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Abstract
Growing evidence indicates that a suboptimal intrauterine environment confers risk for schizophrenia. The developmental model of schizophrenia posits that aberrant brain growth during early brain development and adolescence may interact to contribute to this psychiatric disease in adulthood. Although a variety of factors may perturb the environment of the developing fetus and predispose for schizophrenia later, a common mechanism has yet to be elucidated. Micronutrient deficiencies during the perinatal period are known to induce potent effects on brain development by altering neurodevelopmental processes. Iron is an important candidate nutrient to consider because of its role in energy metabolism, monoamine synthesis, synaptogenesis, myelination, and the high prevalence of iron deficiency (ID) in the mother-infant dyad. Understanding the current state of science regarding perinatal ID as an early risk factor for schizophrenia is imperative to inform empirical work investigating the etiology of schizophrenia and develop prevention and intervention programs. In this narrative review, we focus on perinatal ID as a common mechanism underlying the fetal programming of schizophrenia. First, we review the neural aberrations associated with perinatal ID that indicate risk for schizophrenia in adulthood, including disruptions in dopaminergic neurotransmission, hippocampal-dependent learning and memory, and sensorimotor gating. Second, we review the pathophysiology of perinatal ID as a function of maternal ID during pregnancy and use epidemiological and cohort studies to link perinatal ID with risk of schizophrenia. Finally, we review potential confounding phenotypes, including nonanemic causes of perinatal brain ID and future risk of schizophrenia.
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Affiliation(s)
- Andrea M. Maxwell
- Medical Scientist Training Program, University of Minnesota, Minneapolis, MN 55455 (USA)
| | - Raghavendra B. Rao
- Department of Pediatrics, Division of Neonatology, University of Minnesota Medical School, Minneapolis, MN 55455 (USA)
- Center for Neurobehavioral Development, University of Minnesota, Minneapolis, MN 55455 (USA)
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2
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Underreporting of Energy Intake Increases over Pregnancy: An Intensive Longitudinal Study of Women with Overweight and Obesity. Nutrients 2022; 14:nu14112326. [PMID: 35684126 PMCID: PMC9183022 DOI: 10.3390/nu14112326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/25/2022] [Accepted: 05/27/2022] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Energy intake (EI) underreporting is a widespread problem of great relevance to public health, yet is poorly described among pregnant women. This study aimed to describe and predict error in self-reported EI across pregnancy among women with overweight or obesity. (2) Methods: Participants were from the Healthy Mom Zone study, an adaptive intervention to regulate gestational weight gain (GWG) tested in a feasibility RCT and followed women (n = 21) with body mass index (BMI) ≥25 from 8−12 weeks to ~36 weeks gestation. Mobile health technology was used to measure daily weight (Wi-Fi Smart Scale), physical activity (activity monitor), and self-reported EI (MyFitnessPal App). Estimated EI was back-calculated daily from measured weight and physical activity data. Associations between underreporting and gestational age, demographics, pre-pregnancy BMI, GWG, perceived stress, and eating behaviors were tested. (3) Results: On average, women were 30.7 years old and primiparous (62%); reporting error was −38% ± 26 (range: −134% (underreporting) to 97% (overreporting)), representing an ~1134 kcal daily underestimation of EI (1404 observations). Estimated (back-calculated), but not self-reported, EI increased across gestation (p < 0.0001). Higher pre-pregnancy BMI (p = 0.01) and weekly GWG (p = 0.0007) was associated with greater underreporting. Underreporting was lower when participants reported higher stress (p = 0.02) and emotional eating (p < 0.0001) compared with their own average. (4) Conclusions: These findings suggest systemic underreporting in pregnant women with elevated BMI using a popular mobile app to monitor diet. Advances in technology that allow estimation of EI from weight and physical activity data may provide more accurate dietary self-monitoring during pregnancy.
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3
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Maternal Diet Influences Fetal Growth but Not Fetal Kidney Volume in an Australian Indigenous Pregnancy Cohort. Nutrients 2021; 13:nu13020569. [PMID: 33572217 PMCID: PMC7914647 DOI: 10.3390/nu13020569] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 12/15/2022] Open
Abstract
Suboptimal nutrition during pregnancy is recognised as a significant modifiable determinant in the development of chronic disease in offspring in later life. The current study aimed: (i) to assess the dietary intakes of pregnant Indigenous Australian women against national recommendations and (ii) to investigate the associations between maternal nutrition during pregnancy and the growth of the offspring, including kidney development in late gestation in the Gomeroi gaaynggal cohort (n = 103). Maternal dietary intake in the third trimester was assessed using the Australian Eating Survey Food Frequency Questionnaire. Estimated fetal weight (EFW) and kidney size were obtained by ultrasound. Birth weight was retrieved from hospital birth records. Of the five key nutrients for optimal reproductive health (folate, iron, calcium, zinc and fibre), the nutrients with the highest percentage of pregnant women achieving the nutrient reference values (NRVs) were zinc (75.7%) and folate (57.3%), whereas iron was the lowest. Only four people achieved all NRVs (folate, iron, calcium, zinc and fibre) important in pregnancy. Sodium and saturated fat intake exceeded recommended levels and diet quality was low, with a median score of 28 out of 73 points. After adjusting for smoking and pre-pregnancy body mass index, only maternal intake of retinol equivalents and the proportion of energy from nutrient-dense or energy-dense, nutrient-poor (EDNP) foods were associated with fetal growth. EFW decreased by 0.13 g and birth weight decreased by 0.24 g for every µg increase in maternal dietary retinol intake. Interestingly, EFW, but not actual birth weight, was positively associated with percentage energy from nutrient dense foods and negatively associated with percentage energy from EDNP foods. Dietary supplement usage was associated with increased birthweight, most significantly iron and folate supplementation. Current dietary intakes of pregnant Australian women from this cohort do not align with national guidelines. Furthermore, current findings show that maternal retinol intake and diet composition during pregnancy can influence fetal growth, but not fetal kidney growth in late gestation. Strategies that aim to support and optimise nutrient intakes of Indigenous pregnant women are urgently needed. Future studies with long-term follow-up of the children in the current cohort to assess renal damage and blood pressure are imperative.
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Lee YQ, Loh J, Ang RSE, Chong MFF. Tracking of Maternal Diet from Pregnancy to Postpregnancy: A Systematic Review of Observational Studies. Curr Dev Nutr 2020; 4:nzaa118. [PMID: 32793849 PMCID: PMC7408223 DOI: 10.1093/cdn/nzaa118] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 12/18/2022] Open
Abstract
We systematically reviewed studies to examine changes in women's diets from pregnancy to the postpregnancy period and sought to understand the characteristics of women making these changes. From a search of 4 databases and up to November 2019, 17 studies met our inclusion criteria. They reported changes in various dietary aspects. Mixed findings were reported for changes in energy and micronutrient intakes. Most studies reported significant decreases in fruit and vegetable consumption, diet quality, and adherence to a healthier dietary pattern during the transition from pregnancy to postpregnancy, whereas increases in discretionary food and fat intakes were observed. Women with lower education level, lower income, and/or who worked full-time tended to have poorer dietary behaviors postpregnancy. Further research, with better aligned dietary measurement time points during pregnancy and postpartum and standardization of dietary assessment tools, is needed for future studies to be comparable. The systematic review protocol was registered in the PROSPERO International Prospective Register of Systematic Reviews as CRD42020158033.
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Affiliation(s)
- Yu Qi Lee
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Jason Loh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Rebekah Su Ern Ang
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Mary Foong-Fong Chong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
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5
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Courtney AU, O’Brien EC, Crowley RK, Geraghty AA, Brady MB, Kilbane MT, Twomey PJ, McKenna MJ, McAuliffe FM. DASH (Dietary Approaches to Stop Hypertension) dietary pattern and maternal blood pressure in pregnancy. J Hum Nutr Diet 2020; 33:686-697. [DOI: 10.1111/jhn.12744] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- A. U. Courtney
- UCD Perinatal Research Centre School of Medicine University College DublinNational Maternity Hospital Dublin Ireland
| | - E. C. O’Brien
- UCD Perinatal Research Centre School of Medicine University College DublinNational Maternity Hospital Dublin Ireland
| | - R. K. Crowley
- Department of Endocrinology St Vincent’s University Hospital Dublin Ireland
| | - A. A. Geraghty
- UCD Perinatal Research Centre School of Medicine University College DublinNational Maternity Hospital Dublin Ireland
| | - M. B. Brady
- UCD Perinatal Research Centre School of Medicine University College DublinNational Maternity Hospital Dublin Ireland
| | - M. T. Kilbane
- Department of Clinical Chemistry St Vincent’s University Hospital Dublin Ireland
| | - P. J. Twomey
- Department of Clinical Chemistry St Vincent’s University Hospital Dublin Ireland
| | - M. J. McKenna
- UCD Perinatal Research Centre School of Medicine University College DublinNational Maternity Hospital Dublin Ireland
- Department of Endocrinology St Vincent’s University Hospital Dublin Ireland
| | - F. M. McAuliffe
- UCD Perinatal Research Centre School of Medicine University College DublinNational Maternity Hospital Dublin Ireland
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Milman NT. Dietary Iron Intake in Pregnant Women in Europe: A Review of 24 Studies from 14 Countries in the Period 1991-2014. J Nutr Metab 2020; 2020:7102190. [PMID: 32185079 PMCID: PMC7060865 DOI: 10.1155/2020/7102190] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Accepted: 02/03/2020] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE Assessment of dietary iron intake in pregnant women in Europe. DESIGN Review. Setting. Literature search of dietary surveys reporting the intake of dietary iron using the PubMed and Google Scholar databases covering the years 1990-2019. SUBJECTS Healthy pregnant women. RESULTS 24 dietary surveys/studies in 14 European countries were included. Nine studies (38%) used Food Frequency Questionnaires, which yielded significantly higher iron intake than studies using Dietary Records. Results from Dietary Record studies in 11 countries showed that iron intake varied between 8.3-15.4 mg/day with an estimated "median" value of 10-11 mg/day. Spain, Bosnia, and Poland reported an intake of 8.3-10.1 mg/day, Croatia, England, Norway, and Finland an intake of 10.2-11.4 mg/day, and Germany, Portugal, Czech Republic, and Greece an intake of 12.2-15.4 mg/day. The recommended iron intake in the various countries varied from 14.8-30 mg/day. In all studies, 60-100% of the women had a dietary iron intake below the recommended intake. CONCLUSIONS In Europe, the majority of pregnant women have a dietary iron intake, which is markedly below the recommended intake. This contributes to a low iron status in many pregnant women. Most guidelines do not advice routine iron supplements, while two guidelines (World Health Organization and Nordic Nutrition Recommendations) recommend routine iron supplementation during pregnancy. Within the European community, we need to reach consensus on the various guidelines and on the issue of iron supplementation. We should establish common European standardized dietary methods, uniform Dietary Reference Values, and uniform statistical methods in order to perform more reliable comparisons between studies in different countries.
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Affiliation(s)
- Nils Thorm Milman
- Department of Clinical Biochemistry, Næstved Hospital, University College Zealand, DK-4700 Næstved, Denmark
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Lebrun A, Plante AS, Savard C, Dugas C, Fontaine-Bisson B, Lemieux S, Robitaille J, Morisset AS. Tracking of Dietary Intake and Diet Quality from Late Pregnancy to the Postpartum Period. Nutrients 2019; 11:nu11092080. [PMID: 31484415 PMCID: PMC6769665 DOI: 10.3390/nu11092080] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 08/23/2019] [Accepted: 08/29/2019] [Indexed: 11/16/2022] Open
Abstract
The present study aimed to characterize dietary intake and diet quality from late pregnancy to six months postpartum. Participants (n = 28) completed 2-3 Web-based 24 h recalls at three distinct periods: (1) during the third trimester of pregnancy; (2) three months and (3) six months after delivery. Energy, macro-and micronutrient intakes (from foods and supplements), as well as the Canadian healthy eating index (C-HEI) were derived from the dietary recalls. No significant variation in energy and macronutrient intakes was observed between time points. The proportion of women taking at least one supplement decreased over time (p = 0.003). The total intake of several micronutrients (vitamins A, C, D, group B vitamins, iron, magnesium, zinc, calcium, phosphorus, manganese, and copper) decreased significantly over time (p < 0.05 for all micronutrients). The total C-HEI score and its components did not change, except for the total vegetables and fruit subscore, which decreased over time (8.2 ± 2.0 in the 3rd trimester, 7.1 ± 2.2 at three months postpartum, 6.9 ± 2.4 at 6 months postpartum, p = 0.04). In conclusion, we observed a general stability in diet quality, energy, and macronutrient intakes from the third trimester of pregnancy to six months postpartum. However, several micronutrient intakes decreased over time, mostly due to changes in supplement use.
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Affiliation(s)
- Audrée Lebrun
- School of Nutrition, Laval University, Québec City, QC G1V 0A6, Canada
- Endocrinology and Nephrology Unit, CHU de Québec-Université Laval Research Center, Québec City, QC G1V 4G2, Canada
- Institute of Nutrition and Functional Foods (INAF), Laval University, Québec City, QC G1V 0A6, Canada
| | - Anne-Sophie Plante
- Endocrinology and Nephrology Unit, CHU de Québec-Université Laval Research Center, Québec City, QC G1V 4G2, Canada
| | - Claudia Savard
- School of Nutrition, Laval University, Québec City, QC G1V 0A6, Canada
- Endocrinology and Nephrology Unit, CHU de Québec-Université Laval Research Center, Québec City, QC G1V 4G2, Canada
- Institute of Nutrition and Functional Foods (INAF), Laval University, Québec City, QC G1V 0A6, Canada
| | - Camille Dugas
- School of Nutrition, Laval University, Québec City, QC G1V 0A6, Canada
- Endocrinology and Nephrology Unit, CHU de Québec-Université Laval Research Center, Québec City, QC G1V 4G2, Canada
- Institute of Nutrition and Functional Foods (INAF), Laval University, Québec City, QC G1V 0A6, Canada
| | - Bénédicte Fontaine-Bisson
- School of Nutrition Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Institut du Savoir Montfort, Montfort Hospital, Ottawa, ON K1K 0T2, Canada
| | - Simone Lemieux
- School of Nutrition, Laval University, Québec City, QC G1V 0A6, Canada
- Institute of Nutrition and Functional Foods (INAF), Laval University, Québec City, QC G1V 0A6, Canada
| | - Julie Robitaille
- School of Nutrition, Laval University, Québec City, QC G1V 0A6, Canada
- Endocrinology and Nephrology Unit, CHU de Québec-Université Laval Research Center, Québec City, QC G1V 4G2, Canada
- Institute of Nutrition and Functional Foods (INAF), Laval University, Québec City, QC G1V 0A6, Canada
| | - Anne-Sophie Morisset
- School of Nutrition, Laval University, Québec City, QC G1V 0A6, Canada.
- Endocrinology and Nephrology Unit, CHU de Québec-Université Laval Research Center, Québec City, QC G1V 4G2, Canada.
- Institute of Nutrition and Functional Foods (INAF), Laval University, Québec City, QC G1V 0A6, Canada.
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Abstract
OBJECTIVE The present study reviewed the literature on iodine status among women of childbearing age and pregnant women in the UK. Particular attention was given to study quality and methods used to assess iodine status. DESIGN A systematic review was conducted to examine the literature and critically evaluate study design. SETTING Studies were identified in PubMed, Web of Science, Scopus and Ovid MEDLINE databases, as well as from secondary references. PARTICIPANTS Women of childbearing age or pregnant, living in the UK. RESULTS Fifty-seven articles were identified and twelve articles were selected, including a total of 5283 women. Nine studies conducted urinary iodine assessments, three studies conducted dietary assessments only, and seven studies classified their target population as iodine deficient according to WHO criteria. CONCLUSIONS No single study from the selected articles could produce nationally representative results regarding the prevalence of iodine deficiency among the female population in the UK. Consideration of the evidence as a whole suggests that women of childbearing age and pregnant women in the UK are generally iodine insufficient. Further large-scale research is required for more accurate and reliable evidence on iodine status in the UK.
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Lee YQ, Collins CE, Schumacher TL, Weatherall LJ, Keogh L, Sutherland K, Gordon A, Rae KM, Pringle KG. Disparities exist between the dietary intake of Indigenous Australian women during pregnancy and the Australian dietary guidelines: the
Gomeroi gaaynggal
study. J Hum Nutr Diet 2018; 31:473-485. [DOI: 10.1111/jhn.12550] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Y. Q. Lee
- Priority Research Centre for Reproductive Sciences University of Newcastle Newcastle NSW Australia
- School of Biomedical Sciences and Pharmacy Faculty of Health and Medicine University of Newcastle Newcastle NSW Australia
| | - C. E. Collins
- Priority Research Centre for Physical Activity and Nutrition University of Newcastle Newcastle NSW Australia
- School of Health Sciences Faculty of Health and Medicine University of Newcastle Newcastle NSW Australia
| | - T. L. Schumacher
- Priority Research Centre for Physical Activity and Nutrition University of Newcastle Newcastle NSW Australia
- Gomeroi gaaynggal Centre Faculty of Health and Medicine University of Newcastle Tamworth NSW Australia
- School of Medicine and Public Health Faculty of Health and Medicine University of Newcastle Newcastle NSW Australia
- Department of Rural Health University of Newcastle Tamworth NSW Australia
| | - L. J. Weatherall
- Gomeroi gaaynggal Centre Faculty of Health and Medicine University of Newcastle Tamworth NSW Australia
| | - L. Keogh
- Gomeroi gaaynggal Centre Faculty of Health and Medicine University of Newcastle Tamworth NSW Australia
| | - K. Sutherland
- Gomeroi gaaynggal Centre Faculty of Health and Medicine University of Newcastle Tamworth NSW Australia
| | - A. Gordon
- Charles Perkins Centre University of Sydney Australia
| | - K. M. Rae
- Priority Research Centre for Reproductive Sciences University of Newcastle Newcastle NSW Australia
- Gomeroi gaaynggal Centre Faculty of Health and Medicine University of Newcastle Tamworth NSW Australia
- School of Medicine and Public Health Faculty of Health and Medicine University of Newcastle Newcastle NSW Australia
- Department of Rural Health University of Newcastle Tamworth NSW Australia
- Priority Research Centre for Generational Health and Ageing University of Newcastle Newcastle NSW Australia
| | - K. G. Pringle
- Priority Research Centre for Reproductive Sciences University of Newcastle Newcastle NSW Australia
- School of Biomedical Sciences and Pharmacy Faculty of Health and Medicine University of Newcastle Newcastle NSW Australia
- Gomeroi gaaynggal Centre Faculty of Health and Medicine University of Newcastle Tamworth NSW Australia
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Dubois L, Diasparra M, Bédard B, Colapinto CK, Fontaine-Bisson B, Morisset AS, Tremblay RE, Fraser WD. Adequacy of nutritional intake from food and supplements in a cohort of pregnant women in Québec, Canada: the 3D Cohort Study (Design, Develop, Discover). Am J Clin Nutr 2017; 106:541-548. [PMID: 28615265 DOI: 10.3945/ajcn.117.155499] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 05/16/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Assessments of the dietary intakes in various populations suggest that pregnant women have difficulty meeting all their nutritional requirements through diet alone. Few large-scale studies have considered both food sources and supplements in assessing the adequacy of nutritional intakes during pregnancy.Objective: Our study aimed to assess nutritional intakes during pregnancy by examining dietary sources and supplements. It then compared these findings with Dietary Reference Intakes.Design: We conducted a nutrition study in a large pregnancy cohort using a 3-d food record during the second trimester of pregnancy. Detailed information about supplement consumption was obtained by interview at each prenatal visit. We estimated the distribution of total usual intakes for energy, macronutrients, and micronutrients for 1533 pregnant women.Results: A third of the participants had total fat intakes that exceeded the Acceptable Micronutrient Distribution Range. A majority of women (85%) had sodium intakes above the Tolerable Upper Intake Level (UL). Median intakes for fiber and potassium were lower than Adequate Intakes. Dietary intakes of vitamin B-6, magnesium, and zinc were below the Estimated Average Requirements (EARs) for 10-15% of the women. A majority of the women had dietary intakes below the EARs for iron (97%), vitamin D (96%), and folate (70%). When we considered micronutrient intakes from both food and supplements, we found that the prevalence of inadequate intake was <10% for all nutrients except vitamin D (18%) and iron (15%), whereas 32% and 87% of the women had total intakes above the ULs for iron and folic acid, respectively.Conclusions: The level of intake of some nutrients from food alone remains low in the diets of pregnant women. Supplement use reduces the risk of inadequate intake for many micronutrients, but diet-related issues during pregnancy remain and deserve to be addressed in public health interventions. This trial was registered at clinicaltrials.gov as NCT03113331.
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Affiliation(s)
- Lise Dubois
- School of Epidemiology, Public Health and Preventive Medicine, and
| | - Maikol Diasparra
- School of Epidemiology, Public Health and Preventive Medicine, and
| | - Brigitte Bédard
- School of Epidemiology, Public Health and Preventive Medicine, and
| | - Cynthia K Colapinto
- Sainte Justine University Hospital Research Center, and.,Research Center of the Sherbrooke University Hospital Center, Sherbrooke, Canada
| | - Bénédicte Fontaine-Bisson
- School of Nutrition Sciences, University of Ottawa, Ottawa, Canada.,Research Institute of the Montfort Hospital, Ottawa, Canada
| | | | - Richard E Tremblay
- Departments of Pediatrics and Psychology, University of Montreal, Montreal, Canada.,School of Public Heath, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - William D Fraser
- Sainte Justine University Hospital Research Center, and.,Research Center of the Sherbrooke University Hospital Center, Sherbrooke, Canada
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Maternal prenatal iron status and tissue organization in the neonatal brain. Pediatr Res 2016; 79:482-8. [PMID: 26599151 PMCID: PMC4821682 DOI: 10.1038/pr.2015.248] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 09/09/2015] [Indexed: 01/09/2023]
Abstract
BACKGROUND Children prenatally exposed to inadequate iron have poorer motor and neurocognitive development. No prior study to our knowledge has assessed the influence of maternal prenatal iron intake on newborn brain tissue organization in full-term infants. METHODS Third trimester daily iron intake was obtained using the Automated Self-Administered 24-h Dietary Recall with n = 40 healthy pregnant adolescents (aged 14-19 y). Cord blood ferritin was collected in a subsample (n = 16). Newborn (mean = 39 gestational weeks at birth; range 37-41) magnetic resonance imaging scans were acquired on a 3.0 Tesla MR Scanner. Diffusion Tensor Imaging (DTI) slices were acquired to measure the directional diffusion of water indexed by fractional anisotropy (FA). RESULTS Reported iron intake was inversely associated with newborn FA values (P ≤ 0.0001) predominantly in cortical gray matter. FA findings were similar using cord blood ferritin values. CONCLUSION Higher maternal prenatal iron intake accentuates, and lower intake attenuates, the normal age-related decline in FA values in gray matter, perhaps representing increasing dendritic arborization and synapse formation with higher iron intake. These DTI results suggest that typical variation in maternal iron outside the scope of standard clinical surveillance exerts subtle effects on infant brain development.
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12
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Brunst KJ, Kannan S, Ni YM, Gennings C, Ganguri HB, Wright RJ. Validation of a Food Frequency Questionnaire for Estimating Micronutrient Intakes in an Urban US Sample of Multi-Ethnic Pregnant Women. Matern Child Health J 2016; 20:250-60. [PMID: 26511128 PMCID: PMC4959268 DOI: 10.1007/s10995-015-1824-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE(S) To validate the Block98 food frequency questionnaire (FFQ) for estimating antioxidant, methyl-nutrient and polyunsaturated fatty acids (PUFA) intakes in a pregnant sample of ethnic/racial minority women in the United States (US). METHODS Participants (n = 42) were from the Programming of Intergenerational Stress Mechanisms study. Total micronutrient intakes from food and supplements was ascertained using the modified Block98 FFQ and two 24-h dietary recalls collected at random on nonconsecutive days subsequent to completion of the FFQ in mid-pregnancy. Correlation coefficients (r) corrected for attenuation from within-person variation in the recalls were calculated for antioxidants (n = 7), methyl-nutrients (n = 8), and PUFAs (n = 2). RESULT(S) The sample was largely ethnic minorities (38 % Black, 33 % Hispanic) with 21 % being foreign born and 41 % having less than or equal to a high school degree. Significant and adequate deattenuated correlations (r ≥ 0.40) for total dietary intakes of antioxidants were observed for vitamin C, vitamin E, magnesium, and zinc. Reasonable deattenuated correlations were also observed for methyl-nutrient intakes of vitamin B6, betaine, iron, and n:6 PUFAs; however, they did not reach significance. Most women were classified into the same or adjacent quartiles (≥70 %) for total (dietary + supplements) estimates of antioxidants (5 out of 7) and methyl-nutrients (4 out of 5). CONCLUSIONS The Block98 FFQ is an appropriate dietary method for evaluating antioxidants in pregnant ethnic/minorities in the US; it may be less efficient in measuring methyl-nutrient and PUFA intakes.
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Affiliation(s)
- Kelly J Brunst
- Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.
| | - Srimathi Kannan
- Human Nutrition and Dietetics, College of Agricultural Sciences, Southern Illinois University, 1205 Lincoln Drive, Carbondale, IL, 62901, USA.
| | - Yu-Ming Ni
- New York Medical College, 40 Sunshine Cottage Road, Valhalla, NY, 10595, USA.
| | - Chris Gennings
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, 17 East 102nd Street, New York, NY, 10029, USA.
| | - Harish B Ganguri
- Department of Computer Science, College of Science, Southern Illinois University, 1205 Lincoln Drive, Carbondale, IL, 62901, USA.
| | - Rosalind J Wright
- Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.
- Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, 1428 Madison Avenue, New York, NY, 10029, USA.
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13
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Taylor PN, Okosieme OE, Premawardhana L, Lazarus JH. Should All Women Be Screened for Thyroid Dysfunction in Pregnancy? WOMENS HEALTH 2015; 11:295-307. [DOI: 10.2217/whe.15.7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The subject of universal thyroid screening in pregnancy generates impassioned debate. Thyroid dysfunction is common, has significant adverse implications for fetal and maternal well-being, is readily detectable and can be effectively and inexpensively treated. Furthermore, the currently recommended case-finding strategy does not identify a substantially proportion of women with thyroid dysfunction thus favoring universal screening. On the other hand subclinical thyroid dysfunction forms the bulk of gestational thyroid disorders and the paucity of high-level evidence to support correction of these asymptomatic biochemical abnormalities weighs against universal screening. This review critically appraises the literature, examines the pros and cons of universal thyroid screening in pregnancy, highlighting the now strong case for implementing universal screening and explores strategies for its implementation.
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Affiliation(s)
- Peter N Taylor
- Thyroid Research Group, Institute of Molecular & Experimental Medicine, Cardiff University School of Medicine, Cardiff, UK
| | - Onyebuchi E Okosieme
- Thyroid Research Group, Institute of Molecular & Experimental Medicine, Cardiff University School of Medicine, Cardiff, UK
| | - Lakdasa Premawardhana
- Thyroid Research Group, Institute of Molecular & Experimental Medicine, Cardiff University School of Medicine, Cardiff, UK
| | - John H Lazarus
- Thyroid Research Group, Institute of Molecular & Experimental Medicine, Cardiff University School of Medicine, Cardiff, UK
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Deficient maternal zinc intake-but not folate-is associated with lower fetal heart rate variability. Early Hum Dev 2015; 91:169-72. [PMID: 25658874 PMCID: PMC4471999 DOI: 10.1016/j.earlhumdev.2015.01.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 01/16/2015] [Accepted: 01/20/2015] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Few studies of maternal prenatal diet and child development examine micronutrient status in relation to fetal assessment. METHODS Twenty-four-hour dietary recall of zinc and folate and 20min of fetal heart rate were collected from 3rd trimester pregnant adolescents. RESULTS Deficient zinc was associated with less fetal heart rate variability. Deficient folate had no associations with HRV. Neither deficient zinc nor deficient folate was related to fetal heart rate. CONCLUSIONS These findings, from naturalistic observation, are consistent with emerging data on prenatal zinc supplementation using a randomized control design. PRACTICAL IMPLICATION Taken together, the findings suggest that maternal prenatal zinc intake is an important and novel factor for understanding child ANS development.
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Hatzopoulou K, Filis V, Grammatikopoulou MG, Kotzamanidis C, Tsigga M. Greek pregnant women demonstrate inadequate micronutrient intake despite supplement use. J Diet Suppl 2014; 11:155-65. [PMID: 24670119 DOI: 10.3109/19390211.2013.859210] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND/AIM Maternal diet is important in the outcome of pregnancy and the health of the children. The present cross-sectional study aimed to assess the use of dietary supplements during pregnancy and define the maternal characteristics associated with supplement use. METHODS The diet of 100 childbearing women was recorded for three consecutive days and micronutrient supplementation was added to the dietary intake and the median values were used in the analyses. RESULTS The majority of the participants (92%) consumed at least one supplement. Supplementation of folic acid (FA) was significantly lower during the third trimester compared to the second (p ≤ .007). Higher intake of Ca and Fe supplements was observed in the second trimester (p ≤ .001). The use of supplements contributed to an attenuated consumption of all reported micronutrients (Mg, Ca, FA, and Fe, p ≤ .001). The principal components analysis revealed that the most important factor contributing to supplementation was primiparity. CONCLUSIONS Overall, a high prevalence of micronutrient supplementation during pregnancy was observed without ensuring adequacy in the micronutrient intake. The increased rates of supplement users might be the result of an act for balancing diet in unplanned pregnancies.
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Affiliation(s)
- Konstantina Hatzopoulou
- Department of Human Nutrition & Dietetics, Alexander Technological Educational Institute, GR-57400 Thessaloniki, Greece
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Lindsay KL, Gibney ER, McNulty BA, McAuliffe FM. Pregnant immigrant Nigerian women: an exploration of dietary intakes. Public Health 2014; 128:647-53. [PMID: 25065518 DOI: 10.1016/j.puhe.2014.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 04/23/2014] [Accepted: 05/01/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of the study is to explore the dietary intakes of a prominent ethnic minority group of women from Sub-Saharan Africa during pregnancy, in order to identify nutritional issues of concern which may impact on pregnancy outcomes and whether different food based dietary guidelines may be required to meet their needs. STUDY DESIGN This is an observational study with quantitative assessment of nutrient intakes and an exploration of meal composition and food choices. METHODS Fifty-two Nigerian pregnant women in their second or third trimester of pregnancy were recruited from antenatal clinics in the National Maternity Hospital, Dublin, Ireland. Early pregnancy weight was measured and body mass index recorded. A 24 h dietary recall was used to assess food and nutrient intakes. RESULTS Eighty-nine per cent of the study population were classified as overweight or obese. These women appear to be maintaining traditional African dietary habits and have a healthy macronutrient composition in the diet. The intake of key pregnancy micronutrients such as calcium, vitamin D and folate may be insufficient from diet alone to meet requirements and supplements may be inadequately utilized in a timely manner. CONCLUSIONS These women represent a vulnerable obstetric group that may be at risk of adverse pregnancy outcomes due to high obesity rates and inadequate micronutrient status in early pregnancy. Provision of dietary advice should be tailored to suit their cultural dietary practices and food preferences. Pre-conception counselling on healthy lifestyle and appropriate supplement usage may be beneficial, although larger studies are required to assess the need for specific nutrition policy recommendations.
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Affiliation(s)
- K L Lindsay
- UCD Obstetrics and Gynaecology, School of Medicine and Medical Science, University College Dublin, National Maternity Hospital, Holles St., Dublin 2, Ireland.
| | - E R Gibney
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Bellfield, Dublin 4, Ireland
| | - B A McNulty
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Bellfield, Dublin 4, Ireland
| | - F M McAuliffe
- UCD Obstetrics and Gynaecology, School of Medicine and Medical Science, University College Dublin, National Maternity Hospital, Holles St., Dublin 2, Ireland
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Gresham E, Bisquera A, Byles JE, Hure AJ. Effects of dietary interventions on pregnancy outcomes: a systematic review and meta-analysis. MATERNAL AND CHILD NUTRITION 2014; 12:5-23. [PMID: 25048387 DOI: 10.1111/mcn.12142] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Dietary intake during pregnancy influences maternal health. Poor dietary practices during pregnancy have been linked to maternal complications. The objective was to determine the effect of dietary intervention before or during pregnancy on pregnancy outcomes. A systematic review was conducted without date restrictions. Randomised controlled trials (RCTs) evaluating whole diet or dietary components and pregnancy outcomes were included. Two authors independently identified papers for inclusion and assessed methodological quality. Meta-analysis was conducted separately for each outcome using random effects models. Results were reported by type of dietary intervention: (1) counselling; (2) food and fortified food products; or (3) combination (counseling + food); and collectively for all dietary interventions. Results were further grouped by trimester when the intervention commenced, nutrient of interest, country income and body mass index. Of 2326 screened abstracts, a total of 28 RCTs were included in this review. Dietary counselling during pregnancy was effective in reducing systolic [standardised mean difference (SMD) -0.26, 95% confidence interval (CI) -0.45 to -0.07; P < 0.001] and diastolic blood pressure (SMD -0.57, 95% CI -0.75 to -0.38; P < 0.001). Macronutrient dietary interventions were effective in reducing the incidence of preterm delivery (SMD -0.19, 95% CI -0.34 to -0.04; P = 0.01). No effects were seen for other outcomes. Dietary interventions showed some small, but significant differences in pregnancy outcomes including a reduction in the incidence of preterm birth. Further high-quality RCTs, investigating micronutrient provision from food, and combination dietary intervention, are required to identify maternal diet intakes that optimise pregnancy outcomes.
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Affiliation(s)
- Ellie Gresham
- Research Centre for Gender, Health and Ageing, School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Alessandra Bisquera
- Clinical Research Design IT and Statistical Support (CReDITSS) Unit, University of Newcastle, Callaghan, New South Wales, Australia
| | - Julie E Byles
- Research Centre for Gender, Health and Ageing, School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Alexis J Hure
- Research Centre for Gender, Health and Ageing, School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, New South Wales, Australia
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Lindsay KL, Kennelly M, Culliton M, Smith T, Maguire OC, Shanahan F, Brennan L, McAuliffe FM. Probiotics in obese pregnancy do not reduce maternal fasting glucose: a double-blind, placebo-controlled, randomized trial (Probiotics in Pregnancy Study). Am J Clin Nutr 2014; 99:1432-9. [PMID: 24646819 DOI: 10.3945/ajcn.113.079723] [Citation(s) in RCA: 117] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Recent studies have reported beneficial effects of probiotics on maternal glycemia in healthy pregnant women. Obesity significantly increases risk of impaired glucose tolerance in pregnancy, but glycemic effects of probiotics in this specific obstetric group require additional investigation. OBJECTIVE The aim of the Probiotics in Pregnancy Study was to investigate the effect of a probiotic capsule on maternal fasting glucose in obese pregnant women. DESIGN In this placebo-controlled, double-blind, randomized trial, 175 pregnant women with an early pregnancy body mass index (BMI; in kg/m²) from 30.0 to 39.9 were recruited from antenatal clinics at the National Maternity Hospital, Dublin, Ireland. Exclusion criteria were BMI <30.0 or >39.9, prepregnancy or gestational diabetes, age <18 y, multiple pregnancy, and fetal anomaly. Women were randomly assigned to receive either a daily probiotic or a placebo capsule from 24 to 28 wk of gestation in addition to routine antenatal care. The primary outcome was the change in fasting glucose between groups from preintervention to postintervention. Secondary outcomes were the incidence of gestational diabetes and neonatal anthropometric measures. RESULTS In 138 women who completed the study (63 women in the probiotic group; 75 women in the placebo group), mean (±SD) early pregnancy BMI was 33.6 ± 2.6, which differed significantly between probiotic (32.9 ± 2.4) and placebo (34.1 ± 2.7) groups. With adjustment for BMI, the change in maternal fasting glucose did not differ significantly between treated and control groups [-0.09 ± 0.27 compared with -0.07 ± 0.39 mmol/L; P = 0.391; B = -0.05 (95% CI: -0.17, 0.07)]. There were also no differences in the incidence of impaired glycemia (16% in the probiotic group compared with 15% in the placebo group; P = 0.561), birth weight (3.70 kg in the probiotic group compared with 3.68 kg in the placebo group; P = 0.723), or other metabolic variables or pregnancy outcomes. A secondary analysis of 110 women, excluding antibiotic users and poor compliers, also revealed no differences in maternal glucose or other outcomes between groups. CONCLUSION Probiotic treatment of 4 wk during pregnancy did not influence maternal fasting glucose, the metabolic profile, or pregnancy outcomes in obese women.
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Affiliation(s)
- Karen L Lindsay
- From the University College Dublin (UCD) Obstetrics and Gynaecology, School of Medicine and Medical Science, UCD, National Maternity Hospital, Dublin, Ireland (KLL, MK, and FMM); Laboratory Medicine, National Maternity Hospital, Dublin, Ireland (MC); the Department of Clinical Chemistry, St Vincent's University Hospital, Elm Park, Dublin, Ireland (TS and OCM); the Department of Medicine, Alimentary and Pharmabiotic Centre, University College Cork, Cork, Ireland (FS); and the Institute of Food and Health, UCD School of Agriculture and Food Science, UCD, Belfield, Dublin, Ireland (LB)
| | - Maria Kennelly
- From the University College Dublin (UCD) Obstetrics and Gynaecology, School of Medicine and Medical Science, UCD, National Maternity Hospital, Dublin, Ireland (KLL, MK, and FMM); Laboratory Medicine, National Maternity Hospital, Dublin, Ireland (MC); the Department of Clinical Chemistry, St Vincent's University Hospital, Elm Park, Dublin, Ireland (TS and OCM); the Department of Medicine, Alimentary and Pharmabiotic Centre, University College Cork, Cork, Ireland (FS); and the Institute of Food and Health, UCD School of Agriculture and Food Science, UCD, Belfield, Dublin, Ireland (LB)
| | - Marie Culliton
- From the University College Dublin (UCD) Obstetrics and Gynaecology, School of Medicine and Medical Science, UCD, National Maternity Hospital, Dublin, Ireland (KLL, MK, and FMM); Laboratory Medicine, National Maternity Hospital, Dublin, Ireland (MC); the Department of Clinical Chemistry, St Vincent's University Hospital, Elm Park, Dublin, Ireland (TS and OCM); the Department of Medicine, Alimentary and Pharmabiotic Centre, University College Cork, Cork, Ireland (FS); and the Institute of Food and Health, UCD School of Agriculture and Food Science, UCD, Belfield, Dublin, Ireland (LB)
| | - Thomas Smith
- From the University College Dublin (UCD) Obstetrics and Gynaecology, School of Medicine and Medical Science, UCD, National Maternity Hospital, Dublin, Ireland (KLL, MK, and FMM); Laboratory Medicine, National Maternity Hospital, Dublin, Ireland (MC); the Department of Clinical Chemistry, St Vincent's University Hospital, Elm Park, Dublin, Ireland (TS and OCM); the Department of Medicine, Alimentary and Pharmabiotic Centre, University College Cork, Cork, Ireland (FS); and the Institute of Food and Health, UCD School of Agriculture and Food Science, UCD, Belfield, Dublin, Ireland (LB)
| | - Orla C Maguire
- From the University College Dublin (UCD) Obstetrics and Gynaecology, School of Medicine and Medical Science, UCD, National Maternity Hospital, Dublin, Ireland (KLL, MK, and FMM); Laboratory Medicine, National Maternity Hospital, Dublin, Ireland (MC); the Department of Clinical Chemistry, St Vincent's University Hospital, Elm Park, Dublin, Ireland (TS and OCM); the Department of Medicine, Alimentary and Pharmabiotic Centre, University College Cork, Cork, Ireland (FS); and the Institute of Food and Health, UCD School of Agriculture and Food Science, UCD, Belfield, Dublin, Ireland (LB)
| | - Fergus Shanahan
- From the University College Dublin (UCD) Obstetrics and Gynaecology, School of Medicine and Medical Science, UCD, National Maternity Hospital, Dublin, Ireland (KLL, MK, and FMM); Laboratory Medicine, National Maternity Hospital, Dublin, Ireland (MC); the Department of Clinical Chemistry, St Vincent's University Hospital, Elm Park, Dublin, Ireland (TS and OCM); the Department of Medicine, Alimentary and Pharmabiotic Centre, University College Cork, Cork, Ireland (FS); and the Institute of Food and Health, UCD School of Agriculture and Food Science, UCD, Belfield, Dublin, Ireland (LB)
| | - Lorraine Brennan
- From the University College Dublin (UCD) Obstetrics and Gynaecology, School of Medicine and Medical Science, UCD, National Maternity Hospital, Dublin, Ireland (KLL, MK, and FMM); Laboratory Medicine, National Maternity Hospital, Dublin, Ireland (MC); the Department of Clinical Chemistry, St Vincent's University Hospital, Elm Park, Dublin, Ireland (TS and OCM); the Department of Medicine, Alimentary and Pharmabiotic Centre, University College Cork, Cork, Ireland (FS); and the Institute of Food and Health, UCD School of Agriculture and Food Science, UCD, Belfield, Dublin, Ireland (LB)
| | - Fionnuala M McAuliffe
- From the University College Dublin (UCD) Obstetrics and Gynaecology, School of Medicine and Medical Science, UCD, National Maternity Hospital, Dublin, Ireland (KLL, MK, and FMM); Laboratory Medicine, National Maternity Hospital, Dublin, Ireland (MC); the Department of Clinical Chemistry, St Vincent's University Hospital, Elm Park, Dublin, Ireland (TS and OCM); the Department of Medicine, Alimentary and Pharmabiotic Centre, University College Cork, Cork, Ireland (FS); and the Institute of Food and Health, UCD School of Agriculture and Food Science, UCD, Belfield, Dublin, Ireland (LB)
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Maternal dietary folate intakes during early pregnancy. Proc Nutr Soc 2014. [DOI: 10.1017/s0029665114001323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Taylor PN, Okosieme OE, Dayan CM, Lazarus JH. Therapy of endocrine disease: Impact of iodine supplementation in mild-to-moderate iodine deficiency: systematic review and meta-analysis. Eur J Endocrinol 2014; 170:R1-R15. [PMID: 24088547 DOI: 10.1530/eje-13-0651] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Although the detrimental effects of severe iodine deficiency are well recognised, the benefits of correcting mild-to-moderate iodine deficiency are uncertain. OBJECTIVES We undertook a systematic review of the impact of iodine supplementation in populations with mild-to-moderate iodine deficiency. METHODS We searched Medline and the Cochrane library for relevant articles published between January 1966 and April 2013, which investigated the effect of iodine supplementation on maternal and newborn thyroid function, infant neurodevelopment and cognitive performance in school-age children. The quality of studies was graded and eligible trials were evaluated in the meta-analysis. RESULTS Nine randomised controlled trials (RCTs) and eight observational studies met the inclusion criteria. Controlled trials on infant neurodevelopment were lacking; gestational iodine supplementation reduced maternal thyroid volume and serum thyroglobulin and in some studies prevented a rise in serum thyroid-stimulating hormone. None of the intervention trials recorded an excess frequency of thyroid dysfunction in contrast to observational studies. A pooled analysis of two RCTs which measured cognitive function in school-age children showed modest benefits of iodine supplementation on perceptual reasoning (standardised mean difference (SMD) 0.55; 95% CI 0.05, 1.04; P=0.03) and global cognitive index (SMD 0.27; 95% CI 0.10, 0.44; P=0.002) with significant heterogeneity between studies. CONCLUSION Iodine supplementation improves some maternal thyroid indices and may benefit aspects of cognitive function in school-age children, even in marginally iodine-deficient areas. Further large prospective controlled studies are urgently required to clarify these findings and quantify the risk/benefits of iodine supplementation in regions previously believed to be iodine sufficient such as the UK.
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Affiliation(s)
- Peter N Taylor
- Thyroid Research Group, Institute of Molecular and Experimental Medicine (IMEM), Cardiff University School of Medicine, Cardiff University, Cardiff CF14 4XN, UK
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Wennberg AL, Lundqvist A, Högberg U, Sandström H, Hamberg K. Women's experiences of dietary advice and dietary changes during pregnancy. Midwifery 2013; 29:1027-34. [DOI: 10.1016/j.midw.2012.09.005] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Revised: 08/17/2012] [Accepted: 09/17/2012] [Indexed: 11/17/2022]
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Saadia Z, Roshdy S, Sagir F, Abidin S. Dietary practices of Saudi women during puerperium. J Obstet Gynaecol Res 2013; 39:799-805. [PMID: 23106949 DOI: 10.1111/j.1447-0756.2012.02035.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2012] [Accepted: 08/20/2012] [Indexed: 11/30/2022]
Abstract
AIM Poor maternal health sometimes can be a consequence of practicing different myths during puerperium. This cross-sectional study describes the practice of different myths regarding diet among Saudi women. MATERIAL AND METHODS The study comprised women attending the postnatal clinic at the Mother and Child Hospital in Buraidah from January to December 2011. RESULTS Almost 65.9% of women were using a combination of herbs such as ginger (zingiber officinale), hilba (fenugreek) and black seeds (nigella sativa). The multinomial logistic regression of herbs on age, education, occupation, parity and mode of delivery was statistically significant (χ² [48] = 214.645, P < 0.001). Hilba was more commonly used by women with instrumental delivery. It was common for women to avoid different fruits and vegetables (33.89%). Eggs were avoided by 16.5% of women and 11% avoided cold drinks. The multinomial logistic regression of diet on age, education, occupation, parity and mode of delivery was statistically significant (χ² [72] = 389.861, P < 0.001). Individuals below college level education were more likely to avoid fruits, vegetables and cold drinks in their diet. CONCLUSION Health education programs are needed to improve knowledge about dietary malpractices during puerperium. This may help eliminate myths regarding avoidance of certain dietary components.
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Affiliation(s)
- Zaheera Saadia
- Obstetrics and Gynaecology, College of Medicine, Qassim University, Buraidah, Al-Qassim, KSA.
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Monk C, Georgieff MK, Osterholm EA. Research review: maternal prenatal distress and poor nutrition - mutually influencing risk factors affecting infant neurocognitive development. J Child Psychol Psychiatry 2013; 54:115-30. [PMID: 23039359 PMCID: PMC3547137 DOI: 10.1111/jcpp.12000] [Citation(s) in RCA: 146] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Accumulating data from animal and human studies indicate that the prenatal environment plays a significant role in shaping children's neurocognitive development. Clinical, epidemiologic, and basic science research suggests that two experiences relatively common in pregnancy - an unhealthy maternal diet and psychosocial distress - significantly affect children's future neurodevelopment. These prenatal experiences exert their influence in the context of one another and yet, almost uniformly, are studied independently. SCOPE AND METHOD OF REVIEW In this review, we suggest that studying neurocognitive development in children in relation to both prenatal exposures is ecologically most relevant, and methodologically most sound. To support this approach, we selectively review two research topics that demonstrate the need for dual exposure studies, including exemplar findings on (a) the associations between pregnant women's inadequate maternal intake of key nutrients - protein, fat, iron, zinc, and choline - as well as distress in relation to overlapping effects on children's neurocognitive development; and (b) cross-talk between the biology of stress and nutrition that can amplify each experience for the mother and fetus,. We also consider obstacles to this kind of study design, such as questions of statistical methods for 'disentangling' the exposure effects, and aim to provide some answers. CONCLUSION Studies that specifically include both exposures in their design can begin to determine the relative and/or synergistic impact of these prenatal experiences on developmental trajectories - and thereby contribute most fully to the understanding of the early origins of health and disease.
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Affiliation(s)
- Catherine Monk
- Psychiatry and Obstetrics & Gynecology, Columbia University, New York, NY 10032, USA.
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Blumfield ML, Hure AJ, Macdonald-Wicks L, Smith R, Collins CE. A systematic review and meta-analysis of micronutrient intakes during pregnancy in developed countries. Nutr Rev 2013; 71:118-32. [PMID: 23356639 DOI: 10.1111/nure.12003] [Citation(s) in RCA: 173] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Micronutrient status during pregnancy influences maternal and fetal health, birth outcomes, and the risk of chronic disease in offspring. Research reporting dietary intake during pregnancy in nationally representative population samples, however, is limited. This review summarizes the micronutrient intakes of pregnant women from developed countries and compares them with relevant national recommendations. A systematic search without date limits was conducted. All studies reporting the micronutrient intakes of pregnant women were considered, irrespective of design. Two authors independently identified studies for inclusion and assessed methodological quality. Nutritional adequacy was summarized, with confounding factors considered. Meta-analysis data are reported for developed countries collectively, by geographical region, and by dietary methodology. Pregnant women in developed countries are at risk of suboptimal micronutrient intakes. Folate, iron, and vitamin D intakes were consistently below nutrient recommendations in each geographical region, and calcium intakes in Japan were below the Japanese recommendations and the average intake levels in other developed countries. Research examining the implications of potential nutrient insufficiency on maternal and offspring health outcomes is needed along with improvements in the quality of dietary intake reporting.
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Affiliation(s)
- Michelle L Blumfield
- School of Health Sciences, Faculty of Health, University of Newcastle, Callaghan, New South Wales, Australia
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Ruxton CHS, Derbyshire E, Pickard RS. Micronutrient challenges across the age spectrum: Is there a role for red meat? NUTR BULL 2012. [DOI: 10.1111/nbu.12000] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Morse NL. Benefits of docosahexaenoic acid, folic acid, vitamin D and iodine on foetal and infant brain development and function following maternal supplementation during pregnancy and lactation. Nutrients 2012; 4:799-840. [PMID: 22852064 PMCID: PMC3407995 DOI: 10.3390/nu4070799] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Revised: 07/09/2012] [Accepted: 07/12/2012] [Indexed: 11/17/2022] Open
Abstract
UNLABELLED Scientific literature is increasingly reporting on dietary deficiencies in many populations of some nutrients critical for foetal and infant brain development and function. PURPOSE To highlight the potential benefits of maternal supplementation with docosahexaenoic acid (DHA) and other important complimentary nutrients, including vitamin D, folic acid and iodine during pregnancy and/or breast feeding for foetal and/or infant brain development and/or function. METHODS English language systematic reviews, meta-analyses, randomised controlled trials, cohort studies, cross-sectional and case-control studies were obtained through searches on MEDLINE and the Cochrane Register of Controlled Trials from January 2000 through to February 2012 and reference lists of retrieved articles. Reports were selected if they included benefits and harms of maternal supplementation of DHA, vitamin D, folic acid or iodine supplementation during pregnancy and/or lactation. RESULTS Maternal DHA intake during pregnancy and/or lactation can prolong high risk pregnancies, increase birth weight, head circumference and birth length, and can enhance visual acuity, hand and eye co-ordination, attention, problem solving and information processing. Vitamin D helps maintain pregnancy and promotes normal skeletal and brain development. Folic acid is necessary for normal foetal spine, brain and skull development. Iodine is essential for thyroid hormone production necessary for normal brain and nervous system development during gestation that impacts childhood function. CONCLUSION Maternal supplementation within recommended safe intakes in populations with dietary deficiencies may prevent many brain and central nervous system malfunctions and even enhance brain development and function in their offspring.
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Affiliation(s)
- Nancy L Morse
- Efamol Ltd., 14 Mole Business Park, Leatherhead KT22 7BA, UK.
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Bergamaschi DP, Mariath AB, Abbade JF, Grillo LP, Diniz CSG, Hinnig PF. Selenium supplementation during pregnancy for improving maternal and newborn outcomes. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2012. [DOI: 10.1002/14651858.cd009673] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Denise P Bergamaschi
- University of Sao Paulo; Departamento de Epidemiologia-Estatistica; Faculdade de Saude Publica Av Dr Arnaldo 715, Cerqueira Cesar Sao Paulo Brazil CEP 01246 904
| | - Aline B Mariath
- School of Public Health, University of São Paulo; Department of Nutrition; Av. Doutor Arnaldo 715 - Cerquiera César São Paulo São Paulo Brazil 01.246-904
| | - Joelcio F Abbade
- School of Medicine of Botucatu, São Paulo State University (UNESP); Department of Gynaecology and Obstetrics; Rubião Jr. s/n - Rubião Júnior Botucatu São Paulo Brazil 18.618-000
| | - Luciane P Grillo
- University of Vale do Itajaí; Department of Nutrition; Rua Uruguai 458 Itajaí Santa Catarina Brazil 88302-202
| | - Carmen SG Diniz
- School of Public Health, University of São Paulo; Department of Maternal-Child Health; Av. Doutor Arnaldo 715 - Cerquiera César São Paulo São Paulo Brazil 01.246-904
| | - Patricia F Hinnig
- Faculdade de Saude Publica; Departamento de Epidemiologia; Av Dr Arnaldo 715 Sao Paulo Brazil 01246-904
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Maternal nutrient intakes and levels of energy underreporting during early pregnancy. Eur J Clin Nutr 2012; 66:906-13. [DOI: 10.1038/ejcn.2012.15] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Promoting healthy eating in pregnancy: what kind of support services do women say they want? Prim Health Care Res Dev 2012; 13:237-43. [PMID: 22313583 DOI: 10.1017/s1463423611000636] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AIM To identify characteristics of the services and support women want to enable them to eat healthily during pregnancy to make a potential future service acceptable to this population. BACKGROUND An unhealthy diet during pregnancy may have a significant influence on pregnancy outcome, either directly through nutrient deficiencies or indirectly through maternal weight gain. Many pregnant women in the United Kingdom gain too much weight in pregnancy, and this weight gain may lead to an increased risk of preeclampsia, gestational diabetes and having an obese child. Thus, there is a need for interventions aimed at improving healthy eating in pregnancy. It is crucial in developing successful interventions to understand how participation can be maximised by optimising intervention acceptability. METHODS Four focus groups were conducted; two with prenatal women (n = 9) and two with postnatal women (n = 14). Discussion focused on identifying relevant characteristics of a service targeting prenatal and postnatal women's eating to ensure that a future service was acceptable to the women. FINDINGS The participants' responses were clustered into three broad themes: (1) early information leading to routine formation of healthier eating habits, (2) the delivery of practical sessions to increase information and (3) health professionals providing support and signposting to services. The participants reported wanting a practical service held in a convenient location, preferably led by women who have been pregnant themselves. The participants also reported wanting to be offered this service in pregnancy to help them get into a routine before they gave birth. Several suggestions for how this service should be marketed were mentioned, including through midwives and the internet. This research provides practical information for how to design support for prenatal women to increase their knowledge and practical skills regarding eating healthily during their pregnancy.
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Aranda N, Ribot B, Garcia E, Viteri FE, Arija V. Pre-pregnancy iron reserves, iron supplementation during pregnancy, and birth weight. Early Hum Dev 2011; 87:791-7. [PMID: 21723050 DOI: 10.1016/j.earlhumdev.2011.06.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Revised: 06/06/2011] [Accepted: 06/07/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND Early iron supplementation in women with sufficient reserves could provoke iron excess resulting in haemoconcentration and low infant birth weight (IBW). AIM To clarify the influence of early iron supplementation on maternal iron status and the IBW, taking into account pre-pregnancy iron deposits. STUDY DESIGN Longitudinal, prospective study. SUBJECTS Healthy women volunteers (n=82) intending to become pregnant. OUTCOME MEASURES Women were grouped as a function of their pre-pregnancy (low or present) iron stores (serum ferritin (SF)<or≥20μg/L) and time of commencement of iron supplementation during pregnancy; "early" (<20weeks) or "late" (≥20weeks). Obstetric and clinical history, smoking habit, dietary intake and iron biochemical parameters were obtained at pre-pregnancy as well as at 1st, 2nd and 3rd trimesters. Haemoglobin, MCV, SF and transferrin saturation (TS) were measured. RESULTS Overall, 36% of the women had low iron stores at pre-pregnancy. The mean early supplementation with iron was 140.7mg/d and the mean of late supplementation was 99.01mg/d. Early supplementation improves the biochemical status of the mother and does not provoke a significant increase in haemoconcentration relative to late supplementation independently of the pre-pregnancy iron levels. Supplemental iron had a positive effect on birth weight among women with pre-pregnancy low iron stores (β=4.37; SE=1.8; p=0.038) and did not affect birth weight among women with present iron stores (β=-0.008; SE=3.03; p=0.998). CONCLUSION Early iron supplementation with doses ~100mg/d improves the biochemical status of the mother independently of her pre-pregnancy iron status. Supplementation with iron improves newborn birth weight in those women who start pregnancy with iron deficiency, and makes no significant difference to those women who are not iron deficient.
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Affiliation(s)
- Nuria Aranda
- IISPV, Departament de Ciències Mèdiques Bàsiques, Universitat Rovira i Virgili (URV), Spain
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Hyppönen E. Preventing Vitamin D Deficiency in Pregnancy – Importance for the Mother and Child. ANNALS OF NUTRITION AND METABOLISM 2011; 59:28-31. [DOI: 10.1159/000332072] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Healthy Eating Index during pregnancy according to pre-gravid and gravid weight status. Public Health Nutr 2010; 14:290-6. [DOI: 10.1017/s1368980010001989] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveTo assess differences in the Healthy Eating Index (HEI) during pregnancy with the pre-gravid and gravid weight status of women.DesignCross-sectional.SettingAthens, Greece.SubjectsOne hundred pregnant women, inhabitants of Athens.ResultsThe mean raw HEI score of the sample was 66·9 (sd 7·6) and the mean HEI adjusted for energy intake was 66·9 (sd 0·6). No difference was recorded between the adjusted HEI and different gravidities, the embryo’s sex, different income categories or education. When HEI was categorised as low, average and adequate, living in an urban residence increased the odds for demonstrating low HEI score (OR = 10·231, 95 % CI 1·300, 80·487). HEI score during pregnancy was significantly higher in participants who were either pre-gravidly underweight or of normal body weight (BW). In relation to the gestational weight status, the highest HEI scores and protein intake were shown in the underweight and of normal BW participants compared with the obese. According to the simple correspondence analysis, adequate HEI was associated with rural residence and being underweight or having normal BW during pregnancy. Low HEI was associated with overweight and obesity during pregnancy, with obesity before pregnancy and living in an urban environment. HEI was negatively correlated to the pre-conceptional and gestational BMI (r = −0·298, P ≤ 0·003 and r = −0·345, P ≤ 0·001) and to the week of gestation (r = −0·285, P ≤ 0·004).ConclusionsOverall, the HEI of the sample was mediocre. Women who were underweight or of normal BW exhibited a better diet quality compared with obese women; thus the latter consist a population in greater need for supervised nutrition and dietary counselling during pregnancy.
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Whitrow MJ, Moore VM, Rumbold AR, Davies MJ. Effect of supplemental folic acid in pregnancy on childhood asthma: a prospective birth cohort study. Am J Epidemiol 2009; 170:1486-93. [PMID: 19880541 DOI: 10.1093/aje/kwp315] [Citation(s) in RCA: 190] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
This study aimed to investigate the effect of the timing, dose, and source of folate during pregnancy on childhood asthma by using data from an Australian prospective birth cohort study (n = 557) from 1998 to 2005. At 3.5 years and 5.5 years, 490 and 423 mothers and children participated in the study, respectively. Maternal folate intake from diet and supplements was assessed by food frequency questionnaire in early (<16 weeks) and late (30-34 weeks) pregnancy. The primary outcome was physician-diagnosed asthma, obtained by maternal-completed questionnaire. Asthma was reported in 11.6% of children at 3.5 years (n = 57) and in 11.8% of children at 5.5 years (n = 50). Folic acid taken in supplement form in late pregnancy was associated with an increased risk of childhood asthma at 3.5 years (relative risk (RR) = 1.26, 95% confidence interval (CI): 1.08, 1.43) and with persistent asthma (RR = 1.32, 95% CI: 1.03, 1.69). The effect sizes did not change with adjustment for potential confounders. The association was similar at 5.5 years but did not reach statistical significance (RR = 1.17, 95% CI: 0.96, 1.42) in univariable models. These findings on childhood asthma support previous observations that supplementation with folate in pregnancy leads to an allergic asthma phenotype in mice via epigenetic mechanisms and is associated with poorer respiratory outcomes in young children.
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Affiliation(s)
- Melissa J Whitrow
- Research Centre for the Early Origins of Health and Disease, Robinson Institute, The University of Adelaide, Adelaide, South Australia, Australia
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