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Tain YL, Hsu CN. Amino Acids during Pregnancy and Offspring Cardiovascular-Kidney-Metabolic Health. Nutrients 2024; 16:1263. [PMID: 38732510 PMCID: PMC11085482 DOI: 10.3390/nu16091263] [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: 02/27/2024] [Revised: 04/19/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
Amino acids are essential for normal pregnancy and fetal development. Disruptions in maternal amino acid metabolism have been associated with various adult diseases later in life, a phenomenon referred to as the developmental origins of health and disease (DOHaD). In this review, we examine the recent evidence highlighting the significant impact of amino acids on fetal programming, their influence on the modulation of gut microbiota, and their repercussions on offspring outcomes, particularly in the context of cardiovascular-kidney-metabolic (CKM) syndrome. Furthermore, we delve into experimental studies that have unveiled the protective effects of therapies targeting amino acids. These interventions have demonstrated the potential to reprogram traits associated with CKM in offspring. The discussion encompasses the challenges of translating the findings from animal studies to clinical applications, emphasizing the complexity of this process. Additionally, we propose potential solutions to overcome these challenges. Ultimately, as we move forward, future research endeavors should aim to pinpoint the most effective amino-acid-targeted therapies, determining the optimal dosage and mode of administration. This exploration is essential for maximizing the reprogramming effects, ultimately contributing to the enhancement of cardiovascular-kidney-metabolic health in offspring.
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Affiliation(s)
- You-Lin Tain
- Division of Pediatric Nephrology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan;
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
| | - Chien-Ning Hsu
- Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
- School of Pharmacy, Kaohsiung Medical University, Kaohsiung 807, Taiwan
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Carreira NP, Lima MCD, Travieso SG, Sartorelli DS, Crivellenti LC. [Maternal factors associated with habitual consumption of ultra-processed foods during pregnancy]. CIENCIA & SAUDE COLETIVA 2024; 29:e16302022. [PMID: 38198329 DOI: 10.1590/1413-81232024291.16302022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 03/10/2023] [Indexed: 01/12/2024] Open
Abstract
The scope of the study was to investigate the relationship between maternal sociodemographic, obstetric and lifestyle characteristics and the habitual consumption of ultra-processed foods. It included a cross-sectional study of n = 784 pregnant women attended by the Unified Health System. Diet was estimated using two 24-hour recall surveys, using the multiple-pass method. Ultra-processed foods were classified using the UN NOVA food classification and their habitual consumption was expressed as the contribution to the total energy percentage. Adjusted linear regression models were used to investigate the relationship between maternal characteristics and the percentage of energy (%E) derived from ultra-processed foods. The %E of ultra-processed foods in the diet was 32.1%. Maternal age (-0.45[-0.62; -0.29] p < 0.001), economic bracket D+E in relation to A+B (-2.95[-5.59; -0.32] p = 0.03) and energy underreporting (-6.95[-8.86; -5.04] p < 0.001) were inversely associated with the %E of ultra-processed foods, whereas the pre-pregnancy Body Mass Index (BMI) (0.41[0.22; 0.60] p < 0.001) was directly associated. This would suggest that maternal age, economic status, energy underreporting and pre-gestational anthropometric status are associated with the consumption of ultra-processed foods during pregnancy.
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Affiliation(s)
- Natalia Posses Carreira
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Av. Bandeirantes 3900. 14049-900 Ribeirão Preto SP Brasil.
| | - Maria Carolina de Lima
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Av. Bandeirantes 3900. 14049-900 Ribeirão Preto SP Brasil.
| | - Sofia Germano Travieso
- Curso de Nutrição e Metabolismo, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Ribeirão Preto SP Brasil
| | - Daniela Saes Sartorelli
- Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Ribeirão Preto SP Brasil
| | - Lívia Castro Crivellenti
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Av. Bandeirantes 3900. 14049-900 Ribeirão Preto SP Brasil.
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Kim S, Naziripour A, Prabhala P, Horváth V, Junaid A, Breault DT, Goyal G, Ingber DE. Direct therapeutic effect of sulfadoxine-pyrimethamine on nutritional deficiency-induced enteric dysfunction in a human Intestine Chip. EBioMedicine 2024; 99:104921. [PMID: 38101300 PMCID: PMC10733102 DOI: 10.1016/j.ebiom.2023.104921] [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: 07/17/2023] [Revised: 12/01/2023] [Accepted: 12/01/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Sulfadoxine-pyrimethamine (SP) antimalarial therapy has been suggested to potentially increase the birth weight of infants in pregnant women in sub-Saharan Africa, independently of malarial infection. Here, we utilized female intestinal organoid-derived cells cultured within microfluidic Organ Chips to investigate whether SP could directly impact intestinal function and thereby improve the absorption of essential fats and nutrients crucial for fetal growth. METHODS Using a human organ-on-a-chip model, we replicated the adult female intestine with patient organoid-derived duodenal epithelial cells interfaced with human intestinal endothelial cells. Nutrient-deficient (ND) medium was perfused to simulate malnutrition, resulting in the appearance of enteric dysfunction indicators such as villus blunting, reduced mucus production, impaired nutrient absorption, and increased inflammatory cytokine secretion. SP was administered to these chips in the presence or absence of human peripheral blood mononuclear cells (PBMCs). FINDINGS Our findings revealed that SP treatment effectively reversed multiple intestinal absorptive abnormalities observed in malnourished female Intestine Chips, as validated by transcriptomic and proteomic analyses. SP also reduced the production of inflammatory cytokines and suppressed the recruitment of PBMCs in ND chips. INTERPRETATION Our results indicate that SP could potentially increase birth weights by preventing enteric dysfunction and suppressing intestinal inflammation. This underscores the potential of SP as a targeted intervention to improve maternal absorption, subsequently contributing to healthier fetal growth. While SP treatment shows promise in addressing malabsorption issues that can influence infant birth weight, we did not model pregnancy in our chips, and thus its usefulness for treatment of malnourished pregnant women requires further investigation through clinical trials. FUNDING The Bill and Melinda Gates Foundation, and the Wyss Institute for Biologically Inspired Engineering at Harvard University, and the HDDC Organoid Core of the P30 DK034854.
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Affiliation(s)
- Seongmin Kim
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA 02115, USA
| | - Arash Naziripour
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA 02115, USA
| | - Pranav Prabhala
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA 02115, USA
| | - Viktor Horváth
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA 02115, USA
| | - Abidemi Junaid
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA 02115, USA
| | - David T Breault
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA; Department of Endocrinology, Boston Children's Hospital, Boston, MA 02115, USA; Harvard Stem Cell Institute, Cambridge, MA 02138, USA
| | - Girija Goyal
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA 02115, USA
| | - Donald E Ingber
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA 02115, USA; Vascular Biology Program, Boston Children's Hospital and Department of Pathology, Harvard Medical School, Boston, MA 02115, USA; Harvard John A. Paulson School of Engineering and Applied Sciences, Cambridge, MA 02139, USA.
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Iusitini L, Tautolo ES, Plank LD, Rush E. Pacific Islands Families Study: Household Food Security during Pregnancy and Secondary School Educational Achievement. Nutrients 2023; 15:4131. [PMID: 37836415 PMCID: PMC10574222 DOI: 10.3390/nu15194131] [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: 08/08/2023] [Revised: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023] Open
Abstract
Nutritional environment in early life is a key factor for brain development and function. It is important to understand the relationship between nutrition in early life and academic achievement in adolescence. The birth cohort of the Pacific Islands Families (PIF) study was born in the year 2000. When their child was six weeks old, mothers were asked questions concerning food security over the past year. Two binary measures of food security were derived as previously used in PIF and also by the Ministry of Health (MOH). In 2020, records of academic achievement from the National Certificate of Educational Achievement (NCEA) for 649 (317 female, 332 male) cohort members showed progressive achievement at levels 1, 2, and 3 of NCEA and allowed University Entrance (UE) to be assessed. The prevalence of food insecurity was not different for sex but high at 29% and 42% using the PIF and MOH definitions of food insecurity, respectively. More females (27%) than males (18%) achieved UE as their highest qualification, and more males (40%) than females (31%) achieved NCEA levels 1 or 2 as their highest qualification. UE was achieved by 25% of those born into food-secure households and 17% from food-insecure households. Logistic regression demonstrated that the odds of achieving UE were 1.8-fold (95% CI 1.2, 2.6, p = 0.003) higher in females than males and, independently, 1.6-fold (95% CI 1.1, 2.5 p = 0.026) higher if the household was food secure. This work emphasises the importance of maternal and early-life food security for subsequent academic achievement and the well-being of future generations.
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Affiliation(s)
- Leon Iusitini
- New Zealand Work Research Institute, Faculty of Business, Economics and Law, Auckland University of Technology, Auckland 1142, New Zealand;
| | - El-Shadan Tautolo
- School of Public Health & Interdisciplinary Studies, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland 1142, New Zealand;
| | - Lindsay D. Plank
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1142, New Zealand;
| | - Elaine Rush
- School of Sport and Recreation, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland 1142, New Zealand
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Santosa I, Shoji H, Arai Y, Awata K, Tokita K, Shimizu T. Hepatic and Skeletal Muscle Autophagy Marker Levels in Rat Models of Prenatal and Postnatal Protein Restriction. Nutrients 2023; 15:3058. [PMID: 37447384 DOI: 10.3390/nu15133058] [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: 05/16/2023] [Revised: 06/29/2023] [Accepted: 07/01/2023] [Indexed: 07/15/2023] Open
Abstract
Fetal growth restriction (FGR) leads to adult-onset metabolic syndrome. Intrauterine and early postnatal caloric restriction ameliorates the risk in animal models. To understand the underlying mechanism, we compared autophagic marker levels between offspring with FGR and those with prenatal and early postnatal protein restriction (IPPR). We postulated that FGR would impair, whereas IPPR would help regulate, autophagy in neonatal rats. This study involved control (Con), FGR offspring (Pre), and IPPR offspring groups (Pre + Post); n = 5/group. We assessed the abundance of autophagy markers in the liver and skeletal muscles. At birth, the Pre group pups had lower levels of some autophagy-related proteins, with increased p62 expression and a low microtubule-associated protein light chain beta (LC3-II:LC3-I) ratio. This finding suggests a lower hepatic autophagy flux in FGR offspring than the Con group. The hepatic levels of autophagy proteins were considerably decreased in the Pre and Pre + Post groups at 21 days of age compared to the Con group, but the LC3-II:LC3-I ratio was higher in the Pre + Post group than in the Con and Pre groups. The muscle levels of beclin-1, LC3-II, and p62 were lower in the Pre group pups, with no difference in the LC3-II:LC3-I ratio among the groups. An imbalance in the nutritional environment is associated with downstream autophagic flux, thus suggesting that FGR offspring will have impaired autophagic flux, and that post-natal nutrition restriction might help reduce this risk.
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Affiliation(s)
- Irena Santosa
- Department of Pediatrics and Adolescent Medicine, Graduate School of Medicine, Juntendo University, Bunkyo, Tokyo 113-8421, Japan
| | - Hiromichi Shoji
- Department of Pediatrics, Faculty of Medicine, Juntendo University, Bunkyo, Tokyo 113-8421, Japan
| | - Yoshiteru Arai
- Department of Pediatrics, Faculty of Medicine, Juntendo University, Bunkyo, Tokyo 113-8421, Japan
| | - Kentaro Awata
- Department of Pediatrics, Faculty of Medicine, Juntendo University, Bunkyo, Tokyo 113-8421, Japan
| | - Kazuhide Tokita
- Department of Pediatrics, Faculty of Medicine, Juntendo University, Bunkyo, Tokyo 113-8421, Japan
| | - Toshiaki Shimizu
- Department of Pediatrics and Adolescent Medicine, Graduate School of Medicine, Juntendo University, Bunkyo, Tokyo 113-8421, Japan
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A maternal low-protein diet during gestation induces hepatic autophagy-related gene expression in a sex-specific manner in Sprague-Dawley rats. Br J Nutr 2022; 128:592-603. [PMID: 34511147 PMCID: PMC9346618 DOI: 10.1017/s0007114521003639] [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] [Indexed: 12/24/2022]
Abstract
This study investigates the mechanism by which maternal protein restriction induces hepatic autophagy-related gene expression in the offspring of rats. Pregnant Sprague-Dawley rats were fed either a control diet (C, 18 % energy from protein) or a low-protein diet (LP, 8·5 % energy from protein) during gestation, followed by the control diet during lactation and post-weaning. Liver tissue was collected from the offspring at postnatal day 38 and divided into four groups according to sex and maternal diet (F-C, F-LP, M-C and M-LP) for further analysis. Autophagy-related mRNA and protein levels were determined by real-time PCR and Western blotting, respectively. In addition, chromatin immunoprecipitation (ChIP) was performed to investigate the interactions between transcription factors and autophagy-related genes. Protein levels of p- eukaryotic translation initiation factor 2a and activating transcription factor 4 (ATF4) were increased only in the female offspring born to dams fed the LP diet. Correlatively, the mRNA expression of hepatic autophagy-related genes including Map1lc3b, P62/Sqstm1, Becn1, Atg3, Atg7 and Atg10 was significantly greater in the F-LP group than in the F-C group. Furthermore, ChIP results showed greater ATF4 and C/EBP homology protein (CHOP) binding at the regions of a set of autophagy-related genes in the F-LP group than in the F-C group. Our data demonstrated that a maternal LP diet transcriptionally programmed hepatic autophagy-related gene expression only in female rat offspring. This transcriptional programme involved the activation of the eIF2α/ATF4 pathway and intricate regulation by transcription factors ATF4 and CHOP.
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Kochhar P, Vukku M, Rajashekhar R, Mukhopadhyay A. microRNA signatures associated with fetal growth restriction: a systematic review. Eur J Clin Nutr 2022; 76:1088-1102. [PMID: 34741137 DOI: 10.1038/s41430-021-01041-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/17/2021] [Accepted: 10/19/2021] [Indexed: 12/20/2022]
Abstract
Placental-origin microRNA (miRNA) profiles can be useful toward early diagnosis and management of fetal growth restriction (FGR) and associated complications. We conducted a systematic review to identify case-control studies that have examined miRNA signatures associated with human FGR. We systematically searched PubMed and ScienceDirect databases for relevant articles and manually searched reference lists of the relevant articles till May 18th, 2021. Of the 2133 studies identified, 21 were included. FGR-associated upregulation of miR-210 and miR-424 and downregulation of a placenta-specific miRNA cluster miRNA located on C19MC (miR-518b, miR-519d) and miR-221-3p was reported by >1 included studies. Analysis of the target genes of these miRNA as well as pathway analysis pointed to the involvement of angiogenesis and growth signaling pathways, such as the phosphatidylinositol 3-kinase- protein kinase B (PI3K-Akt) pathway. Only 3 out of the 21 included studies reported FGR-associated miRNAs in matched placental and maternal blood samples. We conclude that FGR-associated placental miRNAs could be utilized to inform clinical practice towards early diagnosis of FGR, provided enough evidence from studies on matched placental and maternal blood samples become available.Prospective Register of Systematic Reviews (PROSPERO) registration number: CRD42019136762.
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Affiliation(s)
- P Kochhar
- Division of Nutrition, St. John's Research Institute, A Recognized Research Centre of University of Mysore, Bangalore, India
| | - M Vukku
- Division of Nutrition, St. John's Research Institute, A Recognized Research Centre of University of Mysore, Bangalore, India
| | - R Rajashekhar
- Division of Nutrition, St. John's Research Institute, A Recognized Research Centre of University of Mysore, Bangalore, India.,Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - A Mukhopadhyay
- Division of Nutrition, St. John's Research Institute, A Recognized Research Centre of University of Mysore, Bangalore, India.
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Atlass JH, Rogan S, Himes KP. Accuracy of estimated fetal weight in extremely preterm infants and the impact of prepregnancy body mass index. Am J Obstet Gynecol MFM 2022; 4:100615. [PMID: 35283348 DOI: 10.1016/j.ajogmf.2022.100615] [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: 12/19/2021] [Revised: 03/02/2022] [Accepted: 03/06/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Antenatally, we rely on ultrasound estimated fetal weight as a proxy for birthweight to inform discussions regarding perinatal morbidity and mortality. Maternal obesity may negatively impact the quality of ultrasound imaging, and thus, understanding the associations between obesity and estimated fetal weight in the preterm period is important. OBJECTIVE Given the rising obesity rates and association with preterm birth, we sought to determine the accuracy of ultrasound-derived estimated fetal weight in predicting birthweight in preterm infants by prepregnancy body mass index and to evaluate the accuracy of estimated fetal weight in predicting birthweight between small-for-gestational-age and appropriate-for-gestational-age infants. STUDY DESIGN We included all women who delivered a live-born singleton infant between 23 0/7 and 31 6/7 weeks of gestation and had an ultrasound estimated fetal weight within 7 days before delivery. We calculated the mean percentage difference between estimated fetal weight and birthweight and the absolute percent difference. Excess error was defined as an absolute percentage difference of >20%. We used multivariable modified Poisson models to determine the association between prepregnancy body mass index and small for gestational age and excess ultrasound error. RESULTS Our cohort included 641 infants with a mean gestational age of 28.0±2.6 weeks and a mean birthweight of 1110±425 g. More than one-third of our cohort were obese (227 [35%]). The mean percentage difference between estimated fetal weight and birthweight was 7.7%±11.2% among all infants. Ultrasound overestimated birthweight in 77% of the cohort (n=492). Stratified by body mass index, the mean percentage differences between estimated fetal weight and birthweight were 6.7%±11.0% in women with normal weight and 9.5%±12.0% in women with obesity (P=.02). The mean percentage differences between estimated fetal weight and birthweight were 11.0%±11.0% in small-for-gestational-age infants (n=80) and 7.1%±11.0% in appropriate-for-gestational-age infants (P<.001). Small-for-gestational-age infant was associated with an increased risk of excess ultrasound error with an adjusted relative risk of 2.3 (95% confidence interval, 1.2-4.3). CONCLUSION Although ultrasound estimated fetal weight overestimated birthweight, particularly in small-for-gestational-age infants, most estimates were within 10% of actual birthweight. Obesity and small-for-gestational-age birth were both associated with an increased risk of excess ultrasound error (≥20%) in estimating birthweight.
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Affiliation(s)
- Jacqueline H Atlass
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh Medical Center Magee-Womens Hospital, Pittsburgh, PA.
| | - Sarah Rogan
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh Medical Center Magee-Womens Hospital, Pittsburgh, PA
| | - Katherine P Himes
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh Medical Center Magee-Womens Hospital, Pittsburgh, PA; Magee-Womens Research Institute and Foundation, University of Pittsburgh Medical Center Magee-Womens Hospital, Pittsburgh, PA
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The importance of nutrition in pregnancy and lactation: lifelong consequences. Am J Obstet Gynecol 2022; 226:607-632. [PMID: 34968458 PMCID: PMC9182711 DOI: 10.1016/j.ajog.2021.12.035] [Citation(s) in RCA: 149] [Impact Index Per Article: 74.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 12/17/2021] [Accepted: 12/20/2021] [Indexed: 11/25/2022]
Abstract
Most women in the United States do not meet the recommendations for healthful nutrition and weight before and during pregnancy. Women and providers often ask what a healthy diet for a pregnant woman should look like. The message should be “eat better, not more.” This can be achieved by basing diet on a variety of nutrient-dense, whole foods, including fruits, vegetables, legumes, whole grains, healthy fats with omega-3 fatty acids that include nuts and seeds, and fish, in place of poorer quality highly processed foods. Such a diet embodies nutritional density and is less likely to be accompanied by excessive energy intake than the standard American diet consisting of increased intakes of processed foods, fatty red meat, and sweetened foods and beverages. Women who report “prudent” or “health-conscious” eating patterns before and/or during pregnancy may have fewer pregnancy complications and adverse child health outcomes. Comprehensive nutritional supplementation (multiple micronutrients plus balanced protein energy) among women with inadequate nutrition has been associated with improved birth outcomes, including decreased rates of low birthweight. A diet that severely restricts any macronutrient class should be avoided, specifically the ketogenic diet that lacks carbohydrates, the Paleo diet because of dairy restriction, and any diet characterized by excess saturated fats. User-friendly tools to facilitate a quick evaluation of dietary patterns with clear guidance on how to address dietary inadequacies and embedded support from trained healthcare providers are urgently needed. Recent evidence has shown that although excessive gestational weight gain predicts adverse perinatal outcomes among women with normal weight, the degree of prepregnancy obesity predicts adverse perinatal outcomes to a greater degree than gestational weight gain among women with obesity. Furthermore, low body mass index and insufficient gestational weight gain are associated with poor perinatal outcomes. Observational data have shown that first-trimester gain is the strongest predictor of adverse outcomes. Interventions beginning in early pregnancy or preconception are needed to prevent downstream complications for mothers and their children. For neonates, human milk provides personalized nutrition and is associated with short- and long-term health benefits for infants and mothers. Eating a healthy diet is a way for lactating mothers to support optimal health for themselves and their infants.
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Nonterah EA, Welaga P, Chatio ST, Kehoe SH, Ofosu W, Ward KA, Godfrey KM, Oduro AR, Newell ML. Children born during the hunger season are at a higher risk of severe acute malnutrition: Findings from a Guinea Sahelian ecological zone in Northern Ghana. MATERNAL & CHILD NUTRITION 2022; 18:e13313. [PMID: 35008126 PMCID: PMC8932825 DOI: 10.1111/mcn.13313] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 11/28/2021] [Accepted: 12/10/2021] [Indexed: 12/13/2022]
Abstract
Heightened food insecurity in the hunger season increases the risk of severe acute malnutrition (SAM) in childhood. This study examined the association of season of birth with SAM in a Guinean Sahelian ecological zone. We analyzed routine health and sociodemographic surveillance data from the Navrongo Health and Socio-demographic Surveillance System collected between 2011 and 2018. January-June, the period of highest food insecurity, was defined as the hunger season. We defined moderate acute malnutrition as child mid-upper arm circumference (MUAC) between 115 mm and 135 mm and SAM as MAUC ≤ 115 mm. We used adjusted logistic regression to quantify the association between the season of birth and SAM in children aged 6-35 months. From the 29,452 children studied, 24% had moderate acute malnutrition. Overall, 1.4% had SAM, with a higher prevalence (1.8%) in the hunger season of birth. Compared with those born October-December, adjusted odds ratios (aOR) and 95% confidence interval (95% CI) for SAM were increased for children born in the hunger season: January-March (1.77 [1.31-2.39]) and April-June (1.92 [1.44-2.56]). Low birth weight, age at an assessment of nutritional status, and ethno-linguistic group were also significantly associated with SAM in adjusted analyses. Our study established that being born in the hunger season is associated with a higher risk of severe acute malnutrition. The result implies improvement in the food supply to pregnant and lactating mothers through sustainable agriculture or food system change targeting the hunger season may reduce the burden of severe acute malnutrition.
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Affiliation(s)
- Engelbert A Nonterah
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Paul Welaga
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
- School of Medicine and Dentistry, C K Tedam University of Technology and Applied Sciences, Navrongo, Upper East Region, Ghana
| | - Samuel T Chatio
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
| | - Sarah H Kehoe
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton, Southampton, UK
| | - Winfred Ofosu
- Upper East Regional Health Directorate, PMB, Bolgatanga, Ghana
| | - Kate A Ward
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton, Southampton, UK
- Global Health Research Institute, School of Health and Human Development, University of Southampton, Southampton, UK
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton, Southampton, UK
| | - Abraham R Oduro
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
| | - Marie-Louise Newell
- Department of Human Development, University of Southampton, Southampton, UK
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Eyasu K, Gebremariam LW, Gebrearegay F, Hadush Z, Mulugeta A. Community food beliefs during pregnancy in rural kebeles of Ofla Woreda, Northern Ethiopia: an explorative qualitative study. BMC Pregnancy Childbirth 2022; 22:256. [PMID: 35346095 PMCID: PMC8958790 DOI: 10.1186/s12884-022-04593-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 03/14/2022] [Indexed: 11/10/2022] Open
Abstract
Background Dietary related misconceptions during pregnancy affect the heath of mothers and their growing babies. Misconceptions vary from place to place and from community to community. Understanding of a given community’s food perceptions during pregnancy helps policy makers able to design cultural appropriate interventions. In Ethiopia, however, evidences on food beliefs and perceptions during pregnancy are limited. Therefore, this study is aimed at qualitatively assessing community food beliefs during pregnancy in rural kebeles of Ofla Woreda, Northern Ethiopia. Methods We conducted 10 in-depth interviews (n = 10) and four focus group discussions (n = 32) among purposively selected community groups including pregnant mothers, religious leaders, and elders in rural kebeles of Ofla Woreda, Northern Ethiopia. Data were transcribed word-for-word, translated into English, and uploaded into ATLAST ti version 7.5.1.6. Data were analyzed following the principles of thematic analysis. Line-by-line coding was applied to identify codes; identified codes were categorized based on their similarities and differences and themes were developed inductively. Results Three main themes were identified inductively; foods positively and negatively linked with pregnancy; perceived benefits and harms of alcoholic drinks during pregnancy; and religion and fasting. In this study, consumptions of animal source foods such as egg were discouraged because such foods were perceived to increase the risk of having big baby that could delay delivery. However, intakes of locally produced alcoholic drinks during pregnancy were encouraged by the local community. Furthermore, avoidance of animal source foods and meal skipping during religious fasting-periods were also common practices among pregnant mothers in the study area. Conclusions This study explored misconceptions on food intakes during pregnancy. Positive attitude towards intake of “soft” alcoholic drinks might result in alcohol related teratogenic effects. Restriction on the intakes of nutrient rich diets due to religious fasting and other misconceptions would lead to insufficient nutrient intake both to the mothers and their growing fetus. Culturally appropriate intervention to improve awareness on healthy dietary intake during pregnancy is needed. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04593-3.
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Miko E, Csaszar A, Bodis J, Kovacs K. The Maternal–Fetal Gut Microbiota Axis: Physiological Changes, Dietary Influence, and Modulation Possibilities. Life (Basel) 2022; 12:life12030424. [PMID: 35330175 PMCID: PMC8955030 DOI: 10.3390/life12030424] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 02/07/2023] Open
Abstract
The prenatal period and the first years of life have a significant impact on the health issues and life quality of an individual. The appropriate development of the immune system and the central nervous system are thought to be major critical determining events. In parallel to these, establishing an early intestinal microbiota community is another important factor for future well-being interfering with prenatal and postnatal developmental processes. This review aims at summarizing the main characteristics of maternal gut microbiota and its possible transmission to the offspring, thereby affecting fetal and/or neonatal development and health. Since maternal dietary factors are potential modulators of the maternal–fetal microbiota axis, we will outline current knowledge on the impact of certain diets, nutritional factors, and nutritional modulators during pregnancy on offspring’s microbiota and health.
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Affiliation(s)
- Eva Miko
- Department of Medical Microbiology and Immunology, Medical School, University of Pécs, 12 Szigeti Street, 7624 Pécs, Hungary
- National Laboratory for Human Reproduction, University of Pécs, 7624 Pécs, Hungary; (A.C.); (J.B.); (K.K.)
- Janos Szentagothai Research Centre, 20 Ifjusag Street, 7624 Pécs, Hungary
- Correspondence: ; Tel.: +36-(72)-536001 (ext. 31907)
| | - Andras Csaszar
- National Laboratory for Human Reproduction, University of Pécs, 7624 Pécs, Hungary; (A.C.); (J.B.); (K.K.)
- Department of Obstetrics and Gynaecology, Medical School, University of Pécs, 17 Edesanyak Street, 7624 Pécs, Hungary
| | - Jozsef Bodis
- National Laboratory for Human Reproduction, University of Pécs, 7624 Pécs, Hungary; (A.C.); (J.B.); (K.K.)
- Department of Obstetrics and Gynaecology, Medical School, University of Pécs, 17 Edesanyak Street, 7624 Pécs, Hungary
| | - Kalman Kovacs
- National Laboratory for Human Reproduction, University of Pécs, 7624 Pécs, Hungary; (A.C.); (J.B.); (K.K.)
- Department of Obstetrics and Gynaecology, Medical School, University of Pécs, 17 Edesanyak Street, 7624 Pécs, Hungary
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Timur Taşhan S, İnci Coşkun E, Nacar G, Erci B. The effect of motivational video and nutrition on the non-stress test: a randomised controlled clinical trial. J OBSTET GYNAECOL 2022; 42:2144-2150. [PMID: 35170379 DOI: 10.1080/01443615.2022.2034765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study aimed to determine the effect of motivational video stimulation and nutrition on the non-stress test (NST). The sample of the study consisted of 360 pregnant women in total, including two experimental groups and one control group (120 pregnant women in each group). After the pregnant women in the study were divided into three groups at a 1:1:1 ratio with the computer-assisted random sampling method, the draw method was used to determine the experimental and control groups. The pregnant women in the first experimental group were allowed to consume cake and juice 30 min before the NST procedure. The pregnant women in the second experimental group were also allowed to consume cake and juice, while they were also shown a video with the content of development and changes in the mother and the foetus during pregnancy, with relaxing music, for about 15-20 min. There was no intervention made in the control group. The data were collected using a Participant Information Form and an NST Findings Registry Form which were created by the researchers based on their review of the relevant literature. The data were analysed using arithmetic means, percentage distributions, ANOVA, Bonferroni and chi-squared tests. It was found that the mean number of foetal movements and the mean number of accelerations in the cake + juice and motivational video groups were higher than those in the control group (p < 0.001). Besides, the pregnant women in the experimental groups were found to have more reactive NST results. As a result, it was determined that the motivational video and cake + juice interventions improved the movement of the foetus, the number of accelerations and the ratio of reactivity in NST, but the two interventions did not have any superiority over each other. It is recommended to offer cake and juice to pregnant women before NST or have them watch a motivational video during NST, for having good NST results.Impact statementWhat is already known about the topic? The false-positive rates of the NST, which enables monitoring foetal movements and foetal heart rates, are high. These false-positive rates of the NST lead to many obstetric complications, in addition to increasing the rates of cesarean-section deliveries. Recent studies showed that there are methods and factors that increase foetal movements and shorten the application period of the NST. It was identified that food intake, music therapy, foetal vibroacoustic and halogen light stimulation before the NST increases foetal movements and shortens the application period of the NST.What this paper adds? In the study, it was found that watching motivational videos and consuming cake and juice increased the number of foetal movements, the number of accelerations and the rate of reactive NST results, but the two interventions did not have superiority over each other.What are the implications of these findings for clinical practice and/or further research? In order to increase reactive NST rates, it is recommended that pregnant women consume cake and fruit juice before the procedure and watch a motivational video during the NST procedure.
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Affiliation(s)
- Sermin Timur Taşhan
- Department of Obstetrics and Gynecology Nursing, Faculty of Nursing, Inonu University, Malatya, Turkey
| | - Ebru İnci Coşkun
- Department of Obstetrics and Gynecology, School of Medicine, Inonu University, Malatya, Turkey
| | - Gülçin Nacar
- Department of Obstetrics and Gynecology Nursing, Faculty of Nursing, Inonu University, Malatya, Turkey
| | - Behice Erci
- Department of Public Health Nursing, Faculty of Nursing, Inonu University, Malatya, Turkey
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Mo L, Zhao C, Huang B, Niu J, Hong S, Li J, Lin Y, Qin F. Health Effects of Dietary Oxidized Milk Administration in Offspring Mice during Pregnancy and Lactation with Metabolomic Strategies. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2022; 70:1679-1688. [PMID: 35104143 DOI: 10.1021/acs.jafc.1c07132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Milk is an important source of nutrients during pregnancy. Previous studies have consistently shown that oxidation in milk and dairy products can induce oxidative stress, inflammation, and fibrosis in the liver and kidney. However, the mechanism underlying these effects remains largely unexplored. This study aimed to investigate the effects of oxidized milk on fecal metabolism and liver and kidney function of offspring mice. Oxidative modification of milk was performed using H2O2-Cu or heating, causing varying degrees of oxidative damage. Kunming female mice were fed with a H2O2-Cu, heat, or normal control diet until their offspring were 3 weeks old. Feces were collected for the metabolomics study based on mass spectrometry. Forty-two potentially significant metabolic biomarkers were screened, and each group's relative intensity was compared. The results showed that oxidized milk mainly regulated isoleucine metabolism, proline metabolism, and tricarboxylic acid cycle. In addition, the histopathological analysis showed accumulation of protein and lipid oxidation products in the liver and kidney tissues after intake of oxidized milk, which induced oxidative stress, increased the levels of inflammatory factors, and significantly increased the expression of genes and proteins involved in inflammatory pathways. The above results suggest that intake of oxidized milk during gestation may increase the risk of liver and kidney injury in male offspring by interfering with amino acid and energy metabolism, highlighting the potential health risks of oxidized milk in humans.
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Affiliation(s)
- Ling Mo
- The Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Health, Guilin, Guangxi 541004, China
- Department of Nutrition and Food Hygiene, School of Public Health, Guilin Medical University, Guilin, Guangxi 541004, China
- Center for Food Nutrition and Functional Food Engineering, School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
| | - Chaochao Zhao
- The Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Health, Guilin, Guangxi 541004, China
- Department of Nutrition and Food Hygiene, School of Public Health, Guilin Medical University, Guilin, Guangxi 541004, China
| | - Bo Huang
- The Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Health, Guilin, Guangxi 541004, China
- Department of Nutrition and Food Hygiene, School of Public Health, Guilin Medical University, Guilin, Guangxi 541004, China
| | - Jiawei Niu
- The Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Health, Guilin, Guangxi 541004, China
- Department of Nutrition and Food Hygiene, School of Public Health, Guilin Medical University, Guilin, Guangxi 541004, China
| | - Siyan Hong
- The Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Health, Guilin, Guangxi 541004, China
- Department of Nutrition and Food Hygiene, School of Public Health, Guilin Medical University, Guilin, Guangxi 541004, China
| | - Jingjing Li
- The Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Health, Guilin, Guangxi 541004, China
- Department of Nutrition and Food Hygiene, School of Public Health, Guilin Medical University, Guilin, Guangxi 541004, China
| | - Yintao Lin
- The Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Health, Guilin, Guangxi 541004, China
- Department of Nutrition and Food Hygiene, School of Public Health, Guilin Medical University, Guilin, Guangxi 541004, China
| | - Fengqiong Qin
- The Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Health, Guilin, Guangxi 541004, China
- Department of Nutrition and Food Hygiene, School of Public Health, Guilin Medical University, Guilin, Guangxi 541004, China
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Mohammadi A, Effati-Daryani F, Ghelichkhani F, Zarei S, Mirghafourvand M. Effective factors on nutrition behaviors of pregnant women based on the beliefs, attitudes, subjective norms, and enabling factors model: A cross-sectional study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:12. [PMID: 35281378 PMCID: PMC8893070 DOI: 10.4103/jehp.jehp_1609_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 05/06/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND One of the useful models in health education is the Beliefs, Attitudes, Subjective Norms, and Enabling Factors (BASNEF) model. The model is used to study behavior and to plan for change it and to determine the factors that influence people's decision-making. The aim of this study was to investigate the factors affecting the nutritional behavior of pregnant women based on BASNEF model. MATERIALS AND METHODS This cross-sectional study was performed on 360 pregnant women referring to health centers of Tabriz-Iran by two-stage cluster sampling method from April to December 2016. Data were collected using sociodemographic, nutrition subdomain of Health Promoting Lifestyle-II (HPLP-II), and researcher-made questionnaire based on constructs of BASNEF model. Data were analyzed using the SPSS software version 21 and Pearson correlation test and General Linear Model (GLM). RESULTS Mean ± standard deviation (SD) of nutrition subdomain of HPLP-II was 24.65 ± 4.75 within the range 9-36. Mean ± SD of BASNEF model constructs (score range) was also obtained as 45.30 ± 10.80 (0-100), 17.98 ± 2.40 (8-24), 9.30 ± 2.82 (0-20) and 2.47 ± 1.74 (0-6) for belief, attitude, subjective norms, and enabling factors, respectively. Based on the GLM, there was significant relationships between nutritional behavior and BASNEF model constructs (belief [P < 0.001], attitude [P = 0.043], enabling factors [P < 0.001], and subjective norms [P = 0.038]) as well as the variables of job, husband's education, and job and sufficiency of income for expenses. CONCLUSION The results of the present study showed the impact of BASNEF model constructs and some sociodemographic variables on nutrition behaviors in pregnant women. Therefore, in order to improve nutrition behaviors of pregnant women, designing and implementation of interventions based on the BASNEF model are recommended.
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Affiliation(s)
- Azam Mohammadi
- Department of Midwifery and Reproductive Health, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Effati-Daryani
- Department of Midwifery, Reproductive Health Research Center, Faculty of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Fatemeh Ghelichkhani
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran and Midwifery Department, Emam Sajad Hospital, Iran University of Medical Sciences, Shahriar, Tehran, Iran
| | - Somayeh Zarei
- Department of Midwifery, Shohada Hospital, Qom University of Medical Sciences, Qom, Iran
| | - Mojgan Mirghafourvand
- Department of Midwifery, Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Nutritional support and prophylaxis of azithromycin for pregnant women to improve birth outcomes in peri-urban slums of Karachi, Pakistan-a protocol of multi-arm assessor-blinded randomized controlled trial (Mumta PW trial). Trials 2022; 23:2. [PMID: 34980232 PMCID: PMC8721479 DOI: 10.1186/s13063-021-05960-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 12/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Maternal undernutrition is critical in the etiology of poor perinatal outcomes and accounts for 20% of small-for-gestational-age (SGA) births. High levels of food insecurity, antenatal undernourishment, and childhood undernutrition necessitate the supplementation of fortified balanced energy protein (BEP) during pregnancy in low-income settings especially with scarce literature available in this subject. Hence, this paper extensively covers the protocol of such a trial conducted in an urban slum of Karachi, Pakistan. METHODS The trial is community-based, open-labelled, four-arm, and randomized controlled that will include parallel group assignments with a 1:1:1:1 allocation ratio in low-income squatter settlements in urban Karachi, Pakistan. All pregnant women (PW), if identified between > 8 and < 19 weeks of gestation based on ultrasound, will be offered routine antenatal care (ANC) counseling and voluntary participation in the trial after written informed consent. A total number of 1836 PW will be enrolled with informed consent and randomly allocated to one of the four arms receiving: (1) ANC counseling only (control group), (2) ANC counseling plus BEP supplement (intervention arm 1), (3) ANC counseling plus BEP supplement plus 2 doses azithromycin (intervention arm 2), or (4) ANC counseling plus BEP supplement plus daily single dose of nicotinamide and choline (intervention arm 3). TRIAL REGISTRATION ClinicalTrials.gov NCT04012177 . Registered on July 9, 2019.
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Oxidative Stress Profile of Mothers and Their Offspring after Maternal Consumption of High-Fat Diet in Rodents: A Systematic Review and Meta-Analysis. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:9073859. [PMID: 34868458 PMCID: PMC8636978 DOI: 10.1155/2021/9073859] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 09/27/2021] [Accepted: 10/26/2021] [Indexed: 01/03/2023]
Abstract
Maternal exposure to the high-fat diet (HFD) during gestation or lactation can be harmful to both a mother and offspring. The aim of this systematic review was to identify and evaluate the studies with animal models (rodents) that were exposed to the high-fat diet during pregnancy and/or lactation period to investigate oxidative stress and lipid and liver enzyme profile of mothers and their offspring. The electronic search was performed in the PUBMED (Public/Publisher MEDLINE), EMBASE (Ovid), and Web of Science databases. Data from 77 studies were included for qualitative analysis, and of these, 13 studies were included for meta-analysis by using a random effects model. The pooled analysis revealed higher malondialdehyde levels in offspring of high-fat diet groups. Furthermore, the pooled analysis showed increased reactive oxygen species and lower superoxide dismutase and catalase in offspring of mothers exposed to high-fat diet during pregnancy and/or lactation. Despite significant heterogeneity, the systematic review shows oxidative stress in offspring induced by maternal HFD.
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Paulsamy P, Easwaran V, Ashraf R, Alshahrani SH, Venkatesan K, Qureshi AA, Arrab MM, Prabahar K, Periannan K, Vasudevan R, Kandasamy G, Chidambaram K, Pappiya EM, Venkatesan K, Manoharan V. Association of Maternal Observation and Motivation (MOM) Program with m-Health Support on Maternal and Newborn Health. Healthcare (Basel) 2021; 9:healthcare9121629. [PMID: 34946355 PMCID: PMC8702075 DOI: 10.3390/healthcare9121629] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/20/2021] [Accepted: 11/21/2021] [Indexed: 02/01/2023] Open
Abstract
Maternal and child nutrition has been a critical component of health, sustainable development, and progress in low- and middle-income countries (LMIC). While a decrement in maternal mortality is an important indicator, simply surviving pregnancy and childbirth does not imply better maternal health. One of the fundamental obligations of nations under international human rights law is to enable women to endure pregnancy and delivery as an aspect of their enjoyment of reproductive and sexual health and rights and to live a dignified life. The aim of this study was to discover the correlation between the Maternal Observation and Motivation (MOM) program and m-Health support for maternal and newborn health. A comparative study was done among 196 pregnant mothers (study group-94; control group-102 mothers) with not less than 20 weeks of gestation. Maternal outcomes such as Hb and weight gain and newborn results such as birth weight and crown-heel length were obtained at baseline and at 28 and 36 weeks of gestation. Other secondary data collected were abortion, stillbirth, low birth weight, major congenital malformations, twin or triplet pregnancies, physical activity, and maternal well-being. The MOM intervention included initial face-to-face education, three in-person visits, and eight virtual health coaching sessions via WhatsApp. The baseline data on Hb of the mothers show that 31 (32.98%) vs. 27 (28.72%) mothers in the study and control group, respectively, had anemia, which improved to 27.66% and 14.98% among study group mothers at 28 and 36 weeks of gestation (p < 0.001). The weight gain (p < 0.001), level of physical activity (p < 0.001), and maternal well-being (p < 0.01) also had significant differences after the intervention. Even after controlling for potentially confounding variables, the maternal food practices regression model revealed that birth weight was directly correlated with the consumption of milk (p < 0.001), fruits (p < 0.01), and green vegetables (p < 0.05). As per the physical activity and maternal well-being regression model, the birth weight and crown-heel length were strongly related with the physical activity and maternal well-being of mothers at 36 weeks of gestation (p < 0.05). Combining the MOM intervention with standard antenatal care is a safe and effective way to improve maternal welfare while upholding pregnant mothers' human rights.
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Affiliation(s)
- Premalatha Paulsamy
- College of Nursing, Mahalah Branch for Girls, King Khalid University, Khamis Mushaiyt 61421, Saudi Arabia; (P.P.); (S.H.A.); (M.M.A.)
| | - Vigneshwaran Easwaran
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia; (V.E.); (G.K.)
| | - Rizwan Ashraf
- Department of Pharmacology, University College of Medicine and Dentistry, The University of Lahore, Lahore 55150, Pakistan;
| | - Shadia Hamoud Alshahrani
- College of Nursing, Mahalah Branch for Girls, King Khalid University, Khamis Mushaiyt 61421, Saudi Arabia; (P.P.); (S.H.A.); (M.M.A.)
| | - Krishnaraju Venkatesan
- Department of Pharmacology, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia; (A.A.Q.); (R.V.); (K.C.)
- Correspondence:
| | - Absar Ahmed Qureshi
- Department of Pharmacology, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia; (A.A.Q.); (R.V.); (K.C.)
| | - Mervat Moustafa Arrab
- College of Nursing, Mahalah Branch for Girls, King Khalid University, Khamis Mushaiyt 61421, Saudi Arabia; (P.P.); (S.H.A.); (M.M.A.)
- Family and Community Health Nursing, Faculty of Nursing, Menoufia University, Shibin el Kom 32511, Egypt
| | - Kousalya Prabahar
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi Arabia;
| | - Kalaiselvi Periannan
- Department of Mental Health Nursing, Oxford School of Nursing & Midwifery, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford OX3 0FL, UK;
| | - Rajalakshimi Vasudevan
- Department of Pharmacology, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia; (A.A.Q.); (R.V.); (K.C.)
| | - Geetha Kandasamy
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia; (V.E.); (G.K.)
| | - Kumarappan Chidambaram
- Department of Pharmacology, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia; (A.A.Q.); (R.V.); (K.C.)
| | - Ester Mary Pappiya
- Regional Nursing Administration, Directorate of General Health Affair, Ministry of Health, Najran 21431, Saudi Arabia;
| | - Kumar Venkatesan
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia;
| | - Vani Manoharan
- Georgia CTSA, Emory University Hospital, Atlanta, GA 30078, USA;
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Loo RSX, Yap F, Ku CW, Cheung YB, Tan KH, Chan JKY, Loy SL. Maternal meal irregularities during pregnancy and lifestyle correlates. Appetite 2021; 168:105747. [PMID: 34637771 DOI: 10.1016/j.appet.2021.105747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 10/05/2021] [Accepted: 10/08/2021] [Indexed: 11/02/2022]
Abstract
Meal regularity can influence metabolic health. However, habits of skipping and delaying meals are rarely studied among pregnant women. This study examined the incidence of maternal meal skipping and meal delaying, and their associated lifestyle patterns during pregnancy. Pregnant women in the second trimester (18-24 weeks' gestation; n = 90) were recruited from the antenatal clinics in KK Women's and Children's Hospital, Singapore, 2019-2020. Data on sociodemographic, lifestyle and dietary habits were collected. Firstly, principal component analysis was used to identify lifestyle patterns. Subsequently, multiple logistic regression model was used to examine the association of lifestyle patterns with meal skipping and delaying. In total, 32 (35.6%) women had irregular meals, in which 25 (27.8%) and 26 (28.9%) women reported meal skipping and meal delaying for at least 3 times a week, respectively. Women with 'poor sleep and emotion' pattern as characterized by higher scores for poor sleep, depression, anxiety, and stress symptoms were associated with higher odds of meal skipping (OR 1.99; 95% CI 1.13, 3.53) and meal delaying (2.50; 1.31, 4.79). 'Sedentary' pattern, as characterized by greater daily time spent on television and screen electronic devices, and 'weight and inactivity' pattern, as characterized by higher BMI and physical inactivity level, were not associated with meal regularity. In this study, almost one-third of women reporting meal irregularities during pregnancy. 'Poor sleep and emotion' pattern is associated with a higher incidence of meal skipping and delaying. These findings suggest the need to address sleep and emotional health in interventions promoting healthy nutrition specifically regular eating in pregnancy.
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Affiliation(s)
| | - Fabian Yap
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore; Duke-NUS Medical School, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Chee Wai Ku
- Duke-NUS Medical School, Singapore; Department of Obstetrics & Gynaecology, KK Women's and Children's Hospital, Singapore
| | - Yin Bun Cheung
- Program in Health Services & Systems Research and Center for Quantitative Medicine, Duke-NUS Medical School, Singapore; Tampere Center for Child, Adolescent and Maternal Health Research, Tampere University, Tampere, Finland
| | - Kok Hian Tan
- Duke-NUS Medical School, Singapore; Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore
| | - Jerry Kok Yen Chan
- Duke-NUS Medical School, Singapore; Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore
| | - See Ling Loy
- Duke-NUS Medical School, Singapore; Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore.
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Ovadia YS, Zangen S, Rosen SR, Gefel D, Almashanu S, Benbassat C, Fytlovich S, Aharoni D, Anteby EY, Shenhav S. Maternal iodine deficiency: a newborns' overweight risk factor? A prospective study. Arch Gynecol Obstet 2021; 305:777-787. [PMID: 34599677 DOI: 10.1007/s00404-021-06261-x] [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: 01/22/2021] [Accepted: 09/15/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Childhood obesity and iodine deficiency are global public health concerns. Whether maternal iodine status mediates overweight in infancy has yet to be explored. We aimed to assess the relationship between maternal iodine status and infant birth weight, including small and large for gestational age (SGA and LGA, respectively). METHODS A prospective study was carried out among 134 mother-infant pairs from Israel. Maternal iodine intake and status were estimated via questionnaire and serum thyroglobulin (Tg), respectively. Estimated iodine intake below the Recommended Daily Allowance for iodine sufficiency in pregnancy (220 μg/d) considered Inadequate. Maternal and neonatal thyroid function and anthropometric measurements, as well as maternal thyroid antibodies were also tested. RESULTS After screening, 118 participants met the inclusion criteria (distributed trimesters I, II and III: n = 3, n = 21, and n = 94, respectively). There was a negative association of iodine intake with Tg values among the study population. Maternal median Tg value was higher than the sufficiency cutoff (16.5 vs 13 µg/L), indicating insufficient iodine status. No SGA cases were found. Inadequate iodine intake was associated with maternal isolated hypothyroxinemia (OR = 3.4; 95% CI 1.2, 9.9) and higher birthweight (including macrosomia and LGA) rates. A suggestive association of elevated Tg with a greater risk of LGA was observed. Offsprings' birth weight percentiles were associated with Tg values in pregnant women with suggestive sufficient iodine status (n = 62, R2 = 0.11, p < 0.05). CONCLUSIONS Iodine status during pregnancy can be associated with newborn anthropometric index. Maternal inadequate iodine intake may alter fetal growth and might increase the risk of LGA among newborns. These initial findings support the need to further study the impact of iodine deficiency on newborns overweight in Israel and elsewhere.
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Affiliation(s)
- Yaniv S Ovadia
- Obstetrics and Gynecology Department, Barzilai University Medical Center Ashkelon, Ashkeon, Israel. .,Foreign studies department; Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rhovot, Israel.
| | - Shmuel Zangen
- Department of Neonatology, Barzilai University Medical Center Ashkelon, Ashkelon, Israel.,Faculty of Health Sciences, Ben-Gurion University of Negev, Beer-Sheva, Israel
| | - Shani R Rosen
- School of Nutritional Science, Institute of Biochemistry, Food Science and Nutrition; Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Dov Gefel
- School of Nutritional Science, Institute of Biochemistry, Food Science and Nutrition; Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Shlomo Almashanu
- National Newborn Screening Program, Ministry of Health, Tel-Hashomer, Israel
| | - Carlos Benbassat
- Endocrine Institute, Shamir Medical Center, Zerifin, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shlomo Fytlovich
- Laboratory of Clinical Biochemistry, Barzilai University Medical Center Ashkelon, Ashkelon, Israel
| | - Dorit Aharoni
- Laboratory of Clinical Biochemistry, Barzilai University Medical Center Ashkelon, Ashkelon, Israel
| | - Eyal Y Anteby
- Obstetrics and Gynecology Department, Barzilai University Medical Center Ashkelon, Ashkeon, Israel.,Faculty of Health Sciences, Ben-Gurion University of Negev, Beer-Sheva, Israel
| | - Simon Shenhav
- Obstetrics and Gynecology Department, Barzilai University Medical Center Ashkelon, Ashkeon, Israel.,Faculty of Health Sciences, Ben-Gurion University of Negev, Beer-Sheva, Israel
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21
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de Dios-Aguado M, Agulló-Ortuño MT, Ugarte-Gurrutxaga MI, Yañez-Araque B, Molina-Gallego B, Gómez-Cantarino S. Nutritional Health Education in Pregnant Women in a Rural Health Centre: Results in Spanish and Foreign Women. Healthcare (Basel) 2021; 9:1293. [PMID: 34682974 PMCID: PMC8544496 DOI: 10.3390/healthcare9101293] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 09/18/2021] [Accepted: 09/22/2021] [Indexed: 12/03/2022] Open
Abstract
The dietary behaviour of pregnant women, as well as the socio-cultural conditions in which pregnancy takes place, influence obstetric outcomes. To analyse the influence of socioeconomic factors and dietary habits on obstetric outcomes in Spanish and foreign pregnant women living in a rural environment, a population-based, prospective-observational study in a cohort of Spanish and foreign pregnant women in the town of Yepes, in the province of Toledo, Spain was conducted. Foreign pregnant women are ecodependent on their partners, have secondary education and low socioeconomic level. Spanish pregnant women have secondary education, a medium socio-economic level, live with their partners and are economically independent. Moreover, 85% of Spanish pregnant women gave birth at term and reached a gestational age of 40 ± 1.83 weeks. However, only 55% of foreign pregnant women reached a gestational age of 39.72 ± 2.28 weeks. Through health education, pregnant women in this geographical area of Castilla la Mancha, Spain, adopted bicultural dietary patterns, thus reaching the prescribed diet of 2000 Kcal. Through this diet, both Spanish and foreign pregnant women maintained albumin and plasma protein levels within the established range, with no significant differences in obstetric outcomes among pregnant women in the study.
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Affiliation(s)
- Mercedes de Dios-Aguado
- Primary Health Care No.1. Health Centre, Yepes, Castilla-La Mancha Public Health Service (SESCAM), 45005 Toledo, Spain;
- Research Group Nursing, Pain and Care (ENDOCU), UCLM, Av. Carlos III s/n, 45071 Toledo, Spain; (M.I.U.-G.); (B.M.-G.)
| | - María Teresa Agulló-Ortuño
- Faculty of Physiotherapy and Nursing of the Toledo Campus, University of Castilla-La Mancha (UCLM), 45071 Toledo, Spain;
| | - María Idoia Ugarte-Gurrutxaga
- Research Group Nursing, Pain and Care (ENDOCU), UCLM, Av. Carlos III s/n, 45071 Toledo, Spain; (M.I.U.-G.); (B.M.-G.)
- Faculty of Physiotherapy and Nursing of the Toledo Campus, University of Castilla-La Mancha (UCLM), 45071 Toledo, Spain;
| | - Benito Yañez-Araque
- Department of Physical Activity and Sports Sciences, Campus Toledo, University of Castilla-La Mancha, 45071 Toledo, Spain;
| | - Brígida Molina-Gallego
- Research Group Nursing, Pain and Care (ENDOCU), UCLM, Av. Carlos III s/n, 45071 Toledo, Spain; (M.I.U.-G.); (B.M.-G.)
- Faculty of Physiotherapy and Nursing of the Toledo Campus, University of Castilla-La Mancha (UCLM), 45071 Toledo, Spain;
| | - Sagrario Gómez-Cantarino
- Research Group Nursing, Pain and Care (ENDOCU), UCLM, Av. Carlos III s/n, 45071 Toledo, Spain; (M.I.U.-G.); (B.M.-G.)
- Faculty of Physiotherapy and Nursing of the Toledo Campus, University of Castilla-La Mancha (UCLM), 45071 Toledo, Spain;
- Health Sciences Research Unit: Nursing (UICISA: E), Coimbra School of Nursing (ESEnfC), 3004-011 Coimbra, Portugal
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22
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Cerritelli F, Frasch MG, Antonelli MC, Viglione C, Vecchi S, Chiera M, Manzotti A. A Review on the Vagus Nerve and Autonomic Nervous System During Fetal Development: Searching for Critical Windows. Front Neurosci 2021; 15:721605. [PMID: 34616274 PMCID: PMC8488382 DOI: 10.3389/fnins.2021.721605] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/19/2021] [Indexed: 12/17/2022] Open
Abstract
The autonomic nervous system (ANS) is one of the main biological systems that regulates the body's physiology. Autonomic nervous system regulatory capacity begins before birth as the sympathetic and parasympathetic activity contributes significantly to the fetus' development. In particular, several studies have shown how vagus nerve is involved in many vital processes during fetal, perinatal, and postnatal life: from the regulation of inflammation through the anti-inflammatory cholinergic pathway, which may affect the functioning of each organ, to the production of hormones involved in bioenergetic metabolism. In addition, the vagus nerve has been recognized as the primary afferent pathway capable of transmitting information to the brain from every organ of the body. Therefore, this hypothesis paper aims to review the development of ANS during fetal and perinatal life, focusing particularly on the vagus nerve, to identify possible "critical windows" that could impact its maturation. These "critical windows" could help clinicians know when to monitor fetuses to effectively assess the developmental status of both ANS and specifically the vagus nerve. In addition, this paper will focus on which factors-i.e., fetal characteristics and behaviors, maternal lifestyle and pathologies, placental health and dysfunction, labor, incubator conditions, and drug exposure-may have an impact on the development of the vagus during the above-mentioned "critical window" and how. This analysis could help clinicians and stakeholders define precise guidelines for improving the management of fetuses and newborns, particularly to reduce the potential adverse environmental impacts on ANS development that may lead to persistent long-term consequences. Since the development of ANS and the vagus influence have been shown to be reflected in cardiac variability, this paper will rely in particular on studies using fetal heart rate variability (fHRV) to monitor the continued growth and health of both animal and human fetuses. In fact, fHRV is a non-invasive marker whose changes have been associated with ANS development, vagal modulation, systemic and neurological inflammatory reactions, and even fetal distress during labor.
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Affiliation(s)
- Francesco Cerritelli
- Research and Assistance for Infants to Support Experience Lab, Foundation Center for Osteopathic Medicine Collaboration, Pescara, Italy
| | - Martin G. Frasch
- Department of Obstetrics and Gynecology and Center on Human Development and Disability, University of Washington, Seattle, WA, United States
| | - Marta C. Antonelli
- Facultad de Medicina, Instituto de Biología Celular y Neurociencia “Prof. E. De Robertis”, Universidad de Buenos Aires, Buenos Aires, Argentina
- Department of Obstetrics and Gynecology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Chiara Viglione
- Research and Assistance for Infants to Support Experience Lab, Foundation Center for Osteopathic Medicine Collaboration, Pescara, Italy
| | - Stefano Vecchi
- Research and Assistance for Infants to Support Experience Lab, Foundation Center for Osteopathic Medicine Collaboration, Pescara, Italy
| | - Marco Chiera
- Research and Assistance for Infants to Support Experience Lab, Foundation Center for Osteopathic Medicine Collaboration, Pescara, Italy
| | - Andrea Manzotti
- Research and Assistance for Infants to Support Experience Lab, Foundation Center for Osteopathic Medicine Collaboration, Pescara, Italy
- Department of Pediatrics, Division of Neonatology, “V. Buzzi” Children's Hospital, Azienda Socio-Sanitaria Territoriale Fatebenefratelli Sacco, Milan, Italy
- Research Department, Istituto Osteopatia Milano, Milan, Italy
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23
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Effect of dehydration during pregnancy on birth weight and length in West Jakarta. J Nutr Sci 2021; 10:e70. [PMID: 34527228 PMCID: PMC8411261 DOI: 10.1017/jns.2021.59] [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: 02/06/2021] [Revised: 07/20/2021] [Accepted: 07/22/2021] [Indexed: 11/25/2022] Open
Abstract
Nutrition and maternal behavior are critical factors in fetal development. Maternal water intake is necessary to regulate metabolism and may influence fetal growth. This study aims to determine the effect of dehydration during pregnancy on birth weight and length. This cohort-prospective study took place in the area of Kebon Jeruk District Health Centre. A total of 38 subjects of pregnant women in their second trimester were examined. Subject characteristics were collected through direct measurements and interviews. Urine and blood samples were collected at the sixth trimester (32–34 and 35–37 weeks) to determine hydration status. Nutritional status was collected through food recall, while birth weight and length were obtained from the anthropometric measurements 30 min after birth. From a total of 38 subjects, 20 were dehydrated, and 18 were well hydrated. There was a significant relationship between hydration status and water intake, birth weight and length, head circumference, and chest circumference. After being corrected to the level of water intake, the difference in birth weight and length between the two groups were 500⋅6 g and 0⋅4 cm, and 0⋅8 cm and 1⋅4 cm for the head circumference and chest circumference (P < 0⋅05). It is recommended for mothers to monitor their weight and ensure fluid intake of 3⋅0 l per day. Further research requires more subjects to observe the effects of chronic maternal dehydration on pregnancy output and a cohort study that monitors infant development in the first six months of life.
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24
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Validity and Reproducibility of a Food Frequency Questionnaire to Assess Nutrients Intake of Pregnant Women in the South-East of Spain. Nutrients 2021; 13:nu13093032. [PMID: 34578909 PMCID: PMC8467594 DOI: 10.3390/nu13093032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/27/2021] [Accepted: 08/27/2021] [Indexed: 11/17/2022] Open
Abstract
Proper nutrition during pregnancy is pivotal to maintain good health for the child and the mother. This study evaluates the reproducibility and validity of a food frequency questionnaire (FFQ) designed to assess nutrient intake during pregnancy in the GENEIDA (Genetics, Early life Environmental Exposures and Infant Development in Andalusia) prospective birth cohort study. In addition, the nutrient intake was estimated and then compared with European guidelines and other studies. Diet information was collected from 690 pregnant women using a FFQ administered at two periods of pregnancy (used for the reproducibility study) and 24-h dietary recall (for the validity study). Statistical approaches included Spearman's correlation coefficient and percentage agreement, classifying women into the same or adjacent quintiles to assess reproducibility, and limits of agreement (LoA) to evaluate validity. In the study of reproducibility, significant correlations for nutrients adjusted for total energy had an average of 0.417. Moreover, the percentage of subjects classified in the same quintile for nutrient intakes were above 66%. In the validation study, the significant correlation for nutrients adjusted for total energy had an average of 0.272. Nevertheless, the percentage of results in the LoA was above 94%. Our results were similar to other studies suggesting that the FFQ used is a valid tool of collect dietary intakes for South-East Spanish pregnant women.
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25
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Graciliano NG, Silveira JACD, Oliveira ACMD. The consumption of ultra-processed foods reduces overall quality of diet in pregnant women. CAD SAUDE PUBLICA 2021; 37:e00030120. [PMID: 33729301 DOI: 10.1590/0102-311x00030120] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 06/19/2020] [Indexed: 11/21/2022] Open
Abstract
This study analyzed the role of ultra-processed foods (UPFs) in the food and nutritional profile of pregnant women's diet. This was a cross-sectional study conducted in a representative sample of pregnant women attending primary healthcare units in Maceió, capital of the State of Alagoas, Brazil. Food consumption was assessed with the application of two 24-hour food recalls on nonconsecutive days, and the consumption items were grouped according to the NOVA classification. Overall estimates were expressed as absolute dietary consumption (mean calorie intake) and relative consumption (percentage of total energy intake according to food groups and consumption items). Analysis of variance was used to compare mean energy and nutrient intake according to food groups. The association between quintiles of the energy share from UPFs (exposure variable) and (1) consumption items and food groups, (2) percentage of total energy from macronutrients, and (3) micronutrient density was analyzed via adjusted linear regression models. Mean energy intake in pregnant women was 1,966.9Kcal/day, 22% of which from UPFs. A direct relationship was observed between the percentage of energy from UPFs and total energy consumption (β = 228.78Kcal; SE = 21.26). In addition, an increase in the share of UPFs was associated with a statistically significant reduction in the intake of protein, fiber, magnesium, iron, potassium, zinc, selenium, folate, and vitamins D and E, as well as in the consumption of traditional foods such as protein, beans, roots, and tubers. Our data thus indicate that the consumption of UPFs reduces the overall nutritional and food quality of diet in pregnant women.
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26
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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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27
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Hojaji E, Aghajani M, Zavoshy R, Noroozi M, Jahanihashemi H, Ezzeddin N. Household food insecurity associations with pregnancy hypertension, diabetes mellitus and infant birth anthropometric measures: a cross-sectional study of Iranian mothers. Hypertens Pregnancy 2021; 40:109-117. [PMID: 33476216 DOI: 10.1080/10641955.2021.1874010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective: The purpose of this study was to determine the associations between food insecurity on pregnancy and its outcomes.Materials and methods: This cross-sectional study was carried out on 700 Iranian mothers. Household socioeconomic status, prenatal information and household food security status were assessed using questionnaires. Data analysis was applied by SPSS version 22.Results: The results of the study showed a significant association between food insecurity with gestational diabetes mellitus. The results also showed a significant association between birth weight, and height with pregnancy-induced hypertension.Conclusion: food insecure women should be recognized, and receive appropriate training and assistance.
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Affiliation(s)
- Elham Hojaji
- Gastrointestinal and Liver Disease Research Center (GILDRC), Iran University of Medical Sciences, Tehran, Iran.,Department of Human Nutrition, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mobina Aghajani
- Gastrointestinal and Liver Disease Research Center (GILDRC), Iran University of Medical Sciences, Tehran, Iran.,Department of Exercise Physiology, Faculty of Sport Science, University of Mazandaran, Babolsar, Iran
| | - Rosa Zavoshy
- Department of Human Nutrition, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mostafa Noroozi
- Children Growth Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Hassan Jahanihashemi
- Children Growth Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Neda Ezzeddin
- Department of Community Nutrition, Faculty of Nutrition science and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Rosales-Nieto CA, Ehrhardt R, Mantey A, Makela B, Veiga-Lopez A. Preconceptional diet manipulation and fetus number can influence placenta endocrine function in sheep. Domest Anim Endocrinol 2021; 74:106577. [PMID: 33160155 PMCID: PMC7719092 DOI: 10.1016/j.domaniend.2020.106577] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/29/2020] [Accepted: 09/30/2020] [Indexed: 01/21/2023]
Abstract
Changes in maternal nutrition during pregnancy can result in profound effects on placental function and fetal development. Although the preconceptional period holds the potential to reprogram embryonic and placental development, little is known regarding the effects of premating nutritional manipulation on placental function and fetal and postnatal offspring growth. To test this, Polypay-Dorset sheep (n = 99) were assigned to 1 of 3 nutritional treatments (n = 33/treatment) receiving 50% (UN: undernutrition), 100% (C: control), or 200% (ON: overnutrition) of maintenance energy requirements for 21 d before mating during April-May (increasing photoperiod). Thereafter, diets were the same across groups. We evaluated maternal reproductive variables and maternal and offspring weight and body mass index through weaning. Maternal plasma was collected through pregnancy until postnatal day 1 to assay pregnancy-associated glycoproteins (PAGs) and progesterone. Fertility rate was similar among treatments, but ON females had a higher reproductive rate (UN: 82%; C: 100%, ON: 145%). When correcting by total birth weight, twin pregnancies had lower PAGs and progesterone versus singleton pregnancies (P < 0.001). At birth, UN lambs were heavier than C lambs regardless of birth type (P < 0.01). Growth velocity, daily gain, and weaning weight were similar, but UN and ON females grew faster and were heavier at weaning versus C females. We demonstrated that a 3-wk preconceptional maternal undernutrition or overnutrition, when correcting by total birth weight, results in lower endocrine capacity in twin pregnancies. Preconceptional maternal undernutrition and overnutrition increased postnatal female lamb growth, suggestive of reprogramming of pathways regulating growth before conception. This highlights how preconceptional nutrition can result in marked sex-specific differences.
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Affiliation(s)
- C A Rosales-Nieto
- Department of Animal Science, College of Agriculture and Natural Resources, Michigan State University, East Lansing, MI 48824, USA
| | - R Ehrhardt
- Department of Animal Science, College of Agriculture and Natural Resources, Michigan State University, East Lansing, MI 48824, USA; Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA
| | - A Mantey
- Department of Animal Science, College of Agriculture and Natural Resources, Michigan State University, East Lansing, MI 48824, USA
| | - B Makela
- Department of Animal Science, College of Agriculture and Natural Resources, Michigan State University, East Lansing, MI 48824, USA
| | - A Veiga-Lopez
- Department of Animal Science, College of Agriculture and Natural Resources, Michigan State University, East Lansing, MI 48824, USA; Department of Pathology, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA.
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Effects of maternal periconceptional undernutrition in sheep on offspring glucose-insulin axis function into adulthood. J Dev Orig Health Dis 2020; 12:714-720. [PMID: 33213602 DOI: 10.1017/s2040174420001063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Maternal periconceptional undernutrition (PCUN) affected fetal pancreatic maturation in late gestation lambs and impaired glucose tolerance in 10-month-old sheep. To examine the importance of the timing of maternal undernutrition around conception, a further cohort was born to PCUN ewes [undernourished for 61 d before conception (PreC), 30 d after conception (PostC), or 61 d before until 30 d after conception (PrePostC)], or normally fed ewes (Control) (n = 15-20/group). We compared glucose tolerance, insulin secretion, and sensitivity at 36 months of age. We also examined protein expression of insulin signalling proteins in muscle from these animals and in muscle from a fetal cohort (132 d of gestation; n = 7-10/group). Adult PostC and PrePostC sheep had higher glucose area under the curve than Controls (P = 0.07 and P = 0.02, respectively), whereas PreC sheep were similar to Controls (P = 0.97). PostC and PrePostC had reduced first-phase insulin secretion compared with Control (P = 0.03 and P = 0.02, respectively). PreC was similar to Control (P = 0.12). Skeletal muscle SLC2A4 protein expression in PostC and PrePostC was increased 19%-58% in fetuses (P = 0.004), but decreased 39%-43% in adult sheep (P = 0.003) compared with Controls. Consistent with this, protein kinase C zeta (PKCζ) protein expression tended to be increased in fetal (P = 0.09) and reduced in adult (P = 0.07) offspring of all PCUN ewes compared with Controls. Maternal PCUN alters several aspects of offspring glucose homeostasis into adulthood. These findings suggest that maternal periconceptional nutrition has a lasting impact on metabolic homeostasis of the offspring.
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Beringer M, Schumacher T, Keogh L, Sutherland K, Knox P, Herden J, Brown L, Rae K. Nutritional adequacy and the role of supplements in the diets of Indigenous Australian women during pregnancy. Midwifery 2020; 93:102886. [PMID: 33254096 DOI: 10.1016/j.midw.2020.102886] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 10/07/2020] [Accepted: 11/09/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine sources of key nutrients contributing towards nutritional adequacy during pregnancy (fibre, calcium, iron, zinc and folate) in a cohort of women carrying an Indigenous child. DESIGN Analysis of cross-sectional data from a prospective longitudinal cohort study that followed Indigenous women through pregnancy. SETTING Women recruited via antenatal clinics in regional and remote locations in NSW, Australia as part of the Gomeroi gaaynggal project. PARTICIPANTS One hundred and fifty-two pregnant Australian women who identified as Indigenous or carrying an Indigenous child. MEASUREMENTS AND FINDINGS Measurement outcomes included demographic information, smoking status, anthropometrics (weight and height,), self-reported pre-pregnancy weight, health conditions and dietary information (24-hour food recall). Findings indicate the inadequate intake of key pregnancy nutrients in this cohort. Supplements contributed to the nutrient adequacy of the cohort with 53% reporting use. As expected, predominant sources of fibre were from core food groups, whereas calcium was attained from a range of sources including food and beverages, with small amounts from supplementation. Importantly, supplements contributed significant amounts of iron, zinc and folate. KEY CONCLUSIONS There is limited literature on Indigenous Australian maternal nutrition. This study highlights the key dietary contributors of nutritional adequacy during pregnancy for the cohort and that supplementation may be considered a viable source of nutrients during pregnancy for these women. Few women met national nutrient recommendations. The findings present an opportunity to optimise nutrient intakes of Indigenous pregnant women. IMPLICATIONS FOR PRACTICE Culturally appropriate targeted interventions to optimise dietary intakes of Indigenous Australian pregnant women is required. Collaborative support of health workers, Indigenous Australian communities, dietitians, and researchers to raise awareness of nutrition during pregnancy is imperative to achieving nutrient targets and optimising pregnancy outcomes. Targeted interventions provide positive opportunities to achieve improvements.
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Affiliation(s)
- Madison Beringer
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
| | - Tracy Schumacher
- University of Newcastle Department of Rural Health, Tamworth, Faculty of Health and Medicine, University of Newcastle, Australia; Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | | | | | | | | | - Leanne Brown
- University of Newcastle Department of Rural Health, Tamworth, Faculty of Health and Medicine, University of Newcastle, Australia
| | - Kym Rae
- Mater Research Institute, Aubigny Place, South Brisbane, Australia; University of Queensland, Faculty of Medicine, Brisbane, Australia.
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Fernández-Gómez E, Luque-Vara T, Moya-Fernández PJ, López-Olivares M, Gallardo-Vigil MÁ, Enrique-Mirón C. Factors Influencing Dietary Patterns during Pregnancy in a Culturally Diverse Society. Nutrients 2020; 12:E3242. [PMID: 33113986 PMCID: PMC7690697 DOI: 10.3390/nu12113242] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 10/16/2020] [Accepted: 10/21/2020] [Indexed: 12/17/2022] Open
Abstract
The aim of this study was to identify dietary patterns in pregnant women and to assess the relationships between sociodemographic, lifestyle-related, and pregnancy-related factors. This is a descriptive, correlational study involving 306 pregnant women in Melilla (Spain) in any trimester of pregnancy. A validated food frequency questionnaire was used. Dietary patterns were determined via exploratory factor analysis and ordinal logistic regression using the proportional odds model. Three dietary patterns were identified: Western, mixed, and prudent. Sociodemographic, lifestyle-related, and pregnancy-related factors influencing dietary quality were established. The Western dietary pattern was considered the least recommended despite being the most common among women who live in Melilla (p = 0.03), are Christian (p = 0.01), are primiparous women (p < 0.001), and are in their first or second trimester (p = 0.02). Unemployed pregnant women were also more likely to have a less healthy dietary pattern (β = -0.716; p = 0.040). The prudent dietary pattern, the healthiest of the three, was most commonly observed among Muslim women (p = 0.01), women with more than two children (p < 0.001), and women in the third trimester of pregnancy (p = 0.02). Pregnant women who engaged in no physical activity or a low level of physical activity displayed a mixed pattern (p < 0.001). This study provides evidence on the factors influencing dietary patterns during pregnancy and suggests that more specific nutrition programmes should be developed to improve the nutritional status of pregnant women.
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Affiliation(s)
- Elisabet Fernández-Gómez
- Department of Nursing, Faculty of Health Sciences, Melilla Campus, University of Granada, C/Santander s/n, 52001 Melilla, Spain; (E.F.-G.); (T.L.-V.)
| | - Trinidad Luque-Vara
- Department of Nursing, Faculty of Health Sciences, Melilla Campus, University of Granada, C/Santander s/n, 52001 Melilla, Spain; (E.F.-G.); (T.L.-V.)
| | - Pablo José Moya-Fernández
- Department of Applied Economics, Faculty of Social and Legal Sciences, Melilla Campus, University of Granada, C/Santander s/n, 52001 Melilla, Spain;
| | - María López-Olivares
- Doctoral Degree School, Melilla Campus, University of Granada, C/Santander s/n, 52001 Melilla, Spain
| | - Miguel Ángel Gallardo-Vigil
- HUM-358 Research Group, Department of Research and Diagnostic Methods in Education, Faculty of Education and Humanities, Melilla Campus, University of Granada, C/Santander s/n, 52001 Melilla, Spain;
| | - Carmen Enrique-Mirón
- HUM-613 Research Group, Department of Inorganic Chemistry, Faculty of Health Sciences, Melilla Campus, University of Granada, C/Santander s/n, 52001 Melilla, Spain;
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Jain L, Juneja R, Kansal R, Kumar V. Prevalence of myths regarding oral health among pregnant women in North India. Int J Dent Hyg 2020; 19:127-134. [PMID: 32985118 DOI: 10.1111/idh.12471] [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: 06/22/2020] [Revised: 09/14/2020] [Accepted: 09/22/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To study the prevalence of myths regarding oral health care in pregnant women in North Indian population. METHODS This cross-sectional study used a self-administered closed-ended questionnaire to assess oral healthcare related beliefs and practices in 400 pregnant women who reported for prenatal checkup in a tertiary healthcare centre in North India. The questionnaire included questions to elicit information on socio-demographic factors, beliefs and practices of oral hygiene during pregnancy, attitude towards dental problems occurring during pregnancy and the reasons associated with a specific belief. Prevalence of various myths was observed, and its associations with various socio-demographic factors, adverse pregnancy outcomes and dental symptoms were analysed. RESULTS 84.2% of the respondents harboured at least one oral healthcare related myth. 63.4% of respondents deferred brushing for many days after delivery. 36.6% of respondents avoided consumption of hot/cold food and drinks during pregnancy due to fear of tooth loss. 24.5% of respondents believed local anaesthesia could affect baby's developing organs, and 21.8% of the studied population believed tooth extraction might cause miscarriage. Females possessing more myths were more likely to experience severe oral health problems during pregnancy. Education was depicted as a significant negative predictor of the prevalence of myths. No significant correlation between myths prevalence and history of adverse pregnancy outcomes was found. CONCLUSION Neglect of oral health due to myths about oral hygiene practices and dental treatment during pregnancy is a serious concern. A very high prevalence of these myths is an obstacle to goal of optimal maternal and child health.
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Affiliation(s)
- Lokesh Jain
- Kalpana Chawla Government Medical College, Karnal, India
| | - Ruchi Juneja
- Department of Dentistry, Kalpana Chawla Government Medical College, Karnal, India
| | - Richa Kansal
- Department of Obstetrics and Gynecology, Kalpana Chawla Government Medical College, Karnal, India
| | - Varun Kumar
- Department of Dentistry, Kalpana Chawla Government Medical College, Karnal, India
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Sahay A, Kale A, Joshi S. Role of neurotrophins in pregnancy and offspring brain development. Neuropeptides 2020; 83:102075. [PMID: 32778339 DOI: 10.1016/j.npep.2020.102075] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/20/2020] [Accepted: 07/28/2020] [Indexed: 02/06/2023]
Abstract
Neurotrophins are a family of functionally and structurally related proteins which play a key role in the survival, development, and function of neurons in both the central and peripheral nervous systems. Brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), neurotrophin-3 (NT-3), and neurotrophin-4 (NT-4) are the family members of neurotrophins. Neurotrophins play a crucial role in influencing the development of the brain and learning and memory processes. Studies demonstrate that they also play crucial role in influencing reproductive and immune systems. Neurotrophins have been shown to influence various processes in the mother, placenta, and fetus during pregnancy. Development and maturation of feto-placental unit and the fetal growth trajectories are influenced by neurotrophins. In addition to neurotrophins, neuropeptides like neuropeptide Y also play a crucial role during various processes of pregnancy and during fetal brain development. Neurotrophins have also been shown to have a cross talk with various angiogenic factors and influence placental development. Alterations in the levels of neurotrophins and neuropeptides lead to placental pathologies resulting in various pregnancy complications like preeclampsia, intrauterine growth restriction and preterm births. Studies in animals have reported low levels of maternal micronutrients like folic acid, vitamin B12 and omega-3 fatty acids influence brain neurotrophins resulting in impaired cognitive functioning in the offspring. Maternal nutrition is also known to affect the expression of neuropeptides. It is essential to understand the role of various neurotrophins across various stages of pregnancy and its relationship with neurodevelopmental outcomes in children. This will lead to early prediction of poor neurodevelopmental outcomes. The present review describes evidence describing the role of neurotrophins in determining pregnancy outcome and altered neurodevelopment in the offspring. The possible mechanism through which maternal nutrition influences neurotrophins and neuropeptides to regulate offspring brain development and function is also discussed.
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Affiliation(s)
- Akriti Sahay
- Mother and Child Health, Interactive Research School for Health Affairs, Bharati Vidyapeeth (Deemed to be University), Pune, India
| | - Anvita Kale
- Mother and Child Health, Interactive Research School for Health Affairs, Bharati Vidyapeeth (Deemed to be University), Pune, India
| | - Sadhana Joshi
- Mother and Child Health, Interactive Research School for Health Affairs, Bharati Vidyapeeth (Deemed to be University), Pune, India.
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Kakadia JH, Jain BB, Biggar K, Sutherland A, Nygard K, Li C, Nathanielsz PW, Jansson T, Gupta MB. Hyperphosphorylation of fetal liver IGFBP-1 precedes slowing of fetal growth in nutrient-restricted baboons and may be a mechanism underlying IUGR. Am J Physiol Endocrinol Metab 2020; 319:E614-E628. [PMID: 32744097 PMCID: PMC7642856 DOI: 10.1152/ajpendo.00220.2020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
In cultured fetal liver cells, insulin-like growth factor (IGF) binding protein (IGFBP)-1 hyperphosphorylation in response to hypoxia and amino acid deprivation is mediated by inhibition of mechanistic target of rapamycin (mTOR) and activation of amino acid response (AAR) signaling and casein kinase (CK)2. We hypothesized that fetal liver mTOR inhibition, activation of AAR and CK2, and IGFBP-1 hyperphosphorylation occur before development of intrauterine growth restriction (IUGR). Pregnant baboons were fed a control (C) or a maternal nutrient restriction (MNR; 70% calories of control) diet starting at gestational day (GD) 30 (term GD 185). Umbilical blood and fetal liver tissue were obtained at GD 120 (C, n = 7; MNR, n = 10) and 165 (C, n = 7; MNR, n = 8). Fetal weights were unchanged at GD 120 but decreased at GD 165 in the MNR group (-13%, P = 0.03). IGFBP-1 phosphorylation, as determined by parallel reaction monitoring mass spectrometry (PRM-MS), immunohistochemistry, and/or Western blot, was enhanced in MNR fetal liver and umbilical plasma at GD 120 and 165. IGF-I receptor autophosphorylationTyr1135 (-64%, P = 0.05) was reduced in MNR fetal liver at GD 120. Furthermore, fetal liver CK2 (α/α'/β) expression, CK2β colocalization, proximity with IGFBP-1, and CK2 autophosphorylationTyr182 were greater at GD 120 and 165 in MNR vs. C. Additionally, mTOR complex (mTORC)1 (p-P70S6KThr389, -52%, P = 0.05) and mTORC2 (p-AktSer473, -56%, P < 0.001) activity were decreased and AAR was activated (p-GCN2Thr898, +117%, P = 0.02; p-eIF2αSer51, +294%, P = 0.002; p-ERKThr202, +111%, P = 0.03) in MNR liver at GD 120. Our data suggest that fetal liver IGFBP-1 hyperphosphorylation, mediated by mTOR inhibition and both AAR and CK2 activation, is a key link between restricted nutrient and oxygen availability and the development of IUGR.
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Affiliation(s)
- Jenica H Kakadia
- Department of Biochemistry, University of Western Ontario, London, Ontario, Canada
| | - Bhawani B Jain
- Department of Biochemistry, University of Western Ontario, London, Ontario, Canada
| | - Kyle Biggar
- Institute of Biochemistry, Carleton University, Ottawa, Ontario, Canada
| | - Austen Sutherland
- Department of Biochemistry, University of Western Ontario, London, Ontario, Canada
| | - Karen Nygard
- Biotron Integrated Microscopy Facility, University of Western Ontario, London, Ontario, Canada
| | - Cun Li
- University of Wyoming, Laramie, Wyoming
- Southwest National Primate Research Center, San Antonio, Texas
| | - Peter W Nathanielsz
- University of Wyoming, Laramie, Wyoming
- Southwest National Primate Research Center, San Antonio, Texas
| | - Thomas Jansson
- Division of Reproductive Sciences, Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Madhulika B Gupta
- Department of Biochemistry, University of Western Ontario, London, Ontario, Canada
- Department of Pediatrics, University of Western Ontario, London, Ontario, Canada
- Children's Health Research Institute, London, Ontario, Canada
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Asali FF, Tayyem RF, Allehdan SS, Mahfouz IA, Bawadi HA. Use of dietary supplements among pregnant women in the center of Jordan. NFS JOURNAL 2020. [DOI: 10.1016/j.nfs.2020.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ancira‐Moreno M, O'Neill MS, Rivera‐Dommarco JÁ, Batis C, Rodríguez Ramírez S, Sánchez BN, Castillo‐Castrejón M, Vadillo‐Ortega F. Dietary patterns and diet quality during pregnancy and low birthweight: The PRINCESA cohort. MATERNAL & CHILD NUTRITION 2020; 16:e12972. [PMID: 32037674 PMCID: PMC7296796 DOI: 10.1111/mcn.12972] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 11/20/2019] [Accepted: 01/21/2020] [Indexed: 12/11/2022]
Abstract
Although the isolated effects of several specific nutrients have been examined, little is known about the relationship between overall maternal diet during pregnancy and fetal development and growth. This study evaluates the association between maternal diet and low birthweight (LBW) in 660 pregnant women from the Pregnancy Research on Inflammation, Nutrition,& City Environment: Systematic Analyses (PRINCESA) cohort in Mexico City. Using prior day dietary intake reported at multiple prenatal visits, diet was assessed prospectively using a priori (Maternal Diet Quality Score [MDQS]) and a posteriori (dietary patterns extracted by factor analysis) approaches. The association between maternal diet and LBW was investigated by logistic regression, controlling for confounders. Adherence to recommended guidelines (higher MDQS) was associated with a reduced risk of LBW (OR, 0.22; 95% confidence interval [0.06, 0.75], P < .05, N = 49) compared with the lowest adherence category (reference group), controlling for maternal age, education, height, marital status, pre-pregnancy body mass index, parity, energy intake, gestational weight gain, and preterm versus term birth; a posteriori dietary patterns were not associated with LBW risk. Higher adherence to MDQS was associated with a lower risk of having an LBW baby in this sample. Our results support the role of advocating a healthy overall diet, versus individual foods or nutrients, in preventing LBW.
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Affiliation(s)
- Monica Ancira‐Moreno
- UNAM School of Medicine Branch and Research DirectionInstituto Nacional de Medicina GenómicaMéxico CityMexico
- Health DepartmentUniversidad IberoamericanaMexico CityMexico
| | - Marie S. O'Neill
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMichiganUSA
| | | | - Carolina Batis
- Centro de Investigación en Nutricion y SaludNational Institute of Public HealthCuernavacaMexico
| | - Sonia Rodríguez Ramírez
- Centro de Investigación en Nutricion y SaludNational Institute of Public HealthCuernavacaMexico
| | - Brisa N. Sánchez
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMichiganUSA
| | - Marisol Castillo‐Castrejón
- UNAM School of Medicine Branch and Research DirectionInstituto Nacional de Medicina GenómicaMéxico CityMexico
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMichiganUSA
| | - Felipe Vadillo‐Ortega
- UNAM School of Medicine Branch and Research DirectionInstituto Nacional de Medicina GenómicaMéxico CityMexico
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMichiganUSA
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37
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Kennedy RAK, Reynolds CME, Cawley S, O'Malley E, McCartney DM, Turner MJ. A web-based dietary intervention in early pregnancy and neonatal outcomes: a randomized controlled trial. J Public Health (Oxf) 2020; 41:371-378. [PMID: 30010835 DOI: 10.1093/pubmed/fdy117] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 06/09/2018] [Accepted: 06/14/2018] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Maternal nutrition is a determinant of pregnancy outcomes. Few studies have evaluated the potential of online nutrition resources to modify behaviour. This randomized controlled trial aimed to determine whether access to a customized evidence-based nutrition website in pregnancy improved neonatal outcomes. METHODS Women <18 weeks gestation were recruited at their convenience. The control group received standard care. In addition to standard care, the intervention group received access to an evidence-based nutrition website, customized to the preferences of pregnant women. RESULTS Of the 250 women, there were no differences in characteristics between the two groups. Of the women, 91.0% reported they make a conscious effort currently to eat a healthy diet. However, only 19.6% met dietary requirements for calcium, 13.2% for iron, 2.7% for folate and 2.3% for iodine. The most popular website section was pregnancy nutrition advice but engagement was not sustained. Access to the website was not associated with any improvement in clinical outcomes (P > 0.05). CONCLUSIONS We found that provision of a customized website providing nutrition information, did not improve neonatal outcomes. Future studies should explore whether redesign with website interactivity or embedding information on popular digital platforms sustains women's engagement and modifies dietary behaviour.
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Affiliation(s)
- R A K Kennedy
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Cork Street, Dublin 8, Ireland.,School of Biological Sciences, Dublin Institute of Technology, Kevin Street, Dublin 8, Ireland
| | - C M E Reynolds
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Cork Street, Dublin 8, Ireland
| | - S Cawley
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Cork Street, Dublin 8, Ireland.,School of Biological Sciences, Dublin Institute of Technology, Kevin Street, Dublin 8, Ireland
| | - E O'Malley
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Cork Street, Dublin 8, Ireland
| | - D M McCartney
- School of Biological Sciences, Dublin Institute of Technology, Kevin Street, Dublin 8, Ireland
| | - M J Turner
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Cork Street, Dublin 8, Ireland
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Dong J, Shin N, Chen S, Lei J, Burd I, Wang X. Is there a definite relationship between placental mTOR signaling and fetal growth? Biol Reprod 2020; 103:471-486. [PMID: 32401303 DOI: 10.1093/biolre/ioaa070] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/22/2020] [Accepted: 05/11/2020] [Indexed: 02/07/2023] Open
Abstract
Fetal growth restriction and overgrowth are common obstetrical complications that result in adverse perinatal outcomes and long-term health risks later in life, including neurodevelopmental dysfunction and adult metabolic syndrome. The placenta plays a critical role in the nutrition transfer from mother to fetus and even exerts adaptive mechanism when the fetus is under poor developmental conditions. The mammalian/mechanistic target of rapamycin (mTOR) signaling serves as a critical hub of cell growth, survival, and metabolism in response to nutrients, growth factors, energy, and stress signals. Placental mTOR signaling regulates placental function, including oxygen and nutrient transport. Therefore, placental mTOR signaling is hypothesized to have a positive relationship with fetal growth. In this review, we summarize that most studies support the current evidence that there is connection between placental mTOR signaling and abnormal fetal growth; however, but more studies should be performed following a vigorous and unanimous method for assessment to determine placental mTOR activity.
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Affiliation(s)
- Jie Dong
- Reproductive Medical Center, Department of Gynecology and Obstetrics, Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi Province, China
| | - Na Shin
- Integrated Research Center for Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Shuqiang Chen
- Reproductive Medical Center, Department of Gynecology and Obstetrics, Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi Province, China
| | - Jun Lei
- Integrated Research Center for Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Irina Burd
- Integrated Research Center for Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Xiaohong Wang
- Reproductive Medical Center, Department of Gynecology and Obstetrics, Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi Province, China
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Maternal profile according to Mediterranean diet adherence and small for gestational age and preterm newborn outcomes. Public Health Nutr 2020; 24:1372-1384. [PMID: 32345384 DOI: 10.1017/s1368980019004993] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The objective was to evaluate maternal Mediterranean diet (MD) pattern adherence during pregnancy and its association with small for gestational age (SGA) and preterm birth. A secondary objective of the current study was to describe the sociodemographic, lifestyle and obstetric profile of the mothers studied as well as the most relevant paternal and newborn characteristics. DESIGN The current study is a two-phase retrospective population-based study of maternal dietary habits during pregnancy and their effect on newborn size and prematurity. The descriptive first phase examined maternal dietary habits during pregnancy along with the maternal sociodemographic, lifestyle and obstetric profile in a cross-sectional period study. In the second phase, newborn outcomes were evaluated in a nested case-control study. Adherence to MD during pregnancy was measured with the Spanish version of Kidmed index. SETTING Obstetrics ward of the La Fe Hospital in Valencia. PARTICIPANTS All mother-child pairs admitted after delivery during a 12-month period starting from January 2018 were assessed for eligibility. A total of 1118 provided complete outcome data after signing informed consent. RESULTS 14·5 % met the criteria of poor adherence (PA); 34·8 %, medium adherence (MA); and 50·7 %, optimal adherence (OA). Medium adherence to MD was associated in the adjusted scenarios with a higher risk of giving birth to a preterm newborn. No association was found between MD adherence and SGA. CONCLUSIONS Early intervention programmes geared towards pregnant women, where women were aided in reaching OA to MD, might reduce the risk of preterm newborn.
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Fernández-Gómez E, Martín-Salvador A, Luque-Vara T, Sánchez-Ojeda MA, Navarro-Prado S, Enrique-Mirón C. Content Validation through Expert Judgement of an Instrument on the Nutritional Knowledge, Beliefs, and Habits of Pregnant Women. Nutrients 2020; 12:nu12041136. [PMID: 32325669 PMCID: PMC7230573 DOI: 10.3390/nu12041136] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 04/09/2020] [Accepted: 04/15/2020] [Indexed: 12/17/2022] Open
Abstract
The aim of this study was to conduct content validation through expert judgement of an instrument which explores the nutritional knowledge, beliefs, and habits during pregnancy. This is a psychometric study in which 14 experts participated in the evaluation of each of the questionnaire items, which were divided into two blocks according to the characteristics of sufficiency, clarity, coherence, and relevance. Fleiss’ κ statistic was used to measure strength of agreement. A pre-test with 102 participants was conducted to measure the degree of understandability of the instrument. The strength of agreement obtained for each of the dimensions was almost perfect. For each pair of experts, strength of agreement ranged between substantial and almost perfect. Sufficiency was the characteristic of the questionnaire that obtained the highest values in the two blocks, and was also the most statistically significant (p < 0.001). Coherence was the most statistically significant characteristic in the first block (p = 0.030). Clarity was the most statistically significant characteristic in the second block (p = 0.037). The wording of five of the twenty original items was corrected. The new version of the instrument attained a high degree of understandability. The results suggest that the instrument is valid and may therefore be applied.
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Affiliation(s)
- Elisabet Fernández-Gómez
- Department of Nursing, Faculty of Health Sciences, Melilla Campus, University of Granada, Calle Santander s/n, 52001 Melilla, Spain; (E.F.-G.); (A.M.-S.); (M.A.S.-O.); (S.N.-P.)
| | - Adelina Martín-Salvador
- Department of Nursing, Faculty of Health Sciences, Melilla Campus, University of Granada, Calle Santander s/n, 52001 Melilla, Spain; (E.F.-G.); (A.M.-S.); (M.A.S.-O.); (S.N.-P.)
| | - Trinidad Luque-Vara
- Department of Nursing, Faculty of Health Sciences, Melilla Campus, University of Granada, Calle Santander s/n, 52001 Melilla, Spain; (E.F.-G.); (A.M.-S.); (M.A.S.-O.); (S.N.-P.)
- Correspondence: ; Tel.: +34-686-951-942
| | - María Angustias Sánchez-Ojeda
- Department of Nursing, Faculty of Health Sciences, Melilla Campus, University of Granada, Calle Santander s/n, 52001 Melilla, Spain; (E.F.-G.); (A.M.-S.); (M.A.S.-O.); (S.N.-P.)
| | - Silvia Navarro-Prado
- Department of Nursing, Faculty of Health Sciences, Melilla Campus, University of Granada, Calle Santander s/n, 52001 Melilla, Spain; (E.F.-G.); (A.M.-S.); (M.A.S.-O.); (S.N.-P.)
| | - Carmen Enrique-Mirón
- Department of Inorganic Chemistry, HUM-613 Research Group, Faculty of Health Sciences, Melilla Campus, University of Granada, Calle Santander s/n, 52001 Melilla, Spain;
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Wibowo N, Irwinda R, Rachman L. First trimester maternal upper arm circumference correlated to placental size and neonatal anthropometry. MEDICAL JOURNAL OF INDONESIA 2020. [DOI: 10.13181/mji.oa.192950] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND First maternal nutrition, represented by anthropometrics, is an important factor for fetal growth. This study aimed to determine the correlation between maternal nutritional status of first trimester pregnant women with placental size and neonatal anthropometry.
METHODS A retrospective cohort study (N = 134) was conducted in Jakarta and Riau during August–September 2017. Correlation between first trimester maternal nutritional status, placental size (placental weight and volume), and neonatal anthropometry (birth weight, birth length, head circumference, and abdominal circumference) were examined using Spearman correlation test.
RESULTS High maternal body mass index and upper arm circumference (UAC) are weakly correlated with high birth weight (r = 0.281, p<0.001 and r = 0.271, p<0.001), birth length (r = 0.176, p = 0.022 and r= 0.238, p = 0.002), head circumference (r = 0.251, p = 0.001 and r = 0.297, p<0.001), abdominal circumference (r = 0.227, p = 0.003 and r = 0.226, p = 0.003), placental weight (r = 0.198, p = 0.01 and r = 0.228, p<0.001), and placental volume (r = 0.194, p = 0.01 and r = 0.203, p = 0.008). In addition, high maternal height is also weakly correlated with high birth weight (r = 0.157, p = 0.043) and birth length (r = 0.158, p = 0.041).
CONCLUSIONS UAC can be reliably used to assess the nutritional status of pregnant women and to predict placental and newborn sizes.
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Hu Z, Tylavsky FA, Kocak M, Fowke JH, Han JC, Davis RL, LeWinn KZ, Bush NR, Sathyanarayana S, Karr CJ, Zhao Q. Effects of Maternal Dietary Patterns during Pregnancy on Early Childhood Growth Trajectories and Obesity Risk: The CANDLE Study. Nutrients 2020; 12:E465. [PMID: 32069778 PMCID: PMC7071328 DOI: 10.3390/nu12020465] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/07/2020] [Accepted: 02/10/2020] [Indexed: 01/01/2023] Open
Abstract
We investigated the associations between maternal dietary patterns during pregnancy and early childhood growth trajectories and overweight/obesity risk in offspring. Maternal diet was assessed using a food frequency questionnaire during the second trimester, and dietary patterns were derived by reduced rank regression. The associations between maternal dietary pattern scores and body mass index (BMI) trajectories from birth to age four (rising-high, moderate, and low BMI trajectories) as well as overweight/obesity risk at age four were analyzed (n = 1257). Two maternal dietary patterns were identified. The fast food pattern included a higher intake of fried chicken and fish, fruit juices, mayonnaise, and sugar-sweetened beverages, while the processed food pattern included a higher intake of dairy, salad dressing, processed meat, and cold breakfast cereal. Women with greater adherence to the fast food pattern were more likely to have children in the rising-high BMI trajectory group [OR (95% CI) = 1.32 (1.07-1.62); p = 0.008] or having overweight/obesity at age four [OR (95% CI) = 1.31 (1.11-1.54); p = 0.001]. The processed food pattern was not associated with these outcomes. The maternal dietary pattern during pregnancy represented by fried foods and sugar-sweetened beverages may contribute to rapid early childhood growth and increased risk for obesity in offspring.
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Affiliation(s)
- Zunsong Hu
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (Z.H.); (F.A.T.); (M.K.); (J.H.F.)
| | - Frances A. Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (Z.H.); (F.A.T.); (M.K.); (J.H.F.)
| | - Mehmet Kocak
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (Z.H.); (F.A.T.); (M.K.); (J.H.F.)
| | - Jay H. Fowke
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (Z.H.); (F.A.T.); (M.K.); (J.H.F.)
| | - Joan C. Han
- Departments of Pediatrics and Physiology, University of Tennessee Health Science Center, and Children’s Foundation Research Institute, Le Bonheur Children’s Hospital, Memphis, TN 38103, USA;
| | - Robert L. Davis
- Center for Biomedical Informatics, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN 38103, USA;
| | - Kaja Z. LeWinn
- Department of Psychiatry, University of California San Francisco, San Francisco, CA 94118, USA;
| | - Nicole R. Bush
- Departments of Pediatrics and Psychiatry, University of California San Francisco, San Francisco, CA 94118, USA;
| | - Sheela Sathyanarayana
- Seattle Children’s Research Institute, Center for Child Health, Behavior, and Development, Seattle, WA 98121, USA;
- Department of Pediatrics, University of Washington, Seattle, WA 98121, USA;
| | - Catherine J. Karr
- Department of Pediatrics, University of Washington, Seattle, WA 98121, USA;
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, USA
- Department of Epidemiology, University of Washington, Seattle, WA 98195, USA
| | - Qi Zhao
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA; (Z.H.); (F.A.T.); (M.K.); (J.H.F.)
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Taneja S, Chowdhury R, Dhabhai N, Mazumder S, Upadhyay RP, Sharma S, Dewan R, Mittal P, Chellani H, Bahl R, Bhan MK, Bhandari N. Impact of an integrated nutrition, health, water sanitation and hygiene, psychosocial care and support intervention package delivered during the pre- and peri-conception period and/or during pregnancy and early childhood on linear growth of infants in the first two years of life, birth outcomes and nutritional status of mothers: study protocol of a factorial, individually randomized controlled trial in India. Trials 2020; 21:127. [PMID: 32005294 PMCID: PMC6995212 DOI: 10.1186/s13063-020-4059-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 01/08/2020] [Indexed: 12/22/2022] Open
Abstract
Background The period from conception to two years of life denotes a critical window of opportunity for promoting optimal growth and development of children. Poor nutrition and health in women of reproductive age and during pregnancy can negatively impact birth outcomes and subsequent infant survival, health and growth. Studies to improve birth outcomes and to achieve optimal growth and development in young children have usually tested the effect of standalone interventions in pregnancy and/or the postnatal period. It is not clearly known whether evidence-based interventions in the different domains such as health, nutrition, water sanitation and hygiene (WASH) and psychosocial care, when delivered together have a synergistic effect. Further, the effect of delivery of an intervention package in the pre and peri-conception period is not fully understood. This study was conceived with an aim to understand the impact of an integrated intervention package, delivered across the pre and peri-conception period, through pregnancy and till 24 months of child age on birth outcomes, growth and development in children. Methods An individually randomized controlled trial with factorial design is being conducted in urban and peri-urban low- to mid-socioeconomic neighbourhoods in South Delhi, India. 13,500 married women aged 18 to 30 years will be enrolled and randomized to receive either the pre and peri-conception intervention package or routine care (first randomization). Interventions will be delivered until women are confirmed to be pregnant or complete 18 months of follow up. Once pregnancy is confirmed, women are randomized again (second randomization) to receive either the intervention package for pregnancy and postnatal period or to routine care. Newborns will be followed up till 24 months of age. The interventions are delivered through different study teams. Outcome data are collected by an independent outcome ascertainment team. Discussion This study will demonstrate the improvement that can be achieved when key factors known to limit child growth and development are addressed together, throughout the continuum from pre and peri-conception until early childhood. The findings will increase our scientific understanding and provide guidance to nutrition programs in low- and middle-income settings. Trial registration Clinical Trial Registry – India #CTRI/2017/06/008908; Registered 23 June 2017, http://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=19339&EncHid=&userName=society%20for%20applied%20studies
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Affiliation(s)
- Sunita Taneja
- Centre for Health Research and Development, Society for Applied Studies, 45, Kalu Sarai, New Delhi, India
| | - Ranadip Chowdhury
- Centre for Health Research and Development, Society for Applied Studies, 45, Kalu Sarai, New Delhi, India
| | - Neeta Dhabhai
- Centre for Health Research and Development, Society for Applied Studies, 45, Kalu Sarai, New Delhi, India
| | - Sarmila Mazumder
- Centre for Health Research and Development, Society for Applied Studies, 45, Kalu Sarai, New Delhi, India
| | - Ravi Prakash Upadhyay
- Centre for Health Research and Development, Society for Applied Studies, 45, Kalu Sarai, New Delhi, India
| | - Sitanshi Sharma
- Centre for Health Research and Development, Society for Applied Studies, 45, Kalu Sarai, New Delhi, India
| | - Rupali Dewan
- Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Pratima Mittal
- Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Harish Chellani
- Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Rajiv Bahl
- Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland
| | - Maharaj Kishan Bhan
- Knowledge Integration and Translational Platform (KnIT), Biotechnology Industry Research Assistance Council (BIRAC), Department of Biotechnology, Government of India, New Delhi, India.,Indian Institute of Technology, New Delhi, India
| | - Nita Bhandari
- Centre for Health Research and Development, Society for Applied Studies, 45, Kalu Sarai, New Delhi, India.
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Utilization of a Diet Optimization Model in Ensuring Adequate Intake among Pregnant Women in Selangor, Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234720. [PMID: 31783474 PMCID: PMC6927000 DOI: 10.3390/ijerph16234720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 11/12/2019] [Accepted: 11/15/2019] [Indexed: 01/01/2023]
Abstract
Achieving nutritional requirements for pregnant women in rural or suburban households while maintaining the intake of local and culture-specific foods can be difficult. Usage of a linear programming approach can effectively generate diet optimization models that incorporate local and culturally acceptable menus. This study aimed to determine whether a realistic and affordable diet that achieves recommended nutrient intakes for pregnant women could be formulated from locally available foods in Malaysia. A cross-sectional study was conducted to assess the dietary intake of 78 pregnant women using a 24-h dietary recall and a 3-day food record. A market survey was also carried out to estimate the cost of raw foods that are frequently consumed. All linear programming analyses were done using Excel Solver to generate optimal dietary patterns. Our findings showed that the menus designed from diet optimization models using locally available foods would improve dietary adequacy for the seven food groups based on the Malaysian Dietary Guidelines 2010 (MDG 2010) and the 14 nutrients based on Recommended Nutrient Intake 2017 (RNI 2017) in pregnant women. However, inadequacies remained for iron and niacin, indicating that these nutrients may require supplementation.
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45
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Ługowska K, Kolanowski W. The Nutritional Behaviour of Pregnant Women in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4357. [PMID: 31717286 PMCID: PMC6888330 DOI: 10.3390/ijerph16224357] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 11/06/2019] [Accepted: 11/07/2019] [Indexed: 12/14/2022]
Abstract
A woman's diet during pregnancy can significantly affect her health, as well as her child's future development and well-being. Unfortunately, many pregnant women do not follow the recommended nutritional guidelines. The reason could be that they have insufficient knowledge about nutritional best practice. Accordingly, the purpose of this study is to investigate the nutritional behaviour of pregnant women in Poland. The research was conducted using a questionnaire to survey a sample of N = 815 pregnant women in first pregnancy. Among the findings were that the subjects ate an excessive amount of sweets, and white bread, and consumed insufficient quantities of fish, milk and fermented milk drinks. Subjects chose white bread more often than wholemeal bread, and fruit rather than vegetables. The study showed that the nutritional behaviour of pregnant women was characterised by many bad practices.
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Affiliation(s)
| | - Wojciech Kolanowski
- Faculty of Medical and Health Sciences, Siedlce University of Natural Sciences and Humanities, Siedlce PL-08-110, Poland;
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46
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Olmedo-Requena R, Martínez-Galiano JM, Amezcua-Prieto C, Cano-Ibáñez N, Salcedo-Bellido I, Barrios-Rodríguez R, Jiménez-Moleón JJ, Delgado-Rodríguez M. Association between low dairy intake during pregnancy and small for gestational age infants. Eur J Clin Nutr 2019; 73:1642-1645. [PMID: 31611637 DOI: 10.1038/s41430-019-0513-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 09/25/2019] [Accepted: 09/27/2019] [Indexed: 11/09/2022]
Abstract
Maternal nutrition is recognized as one of the main determinants of fetal growth. We analyzed the risk of having a Small for Gestational Age (SGA) newborn according to maternal dairy intake during pregnancy. A matched case-control study was conducted in Spain. Dietary intake during pregnancy was assessed using a validated Food Frequency Questionnaire. Odds ratios (OR) and their 95% confidence intervals (CI) were estimated using conditional logistic regression models. 518 cases (SGA) and 518 controls (adequate birth weight) were included. Most study participants did not meet the current recommendations for dairy intake (78.6% cases and 80.2% controls). Intake of dairy products was not associated with a lower frequency of SGA, aORQ4 vs. Q1 = 1.12 (95% CI 0.73, 1.70), and aORQ5 vs. Q1 = 1.44 (95% CI 0.92, 2.26). Our results suggest that a low dairy intake during pregnancy is not associated with an increased risk of SGA; possibly due to the low consumption of dairy in both groups.
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Affiliation(s)
- Rocío Olmedo-Requena
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - Juan Miguel Martínez-Galiano
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain. .,Department of Nursing, University of Jaén, Campus de Las Lagunillas s/n, Building B3 Office 266, 23071, Jaén, Spain.
| | - Carmen Amezcua-Prieto
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - Naomi Cano-Ibáñez
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - Inmaculada Salcedo-Bellido
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - Rocío Barrios-Rodríguez
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - José Juan Jiménez-Moleón
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - Miguel Delgado-Rodríguez
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Division of Preventive Medicine, University of Jaen, 23071, Jaen, Spain
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47
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Moore CJ, Perreault M, Mottola MF, Atkinson SA. Diet in Early Pregnancy: Focus on Folate, Vitamin B12, Vitamin D, and Choline. CAN J DIET PRACT RES 2019; 81:58-65. [PMID: 31512510 DOI: 10.3148/cjdpr-2019-025] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Purpose: Prenatal multivitamins are recommended in pregnancy. This study assessed food and supplement intakes of folate, vitamin B12 (B12), vitamin D, and choline in pregnant women living in Southern Ontario in comparison with current recommendations. Methods: Women recruited to the Be Healthy in Pregnancy RCT (NCT01693510) completed 3-day diet/supplement records at 12-17 weeks gestation. Intakes of folate, B12, vitamin D, and choline were quantified and compared with recommendations for pregnant women. Results: Folate intake (median (min, max)) was 1963 μg/day dietary folate equivalents (153, 10 846); 90% of women met the Estimated Average Requirement (EAR) but 77% exceeded the Tolerable Upper Intake Level (UL) (n = 232). B12 intake was 12.1 μg/day (0.3, 2336); 96% of women met the EAR with 7% exceeding the EAR 100-fold (n = 232). Vitamin D intake was 564 IU/day (0.0, 11 062); 83% met the EAR, whereas 1.7% exceeded the UL (n = 232). Choline intake was 338 mg/day (120, 1016); only 18% met the Adequate Intake and none exceeded the UL (n = 158). Conclusion: To meet the nutrient requirements of pregnancy many women rely on prenatal vitamins. Reformulating prenatal multivitamin supplements to provide doses of vitamins within recommendations to complement a balanced healthy diet would ensure appropriate micronutrient intakes for pregnant women.
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Coats LE, Davis GK, Newsome AD, Ojeda NB, Alexander BT. Low Birth Weight, Blood Pressure and Renal Susceptibility. Curr Hypertens Rep 2019; 21:62. [PMID: 31228030 PMCID: PMC8109258 DOI: 10.1007/s11906-019-0969-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE OF THE REVIEW The purpose of this review is to highlight the clinical significance of increased renal risk that has its origins in fetal life. This review will also discuss the critical need to identify therapeutic interventions for use in a pregnancy complicated by placental dysfunction and intrauterine growth restriction that can mitigate the developmental origins of kidney disease without inflicting additional harm on the developing fetus. RECENT FINDINGS A reduction in nephron number is a contributory factor in the pathogenesis of hypertension and kidney disease in low birth weight individuals. Reduced nephron number may heighten susceptibility to a secondary renal insult, and recent studies suggest that perinatal history including birth weight should be considered in the assessment of renal risk in kidney donors. This review highlights current findings related to placental dysfunction, intrauterine growth restriction, increased risk for renal injury and disease, and potential therapeutic interventions.
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Affiliation(s)
- Laura E Coats
- Department of Physiology and Biophysics, Mississippi Center for Excellence in Perinatal Health, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Gwendolyn K Davis
- Department of Physiology and Biophysics, Mississippi Center for Excellence in Perinatal Health, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Ashley D Newsome
- Department of Physiology and Biophysics, Mississippi Center for Excellence in Perinatal Health, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Norma B Ojeda
- Department of Pediatrics, Mississippi Center for Excellence in Perinatal Health, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Barbara T Alexander
- Department of Physiology and Biophysics, Mississippi Center for Excellence in Perinatal Health, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
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Olmedo-Requena R, Gómez-Fernández J, Amezcua-Prieto C, Mozas-Moreno J, Khan KS, Jiménez-Moleón JJ. Pre-Pregnancy Adherence to the Mediterranean Diet and Gestational Diabetes Mellitus: A Case-Control Study. Nutrients 2019; 11:nu11051003. [PMID: 31052474 PMCID: PMC6566892 DOI: 10.3390/nu11051003] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 04/26/2019] [Accepted: 04/30/2019] [Indexed: 12/20/2022] Open
Abstract
Gestational diabetes mellitus (GDM), an important public health problem that affects mothers and offspring, is a common metabolic disorder. We evaluated the effect of the pre-pregnancy Mediterranean diet (MD) level of exposure on the odds of GDM development. A case-control study (291 GDM cases and 1175 controls without GDM) was conducted in pregnant women. Pre-pregnancy dietary intake was assessed using a validated food frequency questionnaire to calculate an MD adherence index (range score 0-9: low ≤ 2; middle 3-4; high 5-6; very high ≥ 7). Adjusted odds ratios (aOR) and their 95% confidence intervals (CI) were estimated using multivariable logistic regression models including age, BMI, family history of diabetes mellitus, previous GDM, miscarriages, and gravidity. Overall, middle-high MD adherence was 216/291 (74.2%) and very high adherence was 17/291 (5.8%) in cases. In controls the corresponding figures were 900/1175 (76.6%) and 73/1175 (6.2%), respectively. Compared to low adherence, high MD adherence was associated with GDM reduction (aOR 0.61, 95% CI 0.39,0.94; p = 0.028), and very high MD adherence was even more strongly associated (aOR 0.33, 95% CI 0.15, 0.72; p = 0.005). The protective effect of adherence to the MD prior to pregnancy should be considered as a preventive tool against the development of GDM.
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Affiliation(s)
- Rocío Olmedo-Requena
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain.
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18071 Granada, Spain.
| | | | - Carmen Amezcua-Prieto
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain.
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18071 Granada, Spain.
| | - Juan Mozas-Moreno
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18071 Granada, Spain.
- Obstetrics and Gynecology Service, Virgen de las Nieves University Hospital, 18014 Granada, Spain.
- Departament of Obstetrics and Gynecology. University of Granada. 18016 Granada, Spain.
| | - Khalid S Khan
- Women's Health Research Unit, Barts and the London School of Medicine, Queen Mary University London, E1 4NS London, UK.
- Multidisciplinary Evidence Synthesis Hub (mEsh), Barts and the London School of Medicine and Dentistry, Queen Mary University of London, E1 4NS London, UK.
| | - José J Jiménez-Moleón
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain.
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain.
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18071 Granada, Spain.
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50
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Kennedy RAK, Turner MJ. Development of a novel Periconceptual Nutrition Score (PENS) to examine the relationship between maternal dietary quality and fetal growth. Early Hum Dev 2019; 132:6-12. [PMID: 30908989 DOI: 10.1016/j.earlhumdev.2019.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 02/20/2019] [Accepted: 03/09/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Maternal nutrition may influence intrauterine fetal development. To date, the relationship between contemporary European dietary guidelines and fetal growth has not been examined. AIMS To develop a novel Periconceptual Nutrition Score (PENS) to assess maternal dietary quality in early pregnancy and examine its relationship with fetal growth. STUDY DESIGN Women were recruited conveniently at their first clinic visit and completed a supervised four day retrospective diet history. The PENS was developed using European Food Safety Authority recommended dietary intakes for pregnancy. The relationship between PENS and fetal growth was examined. SUBJECTS Women with a singleton pregnancy. OUTCOME MEASURES Birthweight, small for gestational age (SGA), neonatal head circumference. RESULTS AND CONCLUSIONS Of the 202 women, the mean age was 32.2 ± 5.0 years and 44.6% were nulliparas. The mean PENS was 9.4 ± 3.1. On multivariable regression, there was a positive relationship between the PENS and birthweight (beta = 45.3, 95%CI 14.8-75.9, P = 0.002) and neonatal head circumference (beta = 0.12, 95%CI 0.01-0.23, P = 0.03). Compared with the lowest PENS quartile, the mean birthweight was increased in the highest quartile (Mean difference 328 g, P = 0.02). The incidence of SGA was 16.4% (n = 10/61) in the lowest PENS quartile compared to 6.5% (n = 9/139) in the top three quartiles (P = 0.03). Thus, higher maternal dietary quality was associated with increased intrauterine fetal growth. The PENS is potentially useful in identifying those women before or during pregnancy who may benefit from dietary interventions that may optimise fetal growth. It may also be useful in tracking maternal dietary quality during pregnancy.
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Affiliation(s)
- Rachel A K Kennedy
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Cork Street, Dublin 8, Ireland; School of Biological Sciences, Dublin Institute of Technology, Kevin Street, Dublin 8, Ireland.
| | - Michael J Turner
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Cork Street, Dublin 8, Ireland
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