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Perichart-Perera O, Reyes-Muñoz E, Borboa-Olivares H, Rodríguez-Cano AM, Solis Paredes JM, Hernández-Hernández L, Rodríguez-Hernández C, González-Ludlow I, Suárez-Rico BV, Sánchez-Martínez M, Torres-Herrera U, Canul-Euan AA, Tolentino-Dolores M, Espejel-Nuñez A, Estrada-Gutierrez G. Optimizing perinatal wellbeing in pregnancy with obesity: a clinical trial with a multi-component nutrition intervention for prevention of gestational diabetes and infant growth and neurodevelopment impairment. Front Med (Lausanne) 2024; 11:1339428. [PMID: 38681052 PMCID: PMC11045894 DOI: 10.3389/fmed.2024.1339428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 03/18/2024] [Indexed: 05/01/2024] Open
Abstract
Pregnancy complicated by obesity represents an increased risk of unfavorable perinatal outcomes such as gestational diabetes mellitus (GDM), hypertensive disorders in pregnancy, preterm birth, and impaired fetal growth, among others. Obesity is associated with deficiencies of micronutrients, and pregnant women with obesity may have higher needs. The intrauterine environment in pregnancies complicated with obesity is characterized by inflammation and oxidative stress, where maternal nutrition and metabolic status have significant influence and are critical in maternal health and in fetal programming of health in the offspring later in life. Comprehensive lifestyle interventions, including intensive nutrition care, are associated with a lower risk of adverse perinatal outcomes. Routine supplementation during pregnancy includes folic acid and iron; other nutrient supplementation is recommended for high-risk women or women in low-middle income countries. This study is an open label randomized clinical trial of parallel groups (UMIN Clinical Trials Registry: UMIN000052753, https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000060194) to evaluate the effect of an intensive nutrition therapy and nutrient supplementation intervention (folic acid, iron, vitamin D, omega 3 fatty acids, myo-inositol and micronutrients) in pregnant women with obesity on the prevention of GDM, other perinatal outcomes, maternal and newborn nutritional status, and infant growth, adiposity, and neurodevelopment compared to usual care. Given the absence of established nutritional guidelines for managing obesity during pregnancy, there is a pressing need to develop and implement new nutritional programs to enhance perinatal outcomes.
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Affiliation(s)
- Otilia Perichart-Perera
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología, Mexico City, Mexico
| | - Enrique Reyes-Muñoz
- Gynecological and Perinatal Endocrinology Coordination, Instituto Nacional de Perinatología, Mexico City, Mexico
| | - Hector Borboa-Olivares
- Community Interventions Research Branch, Instituto Nacional de Perinatología, Mexico City, Mexico
| | | | - Juan Mario Solis Paredes
- Department of Research in Reproductive and Perinatal Health, Instituto Nacional de Perinatología, Mexico City, Mexico
| | | | | | - Isabel González-Ludlow
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología, Mexico City, Mexico
| | | | | | | | | | | | - Aurora Espejel-Nuñez
- Department of Immunobiochemistry, Instituto Nacional de Perinatología, Mexico City, Mexico
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Motamed S, Anari R, Motamed S, Amani R. Vitamin D and biomarkers of inflammation and oxidative stress among pregnant women: a systematic review of observational studies. BMC Immunol 2023; 24:41. [PMID: 37891486 PMCID: PMC10612223 DOI: 10.1186/s12865-023-00577-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
OBJECTIVE This systematic review aimed to map the evidence evaluated the relationship between vitamin D and redox and inflammatory status during gestation. METHODS Three databases (PubMed/MEDLINE, Scopus, and Web of Science (WoS)) and reference list of included documents were searched for related observational studies published until 2nd October 2023. To determine the quality of the selected observational studies, the Newcastle-Ottawa Scale (NOS) was used. RESULTS After a primary search of three databases, 19492records were appeared. When duplicates and irrelevant documents were removed, 14 articles were found to have eligible criteria. The design of the identified studies was cross-sectional, case-control and cohort. Evidence showed an adverse association between 25(OH)D and the biomarkers of inflammation, such as high-sensitivity C-reactive protein (hs-CRP), Interleukin-1beta (IL-1β), Interleukin-6 (IL-6), and tumor necrosis factor- alfa (TNF-α) during pregnancy. On the contrary, some studies represented that 25(OH)D positively correlated with hs-CRP in the cord blood. One study suggested a direct association between serum concentrations of 25(OH)D and Interleukin-8 (IL-8), macrophage inflammatory protein (MIP), and TNF-α levels in mothers with gestational diabetes mellitus (GDM). A case-control study showed that lower serum concentration of 25(OH)D positively correlated with total antioxidant capacity (TAC) levels in participants. CONCLUSIONS Evidence confirmed the supposition of the direct relationship between vitamin D levels and biomarkers with anti-inflammatory and anti-oxidative properties. However, the Existence of inconsistent evidence confirms the need for further studies in mothers with GDM and hypertensive disorders. PROSPERO REGISTRATION CODE CRD42020202600.
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Affiliation(s)
| | - Razieh Anari
- National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Somayeh Motamed
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Amani
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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Harreiter J, Mendoza LC, Simmons D, Desoye G, Devlieger R, Galjaard S, Damm P, Mathiesen ER, Jensen DM, Andersen LLT, Dunne F, Lapolla A, Dalfra MG, Bertolotto A, Wender-Ozegowska E, Zawiejska A, Hill D, Jelsma JGM, Snoek FJ, Worda C, Bancher-Todesca D, van Poppel MNM, Corcoy R, Kautzky-Willer A. Vitamin D3 Supplementation in Overweight/Obese Pregnant Women: No Effects on the Maternal or Fetal Lipid Profile and Body Fat Distribution-A Secondary Analysis of the Multicentric, Randomized, Controlled Vitamin D and Lifestyle for Gestational Diabetes Prevention Trial (DALI). Nutrients 2022; 14:nu14183781. [PMID: 36145157 PMCID: PMC9503968 DOI: 10.3390/nu14183781] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/07/2022] [Accepted: 09/09/2022] [Indexed: 11/23/2022] Open
Abstract
Vitamin D deficiency is a common finding in overweight/obese pregnant women and is associated with increased risk for adverse pregnancy outcome. Both maternal vitamin D deficiency and maternal obesity contribute to metabolic derangements in pregnancy. We aimed to assess the effects of vitamin D3 supplementation in pregnancy versus placebo on maternal and fetal lipids. Main inclusion criteria were: women <20 weeks’ gestation, BMI ≥ 29 kg/m2. Eligible women (n = 154) were randomized to receive vitamin D3 (1600 IU/day) or placebo. Assessments were performed <20, 24−28 and 35−37 weeks and at birth. Linear regression models were used to assess effects of vitamin D on maternal and cord blood lipids. In the vitamin D group significantly higher total 25-OHD and 25-OHD3 levels were found in maternal and cord blood compared with placebo. Adjusted regression models did not reveal any differences in triglycerides, LDL-C, HDL-C, free fatty acids, ketone bodies or leptin between groups. Neonatal sum of skinfolds was comparable between the two groups, but correlated positively with cord blood 25-OH-D3 (r = 0.34, p = 0.012). Vitamin D supplementation in pregnancy increases maternal and cord blood vitamin D significantly resulting in high rates of vitamin D sufficiency. Maternal and cord blood lipid parameters were unaffected by Vitamin D3 supplementation.
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Affiliation(s)
- Jürgen Harreiter
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, 1090 Vienna, Austria
- Correspondence: ; Tel.: +43-1-40400-43120
| | - Lilian C. Mendoza
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08025 Barcelona, Spain
| | - David Simmons
- Macarthur Clinical School, Western Sydney University, Sydney 2560, Australia
| | - Gernot Desoye
- Department of Obstetrics and Gynecology, Medical University of Graz, 8036 Graz, Austria
| | - Roland Devlieger
- Department of Development and Regeneration, KU Leuven, University Leuven, 3000 Leuven, Belgium
- Department of Obstetrics and Gynecology, University Hospitals Leuven, 3000 Leuven, Belgium
- Department of Obstetrics, Gynecology and Fertility, GZA Sint-Augustinus, 2610 Wilrijk, Belgium
| | - Sander Galjaard
- Department of Development and Regeneration, KU Leuven, University Leuven, 3000 Leuven, Belgium
- Department of Obstetrics and Gynecology, University Hospitals Leuven, 3000 Leuven, Belgium
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands
| | - Peter Damm
- Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, 2100 Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark
| | - Elisabeth R. Mathiesen
- Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, 2100 Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark
| | - Dorte M. Jensen
- Steno Diabetes Center Odense, Odense University Hospital, 5000 Odense, Denmark
- Department of Gynaecology and Obstetrics, Odense University Hospital, 5000 Odense, Denmark
- Department of Clinical Research, Faculty of Health, University of Southern Denmark, 5000 Odense, Denmark
| | - Lise Lotte T. Andersen
- Department of Gynaecology and Obstetrics, Odense University Hospital, 5000 Odense, Denmark
- Department of Clinical Research, Faculty of Health, University of Southern Denmark, 5000 Odense, Denmark
| | - Fidelma Dunne
- Clinical Research Facility (CRF) and National University of Ireland, H91 TK33 Galway, Ireland
| | - Annunziata Lapolla
- Department of Medicine, Universita Degli Studi di Padova, 35128 Padova, Italy
| | - Maria G. Dalfra
- Department of Medicine, Universita Degli Studi di Padova, 35128 Padova, Italy
| | | | - Ewa Wender-Ozegowska
- Department of Reproduction, Medical Faculty I, Poznan University of Medical Sciences, 60-525 Poznan, Poland
| | - Agnieszka Zawiejska
- Department of Reproduction, Medical Faculty I, Poznan University of Medical Sciences, 60-525 Poznan, Poland
| | - David Hill
- Lawson Health Research Institute, London, ON N6A 4V2, Canada
| | - Judith G. M. Jelsma
- Amsterdam UMC, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands
| | - Frank J. Snoek
- Amsterdam UMC, Department of Medical Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, 1007 MB Amsterdam, The Netherlands
| | - Christof Worda
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria
| | - Dagmar Bancher-Todesca
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria
| | - Mireille N. M. van Poppel
- Amsterdam UMC, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands
- Institute of Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria
| | - Rosa Corcoy
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08025 Barcelona, Spain
- CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Alexandra Kautzky-Willer
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, 1090 Vienna, Austria
- Gender Institute, La Pura, 3571 Gars am Kamp, Austria
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