Gestation. PLoS One 2016; 11:e0160704. [PMID: 27508392 PMCID: PMC4979959 DOI: 10.1371/journal.pone.0160704] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 07/22/2016] [Indexed: 01/11/2023] Open
Abstract
Background Imbalanced macronutrient intakes can induce impairment of endothelial and vascular function, and further lead to metabolic and cardiovascular disease. However, little is known about the influence of such diets on endothelial and vascular dysfunction in pregnant women, even though high-fat diet is a known risk for pregnancy complications such as gestational diabetes and pre-eclampsia. Objective We aimed to assess the association between maternal macronutrient intakes (protein, fat and carbohydrates), dietary quality and retinal microvascular changes in a multi-ethnic Asian mother-offspring cohort. Methods Pregnant women (n = 614) with singleton pregnancies were recruited during their first trimester from June 2009 to Sep 2010. Maternal diet quality and macronutrient intakes, expressed as a percentage of total energy during pregnancy, were ascertained using 24 hr recalls and 3 d food diaries at 26–28 weeks gestation. Retinal examination was completed at the same clinic visit. Dietary quality was assessed and scored using the Health Eating Index in Asian Pregnant women (HEI-AP), while macronutrients intakes ware expressed as percentages of total energy and further log transformed for analysis. Associations were examined cross-sectionally by substitution models with the use of multiple linear regression. Results In adjusted model, each 20 points decrease in HEI-AP score was associated with a significant increase of 1.70 μm (p<0.05) in retinal venular calibre. Each 0.1 log increase in percentage of total fat intake was associated with a significant increment of 1.84 μm (p<0.05) in retinal venular caliber. Additionally, each 0.1 log increase in percentage of mono-unsaturated fat intake was associated with an increment of 1.84 μm (p<0.01) in retinal venular caliber. Conclusions In this cross-sectional study, we found that women with higher fat and lower protein intakes, and lower diet quality tended to have wider retinal venular caliber, which is suggestive of suboptimal microvasculature.
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Costa ML. Preeclampsia: Reflections on How to Counsel About Preventing Recurrence. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2016; 37:887-93. [PMID: 26606702 DOI: 10.1016/s1701-2163(16)30023-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Preeclampsia is one of the most challenging diseases of pregnancy, with unclear etiology, no specific marker for prediction, and no precise treatment besides delivery of the placenta. Many risk factors have been identified, and diagnostic and management tools have improved in recent years. However, this disease remains one of the leading causes of maternal morbidity and mortality worldwide, especially in under-resourced settings. A history of previous preeclampsia is a known risk factor for a new event in a future pregnancy, with recurrence rates varying from less than 10% to 65%, depending on the population or methodology considered. A recent review that performed an individual participant data meta-analysis on the recurrence of hypertensive disorders of pregnancy in over 99 000 women showed an overall recurrence rate of 20.7%; when specifically considering preeclampsia, it was 13.8%, with milder disease upon recurrence. Prevention of recurrent preeclampsia has been attempted by changes in lifestyle, dietary supplementation, antihypertensive drugs, antithrombotic agents, and others, with much uncertainty about benefit. It is always challenging to treat and counsel a woman with a previous history of preeclampsia; this review will be based on hypothetical clinical cases, using common scenarios in obstetrical practice to consider the available evidence on how to counsel each woman during pre-conception and prenatal consultations.
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Affiliation(s)
- Maria Laura Costa
- Department of Obstetrics and Gynecology, University of Campinas (UNICAMP), School of Medicine, Campinas, São Paulo, Brazil
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Le Donne M, Alibrandi A, Vita R, Zanghì D, Triolo O, Benvenga S. Does eating oily fish improve gestational and neonatal outcomes? Findings from a Sicilian study. Women Birth 2016; 29:e50-7. [PMID: 26837604 DOI: 10.1016/j.wombi.2015.12.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 12/29/2015] [Accepted: 12/29/2015] [Indexed: 01/14/2023]
Abstract
BACKGROUND Fish is a source of long-chain polyunsaturated n-3 fatty acids, but it may also contain a number of pollutants. METHODS Between April and July 2013, we selected 114 women who gave birth to living babies, and divided them according to type and frequency of the fish consumed. We evaluated both gestational and neonatal outcomes. Docosahexaenoic acid (DHA) supplementation was taken into account. FINDINGS One hundred and four women (91.2%) consumed fish on the average of 4.7 times/month, while 10 (8.8%) did not consume fish at all. Fifty-nine women (51.8%) were taking supplements containing DHA (200mg/day), almost all of whom (n=55) consumed fish. Pregnancy induced hypertension was more frequent in non-fish eaters than in fish eaters (20% vs 4.8%, P=0.056). Consumption of small size oily fish correlated positively with both neonatal weight (r=0.195, P=0.037) and head circumference (r=0.211, P=0.024). In contrast, consumption of lean fish or shellfish correlated negatively with neonatal head circumference (r=0.206, P=0.028, or r=0.192, P=0.041). DISCUSSION These data agree with previous observational studies and reinforce the protective role of small oily fish consumption on preterm birth risk, neonatal weight, length and head circumference. CONCLUSION Small oily fish consumption should be favored over other types of fish.
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Affiliation(s)
- Maria Le Donne
- Department of Pediatrics, Gynecology, Microbiology and Biomedical Sciences, University of Messina School of Medicine, Messina 98125, Italy.
| | | | - Roberto Vita
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Delia Zanghì
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Onofrio Triolo
- Department of Pediatrics, Gynecology, Microbiology and Biomedical Sciences, University of Messina School of Medicine, Messina 98125, Italy
| | - Salvatore Benvenga
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy; Master Program on Childhood, Adolescent and Women's Endocrine Health, University of Messina School of Medicine, Messina, Italy; Interdepartmental Program of Clinical and Molecular Endocrinology & Women's Endocrine Health, University Hospital Policlinico G. Martino, Messina 98125, Italy
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Abstract
OBJECTIVE To investigate associations of maternal periconceptional shellfish, lean fish and fatty fish intake with risk of pregnancy complications. DESIGN In this prospective cohort study, we collected information on intake of seafood subtypes using FFQ. We categorized seafood intake into frequencies of 1 servings/week. We ascertained gestational hypertension, pre-eclampsia, gestational diabetes and preterm birth diagnoses from medical records. Using generalized linear models with a log link, the Poisson family and robust standard errors, we estimated risk ratios and 95 % confidence intervals across seafood intake categories. SETTING The Omega study, a study of risk factors for pregnancy complications among women recruited from prenatal clinics in Washington State, USA, 1996-2008. SUBJECTS The current study included 3279 participants from the Omega study. RESULTS Median (interquartile range) shellfish, lean fish and fatty fish intake was 0·3 (0-0·9), 0·5 (0-1·0) and 0·5 (0·1-1·0) servings/week, respectively. Lean fish intake of >1 servings/week (v. <0·2 servings/month) was associated with a 1·55-fold higher risk of preterm birth (95 % CI 1·04, 2·30) and was not associated with the other pregnancy complications. Higher intake of seafood (total or other subtypes) was not associated with pregnancy complications (separately or combined). CONCLUSIONS Higher intake of lean fish, but not fatty fish or shellfish, was associated with a higher risk of preterm birth; these findings may have significance for preterm birth prevention. Studies of mechanisms and potential contributing factors (including seafood preparation and nutrient/contaminant content) are warranted.
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15
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Lim WY, Chong M, Calder PC, Kwek K, Chong YS, Gluckman PD, Godfrey KM, Saw SM, Pan A. Relations of plasma polyunsaturated Fatty acids with blood pressures during the 26th and 28th week of gestation in women of Chinese, Malay, and Indian ethnicity. Medicine (Baltimore) 2015; 94:e571. [PMID: 25738474 PMCID: PMC4553961 DOI: 10.1097/md.0000000000000571] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Observational and intervention studies have reported inconsistent results of the relationship between polyunsaturated fatty acids (PUFAs) and hypertension during pregnancy. Here, we examined maternal plasma concentrations of n-3 and n-6 PUFAs between the 26th and the 28th week of gestation in relation to blood pressures and pregnancy-associated hypertension.We used data from a birth cohort study of 751 Chinese, Malay, and Indian women. Maternal peripheral systolic blood pressure (SBP) and diastolic blood pressure (DBP) were taken from the brachial arm, and central SBP and pulse pressures (PPs) were derived from radial artery pressure waveforms between the 26th and the 28th week of gestation. Pregnancy-associated hypertension (including gestational hypertension and preeclampsia) was ascertained from medical records. Plasma phosphatidylcholine n-3 and n-6 PUFAs were measured by gas chromatography and expressed as percentage of total fatty acids.Peripheral SBP was inversely associated with total n-3 PUFAs [-0.51 (95% confidence interval, CI, -0.89 to -0.13) mm Hg] and long-chain n-3 PUFAs [-0.52 (CI -0.92 to -0.13) mmHg]. Similar but weaker associations were observed for central SBP and PP. Dihomo-γ-linolenic acid was marginally positively associated with peripheral SBP, central SBP, and PP, whereas linoleic acid and total n-6 PUFAs showed no significant associations with blood pressures. We identified 28 pregnancy-associated hypertension cases, and 1% increase in total n-3 PUFAs was associated with a 24% lower odds of pregnancy-associated hypertension (odds ratio 0.76; 95% CI 0.60 to 0.97). Maternal ethnicity modified the PUFAs-blood pressure relations, with stronger inverse associations with n-3 PUFAs in Chinese women, and stronger positive associations with n-6 PUFAs in Indian women (P values for interaction ranged from 0.02 to 0.07).Higher n-3 PUFAs at midgestation are related to lower maternal blood pressures and pregnancy-associated hypertension in Asian women, and the ethnicity-related variation between PUFAs and blood pressures deserves further investigation.
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Affiliation(s)
- Wai-Yee Lim
- From the Saw Swee Hock School of Public Health (WYL, SMS, AP), National University of Singapore and National University Health System; KK Women's and Children's Hospital (WYL, KK); Singapore Institute for Clinical Sciences (MC, YSC, PDG), ASTAR; Clinical Nutrition Research Centre (MC, YSC, PDG), Singapore Institute for Clinical Sciences, ASTAR and National University Health System; Department of Paediatrics (MC), Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore; Faculty of Medicine (PCC, KMG), Human Development and Health Academic Unit, University of Southampton; NIHR Southampton Biomedical Research Centre (PCC, KMG), University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK; Department of Biological Sciences (PCC), Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia; Yong Loo Lin School of Medicine (KK, SMS, AP); Department of Obstetrics and Gynecology (YSC), Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore; Liggins Institute (PDG), University of Auckland, Auckland, New Zealand; and Medical Research Council Lifecourse Epidemiology Unit (KMG), University of Southampton, Southampton, UK
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Schoenaker DAJM, Soedamah-Muthu SS, Mishra GD. The association between dietary factors and gestational hypertension and pre-eclampsia: a systematic review and meta-analysis of observational studies. BMC Med 2014; 12:157. [PMID: 25241701 PMCID: PMC4192458 DOI: 10.1186/s12916-014-0157-7] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 08/19/2014] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Dietary factors have been suggested to play a role in the prevention of hypertensive disorders of pregnancy (HDP), including gestational hypertension and pre-eclampsia, but inconsistent findings have been reported. A systematic review and meta-analyses were performed to synthesize evidence from observational studies of reproductive-aged women on the association between dietary factors and HDP. METHODS MEDLINE and EMBASE were searched to identify studies published until the end of May 2014. Studies were included if they were observational studies of reproductive-age women and reported results on dietary factors (energy, nutrients, foods or overall dietary patterns, alone or in combination with dietary supplements) and gestational hypertension and/or pre-eclampsia. Studies were excluded if they reported on supplements not in combination with dietary intake, or examined a biomarker of dietary intake. Random effects meta-analyses were performed on calculated weighted mean differences (WMD) of dietary intake between cases and non-cases, and effect estimates were pooled. RESULTS In total, 23 cohort and 15 case-control studies were identified for systematic review, of which 16 could be included in the meta-analyses. Based on meta-analyses of cohort studies, unadjusted energy intake was higher for pre-eclampsia cases (WMD 46 kcal/day, 95% confidence interval (CI) -13.80 to 106.23; I 2 = 23.9%, P = 0.26), although this was not statistically significant. Unadjusted intakes of magnesium (WMD 8 mg/day, 95% CI -13.99 to -1.38; I 2 = 0.0%, P = 0.41) and calcium (WMD 44 mg/day, 95% CI -84.31 to -3.62, I 2 = 51.1%, P = 0.03) were lower for the HDP cases, compared with pregnant women without HDP. Higher calcium intake consistently showed lower odds for HDP after adjustment for confounding factors (OR = 0.76, 95% CI 0.57 to 1.01, I 2 = 0.0%, P = 0.79). A few studies examining foods and dietary patterns suggested a beneficial effect of a diet rich in fruit and vegetables on pre-eclampsia, although not all the results were statistically significant. CONCLUSIONS Based on a limited number of studies, higher total energy and lower magnesium and calcium intake measured during pregnancy were identified as related to HDP. Further prospective studies are required to provide an evidence base for development of preventive health strategies, particularly focusing on dietary factors during pre-pregnancy and early pregnancy.
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Affiliation(s)
| | | | - Gita D Mishra
- />School of Population Health, University of Queensland, Brisbane, Queensland Australia
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Barrett HL, Dekker Nitert M, McIntyre HD, Callaway LK. Maternal lipids in pre-eclampsia: innocent bystander or culprit? Hypertens Pregnancy 2014; 33:508-23. [PMID: 25121342 DOI: 10.3109/10641955.2014.946614] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Pre-eclampsia continues to be a challenge--to understand the underlying pathogenesis and to prevent or treat in the clinical setting. One area of potential therapies opening up is treatment of maternal lipids and clinical trials are underway using statins in early pre-eclampsia. At present, most potential therapies to treat lipids cannot be recommended for general use in pregnancy and if we were to target maternal lipids to reduce rates of pre-eclampsia, very large numbers of women may need to be treated. Prior to reaching that point, we first need to understand whether maternal lipids are pathogenic in the processes underlying pre-eclampsia. The aim of this review is to examine the role of lipids in the pathogenesis and outcomes of pre-eclampsia, how abnormal lipid genes may be implicated and consider whether treatment of hyperlipidemia has a more general place in the prevention or treatment of pre-eclampsia.
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Affiliation(s)
- Helen L Barrett
- School of Medicine, The University of Queensland, St Lucia , Queensland , Australia
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18
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dos Santos Q, Sichieri R, Marchioni DML, Verly Junior E. Brazilian pregnant and lactating women do not change their food intake to meet nutritional goals. BMC Pregnancy Childbirth 2014; 14:186. [PMID: 24890188 PMCID: PMC4049461 DOI: 10.1186/1471-2393-14-186] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 05/28/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nutritional requirements are increased during pregnancy and lactation. The aim of this study was to compare the food intake and prevalence of inadequate nutrient intake among pregnant, lactating and reproductive-age women. METHODS Two-day dietary records of 322 pregnant and 751 lactating women were compared to those of 6837 non-pregnant and non-lactating women aged 19 to 40 years from a nationwide representative sample. The usual nutrient intake was estimated using the National Cancer Institute method, and compared to nutritional goals to estimate prevalence of inadequate intake. RESULTS Pregnant, lactating and reproductive-age women did not differ in their average consumption of 18 food groups, except for rice, with greatest intake among lactating women. The prevalence of nutrient inadequacy in pregnant women was higher than in reproductive-age women for folate (78% versus 40%) and vitamin B6 (59% versus 33%). In lactating women, prevalence was higher than in reproductive-age women for vitamin A (95% versus 72%), vitamin C (56% versus 37%), vitamin B6 (75% vs. 33%), folate (72% versus 40%) and zinc (64% versus 20%). The percentage of sodium intake above the upper limit was greater than 70% in the three groups. CONCLUSIONS Inadequate intake is frequent in women and increases during pregnancy and lactation, because women do not change their food intake. Guidelines should stimulate healthy food intake for women across the lifespan.
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Affiliation(s)
- Quenia dos Santos
- Institute of Social Medicine, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, Maracanã, Rio de Janeiro 20550-900, Brazil
| | - Rosely Sichieri
- Institute of Social Medicine, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, Maracanã, Rio de Janeiro 20550-900, Brazil
| | - Dirce ML Marchioni
- Department of Nutrition, School of Public Health, University of São Paulo, Av Doutor Arnaldo 715, São Paulo 01246-904, Brazil
| | - Eliseu Verly Junior
- Institute of Social Medicine, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, Maracanã, Rio de Janeiro 20550-900, Brazil
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Kazemian E, Dorosty-Motlagh AR, Sotoudeh G, Eshraghian MR, Ansary S, Omidian M. Nutritional status of women with gestational hypertension compared with normal pregnant women. Hypertens Pregnancy 2014; 32:146-56. [PMID: 23725080 DOI: 10.3109/10641955.2013.784782] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Some evidence indicated the role of nutrition in the development of hypertensive disorders of pregnancy. METHODS This case-control study was conducted on 113 women with gestational hypertension and 150 healthy pregnant women referred to Shahid Akbarabadi Hospital in Tehran. A demographic questionnaire was filled out for all participants. A validated semi-quantitative food frequency questionnaire was used to assess the dietary intakes of the study subjects. All nutrients were adjusted for total energy intake. Logistic regression was used to find the association of energy and nutrient intakes with gestational hypertension. RESULTS We found that higher intakes of energy (OR, 1.33; 95% CI: 1.17-1.52), monounsaturated fatty acids (OR, 1.34; 95% CI: 1.03-1.74) and polyunsaturated fatty acids (OR, 1.26; 95% CI: 1.00-1.54) were positively associated with the risk of gestational hypertension after adjustment for confounders. We also observed decreased odds of gestational hypertension with increased intakes of vitamin C (OR, 0.87; 95% CI: 0.81-0.94), potassium (OR, 0.45; 95% CI: 0.28-0.71) and magnesium (OR, 0.68; 95% CI: 0.51-0.89). CONCLUSION This study demonstrates higher intakes of energy, monounsaturated fatty acids and polyunsaturated fatty acids as well as lower intakes of vitamin C, potassium and magnesium are positively correlated with the risk of developing gestational hypertension.
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Affiliation(s)
- Elham Kazemian
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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Gómez MF, Field CJ, Olstad DL, Loehr S, Ramage S, McCargar LJ. Use of micronutrient supplements among pregnant women in Alberta: results from the Alberta Pregnancy Outcomes and Nutrition (APrON) cohort. MATERNAL AND CHILD NUTRITION 2013; 11:497-510. [PMID: 23557540 DOI: 10.1111/mcn.12038] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Maternal nutrient intake in the prenatal period is an important determinant of fetal growth and development and supports maternal health. Many women, however, fail to meet their prenatal nutrient requirements through diet alone and are therefore advised to consume nutrient supplements. The purpose of this study was to describe the use of natural health products (NHP) by pregnant women in each trimester of pregnancy. Women (n = 599) participating in the first cohort of the Alberta Pregnancy Outcomes and Nutrition (APrON) study completed an interviewer-administered supplement intake questionnaire during each trimester of pregnancy. NHP use was high, with >90% taking multivitamin/mineral supplements, and nearly half taking at least one additional single-nutrient supplement. Compliance with supplementation guidelines was high for folic acid (>90%), vitamin D (∼70%) and calcium (∼80%), but low for iron (<30%) and for all four nutrients together (≤11%). On average, women met or exceeded the recommended dietary allowance for folic acid, vitamin D and iron from NHPs alone, with median daily intakes of 1000 μg, 400 IU and 27 mg, respectively. The median calcium intake was 250 mg d(-1) . Up to 26% of women exceeded the tolerable upper intake level for folic acid and up to 19% did so for iron at some point of their pregnancy. Findings highlight the need to consider both dietary and supplemental sources of micronutrients when assessing the nutrient intakes of pregnant women.
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Affiliation(s)
- Mariel Fajer Gómez
- Alberta Institute for Human Nutrition, University of Alberta, Edmonton, Alberta, Canada.,Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Catherine J Field
- Alberta Institute for Human Nutrition, University of Alberta, Edmonton, Alberta, Canada.,Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada.,Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Dana Lee Olstad
- Alberta Institute for Human Nutrition, University of Alberta, Edmonton, Alberta, Canada.,Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada.,School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Sarah Loehr
- Alberta Institute for Human Nutrition, University of Alberta, Edmonton, Alberta, Canada.,Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Stephanie Ramage
- Alberta Institute for Human Nutrition, University of Alberta, Edmonton, Alberta, Canada.,Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Linda J McCargar
- Alberta Institute for Human Nutrition, University of Alberta, Edmonton, Alberta, Canada.,Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
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Dietary intake in pregnant women in a Spanish Mediterranean area: as good as it is supposed to be? Public Health Nutr 2012; 16:1379-89. [PMID: 22877515 DOI: 10.1017/s1368980012003643] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To assess food and nutrient intakes and compliance with nutritional recommendations in pregnant women according to selected sociodemographic characteristics. DESIGN Cross-sectional study based on data from the INMA-Valencia cohort (Spain), which recruited pregnant women between 2004 and 2005. Information on maternal sociodemographics and anthropometry was collected. Dietary intake was assessed through an FFQ. Intakes of foods were compared with Spanish food-based dietary guidelines. Intake inadequacy for nutrients was assessed using the Dietary Reference Intakes of the US Institute of Medicine. SETTING Valencia, Spain. SUBJECTS We studied 822 pregnant women who had information on dietary intake during their first trimester of pregnancy. RESULTS More than 50% of pregnant women did not meet the guidelines for cereals and legumes; reported intakes of carbohydrates, n-3 and n-6 fatty acids were below recommendations and exceeded the total fat intake according to dietary references. Dietary inadequacy for folate, Fe and vitamin E ranged from 99% to 68%. Vegetable intake was related to age only. Younger and less educated women showed lower intakes of protein and n-3 fatty acids and higher intakes of trans-fatty acids as well as greater inadequacy for micronutrients. Spanish women reported lower intakes of fruit and carbohydrates and higher intakes of protein, total fat, SFA, MUFA and n-3 fatty acids compared with their foreign-born counterparts. CONCLUSIONS Women in the studied area have inadequate intakes of several nutrients relevant during pregnancy. Age, education and country of origin are factors significantly related to dietary intake and adequacy.
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Berti C, Biesalski HK, Gärtner R, Lapillonne A, Pietrzik K, Poston L, Redman C, Koletzko B, Cetin I. Micronutrients in pregnancy: current knowledge and unresolved questions. Clin Nutr 2011; 30:689-701. [PMID: 21872372 DOI: 10.1016/j.clnu.2011.08.004] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2011] [Revised: 07/30/2011] [Accepted: 08/04/2011] [Indexed: 01/11/2023]
Abstract
Micronutrient status is increasingly recognized to play an important role in the health and well-being of pregnant women and in the development and long-term health of the offspring. On 26th - 28th February 2009, The Child Health Foundation invited leading experts in this area to a scientific workshop at Obergurgl, Austria to review and critically discuss current knowledge, to identify issues that may need to be addressed in future recommendations, and to highlight priorities and opportunities for future research. This report summarizes updated key conclusions of the workshop with regards to micronutrients' intake and physiological role related to mother, placenta and fetus, as well as relevance for adverse pregnancy and long-term outcomes.
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Affiliation(s)
- C Berti
- Unit of Obstetrics and Gynecology and Center for Fetal Research Giorgio Pardi, University of Milan, Via G. B. Grassi, 74, 20157 Milano, Italy.
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Canda MT, Sezer O, Demir N. An audit of seafood consumption awareness during pregnancy and its association with maternal and fetal outcomes in a Turkish population. J OBSTET GYNAECOL 2011; 31:293-7. [PMID: 21534748 DOI: 10.3109/01443615.2011.560303] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study was conducted to audit maternal seafood intake awareness during pregnancy and to determine whether there is an association between fish consumption and various pregnancy outcomes. In total, 553 low-risk and healthy pregnant women were given a questionnaire concerning fish consumption. Pregnant women who developed gestational diabetes mellitus, pre-term labour-birth, macrosomia, low birth weight and small for gestational age were analysed. Fatty fish consumers tended to have higher birth weight infants than lean fish consumers. Low fish consumption was significantly correlated with low birth weight and small for gestational age (SGA) infants. The more fatty fish that the low fish consumers consumed, the more likely they were to have SGA infants. Fish consumption did not have an impact on the development of gestational diabetes mellitus, macrosomia or pre-term labour-birth. Low fish consumption during pregnancy may be associated with the development of low birth weight and SGA infants in a Turkish population.
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Affiliation(s)
- M Tunc Canda
- Kent Hospital Obstetrics and Gynecology Unit, Izmir, Turkey.
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Nishigori H, Tanno K, Fukushima A, Kanasugi T, Haba G, Fujiwara J, Ogasawara T, Imai T, Sugiyama T, Kobayashi T, Yoshizumi N. Survey of early preterm singleton live births in Iwate Prefecture as a provincial model of the medical situation in Japan. J Obstet Gynaecol Res 2011; 37:867-73. [PMID: 21410838 DOI: 10.1111/j.1447-0756.2010.01456.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study was to survey early preterm (prior to 32 weeks' gestation) singleton live births in Iwate Prefecture as a provincial model of the medical situation in Japan. MATERIALS AND METHODS Data from 177 early preterm singleton live births, and 31,445 total live births (January 2005-December 2007) in Iwate Prefecture Japan were used to analyze the incidence of early preterm singleton live birth in each medical service area. RESULTS The incidence of spontaneous early preterm singleton live birth did not differ between the coastal and inland medical service areas (3.35 vs 3.57 per 1000 live births). In the Morioka medical service area (radius about 40 km), the incidence of spontaneous early preterm singleton live birth in municipalities without obstetric care facilities was significantly higher than that in municipalities with obstetric care facilities (6.62 vs 2.65 per 1000 live births, P < 0.005). The incidence of early preterm singleton live birth due to pregnancy-induced hypertension in the coastal medical service areas was higher than that in the inland areas (1.67 vs 0.71 per 1000 live births, P < 0.05). CONCLUSIONS In Iwate Prefecture, Japan, the incidence of singleton preterm live birth before 32 weeks of pregnancy varies among its constituent medical service areas according to geographic factors as well as the availability of obstetric care facilities.
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Affiliation(s)
- Hidekazu Nishigori
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Morioka, Iwate, Japan.
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Kendall-Tackett K. Long-chain omega-3 fatty acids and women's mental health in the perinatal period and beyond. J Midwifery Womens Health 2011; 55:561-7. [PMID: 20974418 DOI: 10.1016/j.jmwh.2010.02.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2009] [Revised: 02/17/2010] [Accepted: 02/18/2010] [Indexed: 11/30/2022]
Abstract
Recent research has shown that depression and a range of physical illnesses, including heart disease, metabolic syndrome, and type 2 diabetes, have an inflammatory etiology. The long-chain omega-3 fatty acids (omega-3s) eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which are found in fish and fish-oil products, may protect against these illnesses, in part because they lower inflammation. This article reviews the recent research on omega-3s and women's mental health, with a particular focus on the perinatal period. These studies include population studies examining fish consumption and studies testing the efficacy of EPA and DHA as treatments for depression. Although the findings are mixed, the majority of studies indicate that EPA has efficacy in treating depression either alone or in combination with DHA and/or antidepressant medications. The role of DHA alone in mental health is less clear, but it is generally combined with EPA and appears to have a beneficial effect. In moderate doses, EPA and DHA appear safe for pregnant and postpartum women, and they are well tolerated by patients.
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Measurement of Dietary Intake of Fatty Acids in Pregnant Women: Comparison of Self-Reported Intakes with Adipose Tissue Levels. Ann Epidemiol 2010; 20:599-603. [DOI: 10.1016/j.annepidem.2010.05.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Revised: 05/14/2010] [Accepted: 05/17/2010] [Indexed: 11/21/2022]
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Actualización, recomendaciones y consenso sobre el papel de los ácidos grasos poliinsaturados de cadena larga en la gestación, lactancia y primer año de vida. Med Clin (Barc) 2010; 135:75-82. [DOI: 10.1016/j.medcli.2010.02.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2008] [Accepted: 02/25/2010] [Indexed: 11/20/2022]
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Abstract
Preeclampsia (PE) accounts for about one-quarter of the cases of maternal mortality and ranks second among the causes of pregnancy-associated maternal deaths in Canada and worldwide. The identification of an effective strategy to prevent PE is a priority and a challenge for research in obstetrics. Progress has been hampered by inadequate understanding of the underlying etiology of the disease. The role of maternal diet in the etiology of PE has recently received increased attention. The objective of this paper is to provide an overview of the literature concerning 1) the current understanding of the pathogenesis of PE, 2) the biological plausibility and potential mechanisms underlying the associations between maternal dietary exposures, nutrition, and the risk of PE, and 3) the epidemiological findings of maternal nutrient intake in relation to the risk of PE.
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Affiliation(s)
- Hairong Xu
- Department of Obstetrics and Gynecology, Université de Montréal/Hôpital Sainte-Justine, Montreal, Canada H3T 1C5
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Dietary intake and nutritional adequacy prior to conception and during pregnancy: a follow-up study in the north of Portugal. Public Health Nutr 2009; 12:922-31. [DOI: 10.1017/s1368980008003595] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractObjectiveTo assess maternal diet and nutritional adequacy prior to conception and during pregnancy.DesignFollow-up of a cohort of pregnant women with collection of questionnaire data throughout pregnancy and after delivery.SettingAntenatal clinics at two public hospitals in Porto, Portugal.SubjectsTwo hundred and forty-nine pregnant women who reported a gestational age below 13 weeks at the time they attended their first antenatal visit.ResultsIntakes of energy and macronutrients were within recommended levels for most women. Pregnancy was accompanied by increases in the dietary intake of vitamins A and E, riboflavin, folate, Ca and Mg, but declines in the intake of alcohol and caffeine. The micronutrients with higher inadequacy prevalences prior to pregnancy were vitamin E (83 %), folate (58 %) and Mg (19 %). These three micronutrients, together with Fe, were also those with the highest inadequacy prevalences during pregnancy (91 %, 88 %, 73 % and 21 %, respectively, for folate, Fe, vitamin E and Mg). Ninety-seven per cent of the women reported taking supplements of folic acid during the first trimester, but the median gestational age at initiation was 6·5 (interquartile range 5, 9) weeks. Self-reported prevalences of Fe and Mg supplementation were high, and increased throughout pregnancy.ConclusionThe study identified low dietary intakes of vitamin E, folate and Mg both in the preconceptional period and during pregnancy, and low intake of Fe during pregnancy only. The low dietary intake of folate and the late initiation of supplementation indicate that current national guidelines are unlikely to be effective in preventing neural tube defects.
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Brantsaeter AL, Haugen M, Samuelsen SO, Torjusen H, Trogstad L, Alexander J, Magnus P, Meltzer HM. A dietary pattern characterized by high intake of vegetables, fruits, and vegetable oils is associated with reduced risk of preeclampsia in nulliparous pregnant Norwegian women. J Nutr 2009; 139:1162-8. [PMID: 19369368 PMCID: PMC2682988 DOI: 10.3945/jn.109.104968] [Citation(s) in RCA: 166] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2009] [Revised: 02/15/2009] [Accepted: 03/16/2009] [Indexed: 11/14/2022] Open
Abstract
Several dietary substances have been hypothesized to influence the risk of preeclampsia. Our aim in this study was to estimate the association between dietary patterns during pregnancy and the risk of preeclampsia in 23,423 nulliparous pregnant women taking part in the Norwegian Mother and Child Cohort Study (MoBa). Women participating in MoBa answered questionnaires at gestational wk 15 (a general health questionnaire) and 17-22 (a FFQ). The pregnancy outcomes were obtained from the Medical Birth Registry of Norway. Exploratory factor analysis was used to assess the associations among food variables. Principal component factor analysis identified 4 primary dietary patterns that were labeled: vegetable, processed food, potato and fish, and cakes and sweets. Relative risks of preeclampsia were estimated as odds ratios (OR) and confounder control was performed with multiple logistic regression. Women with high scores on a pattern characterized by vegetables, plant foods, and vegetable oils were at decreased risk [relative risk (OR) for tertile 3 vs. tertile 1: 0.72; 95% CI: 0.62, 0.85]. Women with high scores on a pattern characterized by processed meat, salty snacks, and sweet drinks were at increased risk [OR for tertile 3 vs. tertile 1: 1.21; 95% CI: 1.03, 1.42]. These findings suggest that a dietary pattern characterized by high intake of vegetables, plant foods, and vegetable oils decreases the risk of preeclampsia, whereas a dietary pattern characterized by high consumption of processed meat, sweet drinks, and salty snacks increases the risk.
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Affiliation(s)
- Anne Lise Brantsaeter
- Division of Environmental Medicine, Norwegian Institute of Public Health, NO-0403 Oslo, Norway.
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Position of the American Dietetic Association and American Society for Nutrition: Obesity, Reproduction, and Pregnancy Outcomes. ACTA ACUST UNITED AC 2009; 109:918-27. [DOI: 10.1016/j.jada.2009.03.020] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Picone O, Marszalek A, Servely JL, Chavatte-Palmer P. [Effects of omega 3 supplementation in pregnant women]. JOURNAL DE GYNECOLOGIE, OBSTETRIQUE ET BIOLOGIE DE LA REPRODUCTION 2009; 38:117-124. [PMID: 18947942 DOI: 10.1016/j.jgyn.2008.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2008] [Revised: 06/17/2008] [Accepted: 06/18/2008] [Indexed: 05/27/2023]
Abstract
Maternal nutrition is a major environmental factor, which can be modified and can affect fetal growth and development with potential long-term consequences. There is currently a strong mediatic pressure for supplementing diets with omega 3 fatty acids. Nevertheless, if beneficial effects seem to be confirmed in adults and in animal models, the evidence for favourable effects of omega 3 supplementation in pregnant women are less obvious. Indeed, there is a trend showing a positive effect on cerebral development, but long term effects have not been demonstrated and both the quantity of omega 3 and the omega 3:omega 6 ratios are not precisely determined. Numerous studies are needed, both in pregnant animal models and in patients, to unravel these effects.
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Affiliation(s)
- O Picone
- Service de gynécologie-obstétrique, hôpital Antoine-Béclère, AP-HP, 157, rue de la porte de Trivaux, 92141 Clamart, France.
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Genuis SJ. To sea or not to sea: Benefits and risks of gestational fish consumption. Reprod Toxicol 2008; 26:81-5. [DOI: 10.1016/j.reprotox.2008.08.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2008] [Revised: 07/11/2008] [Accepted: 08/05/2008] [Indexed: 10/21/2022]
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Haugen M, Brantsaeter AL, Alexander J, Meltzer HM. Dietary supplements contribute substantially to the total nutrient intake in pregnant Norwegian women. ANNALS OF NUTRITION AND METABOLISM 2008; 52:272-80. [PMID: 18645244 DOI: 10.1159/000146274] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2007] [Accepted: 03/26/2008] [Indexed: 11/19/2022]
Abstract
BACKGROUND Use of dietary supplements during pregnancy may give an important contribution to nutrient intake, and for nutrients like folate and vitamin D supplements are recommended. Our objective was to study use and contribution of dietary supplement to nutrient intake among women participating in the Norwegian Mother and Child Cohort Study (MoBa). METHODS This study is based on 40,108 women participating in MoBa which is conducted by the Norwegian Institute of Public Health. The women had filled inversion 2 of the food frequency questionnaire in MoBa between February 2002 and February 2005. RESULTS 81% reported use of one or more dietary supplements. The most commonly used category was cod liver oil/fish oil supplements (59%) followed by singular folic acid supplements (36%) and multivitamin/multimineral supplements (31%). The nutrient contribution of the dietary supplements varied from 65% for folate and vitamin D to 1% for potassium among supplement users. The dietary intake of vitamin D, folate, iodine and iron did not reach the Nordic Recommendations for pregnant women. CONCLUSIONS Use of supplements improved the intake of folate, iron and vitamin D, but not sufficiently to reach the recommended amounts.
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Affiliation(s)
- Margaretha Haugen
- Department of Food Safety and Nutrition, Division of Environmental Medicine, Norwegian Institute of Public Health, Oslo, Norway.
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Oken E, Ning Y, Rifas-Shiman SL, Rich-Edwards JW, Olsen SF, Gillman MW. Diet during pregnancy and risk of preeclampsia or gestational hypertension. Ann Epidemiol 2007; 17:663-8. [PMID: 17521921 PMCID: PMC2532559 DOI: 10.1016/j.annepidem.2007.03.003] [Citation(s) in RCA: 106] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2006] [Revised: 02/13/2007] [Accepted: 03/12/2007] [Indexed: 02/05/2023]
Abstract
PURPOSE We sought to examine associations of first-trimester intake of calcium, n-3 and n-6 fatty acids, trans fatty acids, magnesium, folate, and vitamins C, D, and E with preeclampsia (PE) and gestational hypertension (GH). METHODS We studied associations of diet with PE or GH among 1718 women in the prospective cohort study Project Viva, using logistic regression and adjusting for maternal age, prepregnancy body mass index, first trimester systolic blood pressure, race/ethnicity, education, and parity. We assessed first-trimester diet using a validated semiquantitative food frequency questionnaire. RESULTS A total of 59 (3%) women developed PE, and 119 developed (7%) GH. We found a somewhat-lower risk of PE associated with higher intake of the elongated n-3 fatty acids docosahexaenoic and eicosapentaenoic acids (odds ratio [OR] 0.84, 95% confidence interval [95% CI]: 0.69-1.03 per 100 mg/day), fish (OR 0.91, 95% CI 0.75-1.09 per serving/day), and the ratio of docosahexaenoic + eicosapentaenoic to arachadonic acid (OR 0.82, 95% CI 0.66-1.01). We did not observe a lower risk of GH or PE with a greater intake of calcium; vitamin C, D, or E; milk; magnesium; folate; or with lower intake of n-6 or trans fatty acids. CONCLUSIONS Our results support a potential benefit for elongated n-3 fatty acids in preventing preeclampsia.
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Affiliation(s)
- Emily Oken
- Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Harvard School of Public Health, Boston, MA 02215, USA.
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Bibliography. Current world literature. Women's health. Curr Opin Obstet Gynecol 2006; 18:666-74. [PMID: 17099340 DOI: 10.1097/gco.0b013e328011ef42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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