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Fu JY, Wang CA, Mead EC, Phung J, Makrides M, Pennell CE. The role of omega-3 polyunsaturated fatty acids in the prevention of preterm birth. Med J Aust 2024; 220:502-504. [PMID: 38714366 DOI: 10.5694/mja2.52301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/21/2023] [Indexed: 05/09/2024]
Affiliation(s)
| | - Carol A Wang
- University of Newcastle, Newcastle, NSW
- Mothers and Babies Research Program, Hunter Medical Research Institute, Newcastle, NSW
| | - Elyse C Mead
- University of Newcastle, Newcastle, NSW
- Hunter New England Local Health District, NSW Health, Newcastle, NSW
| | - Jason Phung
- University of Newcastle, Newcastle, NSW
- Mothers and Babies Research Program, Hunter Medical Research Institute, Newcastle, NSW
| | - Maria Makrides
- South Australian Health and Medical Research Institute, Adelaide, SA
| | - Craig E Pennell
- University of Newcastle, Newcastle, NSW
- Mothers and Babies Research Program, Hunter Medical Research Institute, Newcastle, NSW
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Major-Smith D, Morgan J, Emmett P, Golding J, Northstone K. Associations between religious/spiritual beliefs and behaviours and dietary patterns: analysis of the parental generation in a prospective cohort study (ALSPAC) in Southwest England. Public Health Nutr 2023; 26:2895-2911. [PMID: 37665131 PMCID: PMC10755456 DOI: 10.1017/s1368980023001866] [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: 09/22/2022] [Revised: 08/18/2023] [Accepted: 08/23/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVE Religious/spiritual beliefs and behaviours (RSBB) have been associated with health outcomes, with diet a potential mediator of this relationship. We therefore explored whether RSBB were associated with differences in diet. DESIGN Dietary patterns and nutrient intakes were derived from food frequency questionnaire completed by pregnant women in 1991-1992 (mean age = 28·3 years, range = 15-46) and by the mothers and partners 4 years post-partum (mothers mean age = 32·3, range = 19-49; partners mean age = 34·5, range = 18-74). RSBB exposures measured in pregnancy included religious belief, affiliation and attendance. We first explored whether RSBBs were associated with dietary patterns in confounder-adjusted linear regression models. If associations were found, we examined whether RSBB were associated with nutrient intake (linear regression) and following nutrient intake guidelines (logistic regression). SETTING Prospective birth cohort study in Southwest England (Avon Longitudinal Study of Parents and Children; ALSPAC). PARTICIPANTS 13 689 enrolled mothers and their associated partners. RESULTS In pregnant women, RSBB were associated with higher 'traditional' (i.e. 'meat and two veg') and lower 'vegetarian' dietary pattern scores. Religious attendance and non-Christian religious affiliation were associated with higher 'health-conscious' dietary pattern scores. Religious attendance was associated with increased micronutrient intake and following recommended micronutrient intake guidelines, with weaker effects for religious belief and affiliation. Comparable patterns were observed for mothers and partners 4 years post-partum, although associations between RSBB and nutrient intakes were weaker for partners. CONCLUSIONS RSBBs are associated with broad dietary patterns and nutrient intake in this cohort. If these reflect causal relationships, diet may potentially mediate the pathway between RSBB and health.
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Affiliation(s)
- Daniel Major-Smith
- Centre for Academic Child Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Jimmy Morgan
- Centre for Academic Child Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Pauline Emmett
- Centre for Academic Child Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Jean Golding
- Centre for Academic Child Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Kate Northstone
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Fu JY, Wang CA, Liu G, Mead E, Phung J, Makrides M, Pennell CE. Development and internal validation of a non-invasive clinical tool to predict sufficient omega-3 levels in early pregnancy. BMC Pregnancy Childbirth 2023; 23:442. [PMID: 37316786 DOI: 10.1186/s12884-023-05687-2] [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: 11/20/2022] [Accepted: 05/07/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Complications from preterm birth (PTB) are the leading cause of death and disability in those under five years. Whilst the role of omega-3 (n-3) supplementation in reducing PTB is well-established, growing evidence suggests supplementation use in those replete may increase the risk of early PTB. AIM To develop a non-invasive tool to identify individuals with total n-3 serum levels above 4.3% of total fatty acids in early pregnancy. METHODS We conducted a prospective observational study recruiting 331 participants from three clinical sites in Newcastle, Australia. Eligible participants (n = 307) had a singleton pregnancy between 8 and 20 weeks' gestation at recruitment. Data on factors associated with n-3 serum levels were collected using an electronic questionnaire; these included estimated intake of n-3 (including food type, portion size, frequency of consumption), n-3 supplementation, and sociodemographic factors. The optimal cut-point of estimated n-3 intake that predicted mothers with total serum n-3 levels likely above 4.3% was developed using multivariate logistic regression, adjusting for maternal age, body mass index, socioeconomic status, and n-3 supplementation use. Total serum n-3 levels above 4.3% was selected as previous research has demonstrated that mothers with these levels are at increased risk of early PTB if they take additional n-3 supplementation during pregnancy. Models were evaluated using various performance metrics including sensitivity, specificity, area under receiver operator characteristic (AUROC) curve, true positive rate (TPR) at 10% false positive rate (FPR), Youden Index, Closest to (0,1) Criteria, Concordance Probability, and Index of Union. Internal validation was performed using 1000-bootstraps to generate 95% confidence intervals for performance metrics generated. RESULTS Of 307 eligible participants included for analysis, 58.6% had total n-3 serum levels above 4.3%. The optimal model had a moderate discriminative ability (AUROC 0.744, 95% CI 0.742-0.746) with 84.7% sensitivity, 54.7% specificity and 37.6% TPR at 10% FPR. CONCLUSIONS Our non-invasive tool was a moderate predictor of pregnant women with total serum n-3 levels above 4.3%; however, its performance is not yet adequate for clinical use. TRIAL REGISTRATION This trial was approved by the Hunter New England Human Research Ethics Committee of the Hunter New England Local Health District (Reference 2020/ETH00498 on 07/05/2020 and 2020/ETH02881 on 08/12/2020).
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Affiliation(s)
- Joanna Yx Fu
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2300, Australia
| | - Carol A Wang
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2300, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
| | - Ge Liu
- South Australian Health and Medical Research Institute, Adelaide, SA, 5000, Australia
| | - Elyse Mead
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2300, Australia
| | - Jason Phung
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2300, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
- John Hunter Hospital, New Lambton Heights, NSW, 2305, Australia
| | - Maria Makrides
- South Australian Health and Medical Research Institute, Adelaide, SA, 5000, Australia
| | - Craig E Pennell
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2300, Australia.
- Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia.
- John Hunter Hospital, New Lambton Heights, NSW, 2305, Australia.
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Wei Z, Li W, Lei C, Caixia A, Chuan Z, Jianqin W. Maternal seafood consumption and fetal growth: a birth cohort study in urban China. BMC Pregnancy Childbirth 2023; 23:253. [PMID: 37055723 PMCID: PMC10099888 DOI: 10.1186/s12884-023-05431-w] [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: 12/01/2022] [Accepted: 02/07/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND Seafood is a good source of essential fatty acids which has a presumably beneficial effect on developing embryos and fetuses, although it is also a source of contaminants. In this context, pregnant women are faced with conflicting reports on the risk and benefits of seafood consumption. This study aims to assess whether the consumption of seafood during pregnancy was associated with fetal growth in an inland city in China. METHODS This study included 10,179 women who delivered a singleton live birth in Lanzhou, China. Seafood consumption was assessed using a Food Frequency Questionnaire. Maternal data including birth outcomes and maternal complications information is extracted from the medical records. Associations between seafood consumption and fetal growth indicators were analyzed using multiple linear regression and multiple logistic regression. RESULTS There was a positive association between total seafood consumption and birth weight (β = 0.027, 95%CI:0.030-0.111) but no association concerning birth length or head circumference. Seafood consumption was associated with decreased risk of low birth weight (OR = 0.575, 95% CI: 0.480, 0.689). The frequency of seafood consumption during pregnancy showed a trend toward a positive association with low birth weight. Significantly reduced rates of low birth weight were found in women who consumed more than 75 g of seafood/week during pregnancy as compared to women with no or very low intakes (P for trend 0.021). A significant interaction was observed between pre-pregnancy BMI and seafood consumption on birth weight among underweight women, but not among overweight women. Gestational weight gain partially mediated the association between seafood consumption and birth weight. CONCLUSIONS Maternal seafood consumption was associated with decreased risk of low birth weight and increased birth weight. This association was mainly driven by freshwater fish and shellfish. These results further corroborate the present dietary recommendation to the Chinese Nutrition Society for pregnant women, especially those with underweight pre-pregnancy BMI and inadequate GWG. In addition, our findings provide implications for future interventions to improve seafood consumption among pregnant women to prevent low birth weight babies in the inland city in China.
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Affiliation(s)
- Zhang Wei
- Lanzhou University Second Hospital, No. 82, Cui Yingmen, Linxia Road, Chengguan District, Lanzhou City, 730050, Gansu Province, China
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road Qilihe District, Lanzhou, 730050, Gansu Province, China
| | - Wang Li
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road Qilihe District, Lanzhou, 730050, Gansu Province, China
| | - Cao Lei
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road Qilihe District, Lanzhou, 730050, Gansu Province, China
| | - An Caixia
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road Qilihe District, Lanzhou, 730050, Gansu Province, China
| | - Zhang Chuan
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road Qilihe District, Lanzhou, 730050, Gansu Province, China
| | - Wang Jianqin
- Lanzhou University Second Hospital, No. 82, Cui Yingmen, Linxia Road, Chengguan District, Lanzhou City, 730050, Gansu Province, China.
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Vafai Y, Yeung E, Roy A, He D, Li M, Hinkle SN, Grobman WA, Newman R, Gleason JL, Tekola-Ayele F, Zhang C, Grantz KL. The association between first-trimester omega-3 fatty acid supplementation and fetal growth trajectories. Am J Obstet Gynecol 2023; 228:224.e1-224.e16. [PMID: 35952840 PMCID: PMC9877160 DOI: 10.1016/j.ajog.2022.08.007] [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: 03/03/2022] [Revised: 06/29/2022] [Accepted: 08/05/2022] [Indexed: 01/29/2023]
Abstract
BACKGROUND Prenatal omega-3 fatty acid supplementation, particularly docosahexaenoic acid and eicosapentaenoic acid, has been associated with greater birthweight in clinical trials; however, its effect on fetal growth throughout gestation is unknown. OBJECTIVE This study aimed to examine the association between first-trimester docosahexaenoic acid and eicosapentaenoic acid supplementation and growth trajectories of estimated fetal weight and specific fetal biometrics measured longitudinally from the second trimester of pregnancy to delivery. STUDY DESIGN In a multisite, prospective cohort of racially diverse, low-risk pregnant women, we used secondary data analysis to examine fetal growth trajectories in relation to self-reported (yes or no) first-trimester docosahexaenoic acid and eicosapentaenoic acid supplementation. Fetal ultrasonographic measurements, including abdominal circumference, biparietal diameter, femur length, head circumference, and humerus length, were measured at enrollment (8-13 weeks) and up to 5 follow-up visits. Estimated fetal weight and head circumference-to-abdominal circumference ratio (a measure of growth symmetry) were calculated. Fetal growth trajectories were modeled for each measure using a linear mixed model with cubic splines. If significant differences in fetal growth trajectories between groups were observed (global P<.05), weekly comparisons were performed to determine when in gestation these differences emerged. Analyses were adjusted for maternal sociodemographics, parity, infant sex, total energy consumption, and diet quality score. All analyses were repeated using dietary docosahexaenoic acid and eicosapentaenoic acid intake, dichotomized at the recommended cutoff for pregnant and lactating women (≥0.25 vs <0.25 g/d), among women who did not report supplement intake in the first trimester of pregnancy were repeated. RESULTS Among 1535 women, 143 (9%) reported docosahexaenoic acid and eicosapentaenoic acid supplementation in the first trimester of pregnancy. Overall, first-trimester docosahexaenoic acid and eicosapentaenoic acid supplementation was associated with statistically significant differences (P-value <.05) in fetal growth trajectories during pregnancy. Specifically, estimated fetal weight was larger among women with docosahexaenoic acid and eicosapentaenoic acid supplementation than among those without supplementation (global P=.028) with significant weekly differences in median estimated fetal weight most apparent between 38 to 41 weeks of gestation (median estimated fetal weight difference at 40 weeks of gestation, 114 g). Differences in fetal growth trajectories for abdominal circumference (P=.003), head circumference (P=.003), and head circumference-to-abdominal circumference ratio (P=.0004) were also identified by supplementation status. In weekly comparisons, docosahexaenoic acid and eicosapentaenoic acid supplement use was associated with larger median abdominal circumference (changed from 2 to 9 mm) in midpregnancy onward (19 to 41 weeks), larger median head circumference between 30 to 33 weeks of gestation, and smaller median head circumference-to-abdominal circumference ratio in the second and third trimesters of pregnancy. There was no specific weekly difference in fetal femur length or humerus length by docosahexaenoic acid and eicosapentaenoic acid supplementation. First-trimester dietary sources of docosahexaenoic acid and eicosapentaenoic acid among women with no first-trimester docosahexaenoic acid and eicosapentaenoic acid supplementation (n=1392) were associated with differences in fetal biparietal diameter (P=.043), but not other metrics of fetal growth. At the recommended dietary docosahexaenoic acid and eicosapentaenoic acid levels compared with below-recommended levels, biparietal diameter was larger between 38 to 41 weeks of gestation. CONCLUSION In this racially diverse pregnancy cohort, first-trimester docosahexaenoic acid and eicosapentaenoic acid supplementation was associated with significant increases in fetal growth, specifically greater estimated fetal abdominal circumference in the second and third trimesters of pregnancy.
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Affiliation(s)
- Yassaman Vafai
- Epidemiology Branch, Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
| | - Edwina Yeung
- Epidemiology Branch, Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
| | - Anindya Roy
- University of Maryland Baltimore County, Baltimore, MD
| | - Dian He
- Epidemiology Branch, Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD; The Prospective Group, Inc, Fairfax, VA
| | - Mengying Li
- Epidemiology Branch, Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
| | - Stefanie N Hinkle
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | | | - Roger Newman
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC
| | - Jessica L Gleason
- Epidemiology Branch, Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
| | - Fasil Tekola-Ayele
- Epidemiology Branch, Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
| | - Cuilin Zhang
- Epidemiology Branch, Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD; Global Center for Asian Women's Health, Bia-Echo Asia Centre for Reproductive Longevity & Equality, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Katherine L Grantz
- Epidemiology Branch, Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.
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Ishitsuka K, Tsuji M, Yamamoto M, Tanaka R, Suga R, Kuwamura M, Sakuragi T, Shimono M, Kusuhara K. Association between maternal fish consumption during pregnancy and preterm births: the Japan Environment and Children's Study. Environ Health Prev Med 2023; 28:47. [PMID: 37648522 PMCID: PMC10480610 DOI: 10.1265/ehpm.23-00084] [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: 04/02/2023] [Accepted: 06/30/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Fish are a rich source of essential nutrients that protect against preterm birth. However, as fish can absorb environmental pollutants, their consumption can also increase the risk of preterm birth. This study aimed to assess whether maternal fish consumption during pregnancy is associated with preterm birth in a nationwide large Japanese cohort that consumed relatively high amounts and many types of fish. METHODS This study included 81,428 mother-child pairs enrolled in a nationwide prospective Japanese birth cohort study. Fish consumption was assessed using a validated food frequency questionnaire. Multivariate logistic regression was used to investigate the association of total consumption of fish, fatty fish and lean fish, fish paste, and seafood and clams with preterm birth, adjusted for potential confounders. RESULTS There was no association between overall fish consumption and preterm births. However, the highest quintile of fish paste consumption was significantly associated with an increased risk of preterm birth (odds ratio [OR]: 1.11; 95% confidence interval [CI: 1.04, 1.17]). The consumption of baked fish paste at least three times per week was significantly associated with preterm birth (OR: 1.20; 95% CI: 1.03, 1.40). Consumption of other types of fish, except fish paste, was not significantly associated with preterm birth risk. CONCLUSIONS Fish paste consumption may increase the risk of preterm birth. Further studies are required to confirm this association.
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Affiliation(s)
- Kazue Ishitsuka
- Department of Environmental Health, School of Medicine, University of Occupational and Environmental Health
- Departiment of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Mayumi Tsuji
- Department of Environmental Health, School of Medicine, University of Occupational and Environmental Health
- Regional Center for Japan Environment and Children’s Study, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Megumi Yamamoto
- Department of Environmental Health, School of Medicine, University of Occupational and Environmental Health
- Department of Environment and Public Health, National Institute for Minamata Disease, Minamata, Japan
| | - Rie Tanaka
- Department of Environmental Health, School of Medicine, University of Occupational and Environmental Health
| | - Reiko Suga
- Regional Center for Japan Environment and Children’s Study, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Mami Kuwamura
- Department of Environmental Health, School of Medicine, University of Occupational and Environmental Health
- Department of Pediatrics, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Toshihide Sakuragi
- Department of Environmental Health, School of Medicine, University of Occupational and Environmental Health
| | - Masayuki Shimono
- Regional Center for Japan Environment and Children’s Study, University of Occupational and Environmental Health, Kitakyushu, Japan
- Department of Pediatrics, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Koichi Kusuhara
- Regional Center for Japan Environment and Children’s Study, University of Occupational and Environmental Health, Kitakyushu, Japan
- Department of Pediatrics, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - the Japan Environment and Children’s Study Group
- Department of Environmental Health, School of Medicine, University of Occupational and Environmental Health
- Departiment of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
- Department of Environment and Public Health, National Institute for Minamata Disease, Minamata, Japan
- Regional Center for Japan Environment and Children’s Study, University of Occupational and Environmental Health, Kitakyushu, Japan
- Department of Pediatrics, University of Occupational and Environmental Health, Kitakyushu, Japan
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Maternal fish and shellfish consumption and preterm birth: a retrospective study in urban China. Br J Nutr 2022; 128:684-692. [PMID: 34558400 DOI: 10.1017/s0007114521003858] [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: 12/24/2022]
Abstract
Preterm birth is the leading cause of perinatal mortality and morbidity. Some prospective cohort studies suggested that fish and shellfish consumption may affect the incidence of preterm birth. However, conflicting evidence exists on the relationship between fish and shellfish consumption and preterm birth. A total of 10 179 women from Gansu province were interviewed after delivery to collect information on their past intake of fish and shellfish using FFQ. Logistic regression models were used to estimate OR and 95 % CI to examine the association between fish and shellfish consumption and preterm birth and its clinical subtypes. Fish and shellfish consumption was associated with reduced risk of preterm birth (OR = 0·65, 95 % CI 0·56, 0·77). Increasing frequency of fish and shellfish consumption, compared with no fish and shellfish consumption, was associated with decreasing odds of preterm birth. Besides, increasing weekly total amount of fish and shellfish consumption, compared with no fish and shellfish consumption, was also associated with decreasing odds of preterm birth. Significant trend effect was also seen between fish and shellfish consumption and very preterm birth (Pfor trend = 0·001) and spontaneous preterm birth (Pfor trend = 0·003). Interaction was observed between total fish and shellfish consumption with maternal age (Pfor interaction = 0·041) and pre-pregnancy BMI underweight (Pfor interaction = 0·012). Our findings showed that maternal fish and shellfish consumption was associated with lower incidence of preterm birth.We recommend for the national guideline of ≥350 g/week of fish and shellfish consumption among pregnant women.
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Simonato M, Visentin S, Verlato G, Cosmi E, Correani A, Cogo P, Carnielli VP. DHA turnover in pregnant women using the natural abundance variation of 13C: a pilot study. Br J Nutr 2022; 129:1-19. [PMID: 35403583 DOI: 10.1017/s0007114522001088] [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: 11/06/2022]
Abstract
The importance of DHA intake to support fetal development and maternal health is well established. In this pilot study we applied the natural abundance approach to determine the contribution of 200 mg/day of DHA supplement to the plasma DHA pool in 19 healthy pregnant women on a free diet.Women received DHA, from pregnancy week 20 until delivery, from an algal source (N=13, Algae group) or from fish oil (N=6, Fish group) with slightly different content of 13C.We measured plasma phospholipids DHA 13C:12C ratio (reported as δ13C) prior to supplementation (T0), after 10 (T1) and 90 days (T2) and prior to delivery (T3).The δ13C of DHA in algae and fish supplements were -15.8±0.2 mUr and -25.3±0.2 mUr (p<0.001).DHA δ13C in the Algae group increased from -27.7±1.6 mUr (T0) to -21.9±2.2 mUr (T3) (p<0.001), whereas there were not significant changes in the Fish group (-27.8±0.9 mUr at T0 and -27.3±1.1 mUr at T3, p=0.09).In the Algae group 200 mg/day of DHA contributed to the plasma phospholipid pool by a median value of 53% (31-75% minimum and maximum). This estimation was not possible in the fish group.Our results demonstrate the feasibility of assessing the contribution of DHA from an algal source to the plasma DHA pool in pregnant women by the natural abundance approach. Plasma δ13C DHA did not change when consuming DHA of fish origin, with almost the same δ13C value of that of the pre-supplementation plasma δ13C DHA.
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Affiliation(s)
- Manuela Simonato
- PCare laboratory, Fondazione Istituto di Ricerca Pediatrica, "Citta' della Speranza", Corso Stati Uniti, 4F, 35127 Padova, Italy
- Department of Women's and Children's Health, University of Padova; Via Giustiniani, 3, 35128 Padova, Italy
| | - Silvia Visentin
- Department of Women's and Children's Health, University of Padova; Via Giustiniani, 3, 35128 Padova, Italy
| | - Giovanna Verlato
- Department of Women's and Children's Health, University of Padova; Via Giustiniani, 3, 35128 Padova, Italy
| | - Erich Cosmi
- Department of Women's and Children's Health, University of Padova; Via Giustiniani, 3, 35128 Padova, Italy
| | - Alessio Correani
- Division of Neonatology, Polytechnic University of Marche and "G. Salesi" Children's Hospital, Via Filippo Corridoni, 11, 60123 Ancona, Italy
| | - Paola Cogo
- Department of Medicine, University Hospital S Maria della Misericordia, University of Udine, Piazzale Santa Maria della Misericordia, 15, 33100 Udine, Italy
| | - Virgilio P Carnielli
- Division of Neonatology, Polytechnic University of Marche and "G. Salesi" Children's Hospital, Via Filippo Corridoni, 11, 60123 Ancona, Italy
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Yang W, Han N, Jiao M, Chang X, Liu J, Zhou Q, Wang HJ. Maternal diet quality during pregnancy and its influence on low birth weight and small for gestational age: a birth cohort in Beijing, China. Br J Nutr 2022; 129:1-10. [PMID: 35249563 DOI: 10.1017/s0007114522000708] [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: 11/06/2022]
Abstract
This study aimed to describe diet quality of pregnant women and explore the association between maternal diet and the prevalence of low birth weight (LBW) and small for gestational age (SGA). A total of 3856 participants from a birth cohort in Beijing, China, were recruited between June 2018 and February 2019. Maternal diet in the first and second trimesters was assessed by the Chinese diet balance index for pregnancy (DBI-P), using data collected by the inconsecutive 2-d 24-h dietary recalls. Logistic regressions were performed to explore the independent effects of DBI-P components on LBW and SGA. The prevalence of LBW and SGA was 3·8% and 6·0%, respectively. Dietary intakes of the participants were imbalanced. The proportions of participants having insufficient intake of vegetables (87·3% and 86·6%), dairy product (95·9% and 96·7%) and aquatic foods (80·5% and 85·3%) were high in both trimesters. The insufficiency of fruit intake was more severe in the second (85·2%) than that in the first trimester (22·5%) (P < 0·05). After adjusting for potential confounders, the intake of fruits and dairy in the second trimester was negatively associated with the risk of LBW (OR = 0·850, 95% CI: 0·723, 0·999) and SGA (OR = 0·885, 95% CI: 0·787, 0.996), respectively. Sufficient consumption of fruits and dairy products in pregnancy may be suggested in order to prevent LBW and SGA.
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Affiliation(s)
- Wangxing Yang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Na Han
- Tongzhou Maternal and Child Health Care Hospital of Beijing, Beijing, People's Republic of China
| | - Mingyuan Jiao
- Tongzhou Maternal and Child Health Care Hospital of Beijing, Beijing, People's Republic of China
| | - Xinlei Chang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Qianling Zhou
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Hai-Jun Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, People's Republic of China
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Simmonds LA, Middleton PF, Makrides M. Recent advances in policy and practice translation of the evidence for additional omega-3 fatty acids and prematurity. Curr Opin Clin Nutr Metab Care 2022; 25:81-85. [PMID: 34937851 DOI: 10.1097/mco.0000000000000806] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW This is a review of the most up-to-date research on the effectiveness of omega-3 fatty acids for reducing the risk of prematurity in well nourished women with access to high-quality obstetric care. It will provide an overview of the translation of the evidence on omega-3 screening into policy, and the latest research on how to implement the policy into practice. RECENT FINDINGS Findings of the included clinical studies support that omega-3 supplementation for women with a singleton pregnancy who have a low omega-3 status reduces the risk of early preterm birth. SUMMARY There is evidence that screening and providing appropriate advice to women with a singleton pregnancy who have a low omega-3 status can reduce their risk of early preterm birth, and avoiding supplementation for women who are replete will avoid unnecessary supplementation and potential harm.
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Affiliation(s)
- Lucy A Simmonds
- South Australian Health and Medical Research Institute, SAHMRI Women and Kids
| | - Philippa F Middleton
- South Australian Health and Medical Research Institute, SAHMRI Women and Kids
- School of Medicine, the University of Adelaide, North Terrace, Adelaide, South Australia, Australia
| | - Maria Makrides
- South Australian Health and Medical Research Institute, SAHMRI Women and Kids
- School of Medicine, the University of Adelaide, North Terrace, Adelaide, South Australia, Australia
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11
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Murff HJ, Greevy RA, Sanghani RS, Hartmann KE, Hartert TV, Graves CR, Lee SS, Tindle HA. Investigating N-3 Fatty Acids to prevent Neonatal Tobacco-related outcomeS (INFANTS): study protocol for a double-blind, randomized, placebo-controlled parallel clinical trial of n-3 polyunsaturated fatty acids in pregnant smokers. Trials 2021; 22:922. [PMID: 34906201 PMCID: PMC8669400 DOI: 10.1186/s13063-021-05865-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 11/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tobacco use during pregnancy is the most important modifiable risk factor associated with adverse pregnancy outcomes, increasing the risk of preterm birth, intrauterine growth restriction and sudden infant death syndrome. Fewer than half of pregnant smokers can quit on their own. Identifying safe and effective therapies to prevent tobacco-related adverse pregnancy outcomes and/or increase smoking cessation in pregnant women would have a substantial public health impact. Cigarette smoking is associated with a relative deficiency in circulating n-3 long-chain polyunsaturated fatty acid (n-3 LCPUFA) levels. A recent analysis found that smokers taking n-3 LCPUFAs during pregnancy had a reduction in preterm labor risk when compared to non-smokers. Studies have shown that supplemental n-3 LCPUFAs may also reduce nicotine cravings and daily cigarette use. Thus, smokers may benefit from supplemental n-3 LCPUFAs by lowering the risk of preterm labor and/or increased smoking cessation. To address important remaining knowledge gaps, we propose the Investigating N-3 Fatty Acids to prevent Neonatal Tobacco related outcomeS (INFANTS). METHODS The INFANTS study is a multicenter, randomized, double-blind, placebo-controlled study that will randomize 400 pregnant smokers to either supplemental n-3 LCPUFAs or placebo. Participants will be enrolled between 12 and 24 weeks' gestation and followed until 6 weeks after delivery. We will recruit from clinical centers throughout Middle Tennessee. We will assess smoking behavior after 12 weeks of supplementation using self-report and validated biomarkers of tobacco exposure. We will measure response to supplementation using biological markers of n-3 LCPUFA status. Our primary endpoint will be preterm labor as reflected by gestational age at delivery. Our secondary endpoint will be change from baseline in cigarettes per day at 12 weeks. DISCUSSION This study tests the hypothesis that smoking-induced n-3 LCPUFA deficiencies contribute to tobacco-related adverse pregnancy outcomes and that supplementation of n-3 LCPUFAs in pregnant smokers may prevent these complications. If our study demonstrates that supplemental n-3 LCPUFAs are effective at reducing the risk of tobacco-related adverse neonatal outcomes and/or reducing tobacco use during pregnancy, our results could have an immediate and major impact on pregnancy care and neonatal outcomes. TRIAL REGISTRATION ClinicalTrials.gov NCT04417595. Registered on April 21, 2020.
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Affiliation(s)
- Harvey J Murff
- Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 450, Nashville, TN, 37232, USA.
- Geriatric Research, Education and Clinical Center, Tennessee Valley Healthcare System, Nashville, TN, USA.
| | - Robert A Greevy
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, USA
| | - Reesha S Sanghani
- Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, USA
| | - Katherine E Hartmann
- Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, USA
| | - Tina V Hartert
- Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, USA
| | | | - Scott S Lee
- Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 450, Nashville, TN, 37232, USA
| | - Hilary A Tindle
- Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 450, Nashville, TN, 37232, USA
- Geriatric Research, Education and Clinical Center, Tennessee Valley Healthcare System, Nashville, TN, USA
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12
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Zhao R, Gao Q, Xiong T, Zhou J, Wang S, Zhang Z, Du Y, Xie H, Chen X, Shen J, Han W, Yang X, Hao L. Moderate Freshwater Fish Intake, but Not n-3 Polyunsaturated Fatty Acids, Is Associated with a Reduced Risk of Small for Gestational Age in a Prospective Cohort of Chinese Pregnant Women. J Acad Nutr Diet 2021; 122:722-730.e12. [PMID: 34673294 DOI: 10.1016/j.jand.2021.10.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 10/12/2021] [Accepted: 10/12/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Although previous studies have found that maternal fish intake is associated with fetal growth, the role of freshwater fish intake remains unknown. OBJECTIVE Our aim was to examine the relationships of freshwater fish and n-3 polyunsaturated fatty acids (PUFAs) intake with the risk of small for gestational age (SGA) in Chinese pregnant women. DESIGN This was a prospective analysis of data from the Tongji Birth cohort in Wuhan, China, from 2018 to 2021. PARTICIPANTS/SETTINGS This study included 1,701 pregnant women who had completed a food frequency questionnaire dietary assessment during mid-pregnancy. MAIN OUTCOME MEASURES Intake of fish was assessed by a semi-quantitative food frequency questionnaire. Total intake of n-3 PUFAs was the sum of data collected from both dietary and supplemental sources of n-3 PUFAs. Birth information was extracted from medical records. STATISTICAL ANALYSES Multivariate logistic regression models were applied to estimate odds ratios and 95% CIs. RESULTS The median (interquartile range) intake of freshwater fish and total n-3 PUFAs was 12.1 (4.3 to 26.4) g/d and 68.2 (24.5 to 370.0) mg/d, respectively. Moderate intake of freshwater fish was associated with reduced risk of SGA. Compared with the lowest quintile (0-3.2 g/d), the multivariable-adjusted odds ratio for women in the fourth quintile of freshwater fish intake (17.9 to 30.0 g/d) was 0.50 (95% CI 0.25 to 0.96). We found a nonlinear association between freshwater fish intake and SGA risk (Pnonlinearity = .027). However, maternal n-3 PUFAs intake was not significantly associated with SGA risk, either from total intake or from dietary sources alone. CONCLUSIONS Moderate freshwater fish intake during pregnancy is associated with lower risk of SGA in a Chinese population. This finding provides supportive evidence for freshwater fish intake during pregnancy, particularly for the inland areas of developing countries.
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Affiliation(s)
- Rui Zhao
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qin Gao
- Department of Public Health, Jining Medical University, Jining, Shandong, China
| | - Ting Xiong
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Juan Zhou
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shanshan Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhen Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yatan Du
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Huihui Xie
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiuzhi Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jian Shen
- The Central Hospital of Wuhan, Wuhan, Hubei, China
| | - Weizhen Han
- The Central Hospital of Wuhan, Wuhan, Hubei, China
| | - Xuefeng Yang
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Liping Hao
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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13
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Goodfellow L, Care A, Harrold J, Sharp A, Ivandic J, Poljak B, Roberts D, Alfirevic A, Müller-Myhsok B, Gibson R, Makrides M, Alfirevic Z. Plasma long-chain omega-3 fatty acid status and risk of recurrent early spontaneous preterm birth: a prospective observational study. Acta Obstet Gynecol Scand 2021; 100:1401-1411. [PMID: 33742474 DOI: 10.1111/aogs.14147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 03/12/2021] [Accepted: 03/15/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION A 2018 Cochrane review found that omega-3 supplementation in pregnancy was associated with a risk reduction of early preterm birth of 0.58; prompting calls for universal supplementation. Recent analysis suggests the benefit may be confined to women with a low baseline omega-3 fatty acid status. However, the contemporary omega-3 fatty acid status of pregnant women in the UK is largely unknown. This is particularly pertinent for women with a previous preterm birth, in whom a small relative risk reduction would have a larger reduction of absolute risk. This study aimed to assess the omega-3 fatty acid status of a UK pregnant population and determine the association between the long-chain omega-3 fatty acids and recurrent spontaneous early preterm birth. MATERIAL AND METHODS A total of 283 high-risk women with previous early preterm birth were recruited to the prospective observational study in Liverpool, UK. Additionally, 96 pregnant women with previous term births and birth ≥39+0 weeks in the index pregnancy provided a low-risk population sample. Within the high-risk group we assessed the odds ratio of recurrent early preterm birth compared with birth at ≥37+0 weeks of gestation according to plasma eicosapentaenoic acid plus docosahexaenoic acid (EPA+DHA) at 15-22 weeks of gestation. RESULTS Our participants had low EPA+DHA; 62% (143/229) of women with previous preterm birth and 69% (68/96) of the population sample had levels within the lowest two quintiles of a previously published pregnancy cohort. We found no association between long-chain omega-3 status and recurrent early preterm birth (n = 51). The crude odds ratio of a recurrent event was 0.91 (95% CI 0.38-2.15, p = 0.83) for women in the lowest, compared with the highest three quintiles of EPA+DHA. CONCLUSIONS In the majority of our participants, levels of long-chain omega-3 were low; within the range that may benefit from supplementation. However, levels showed no association with risk of recurrent early spontaneous preterm birth. This could be because our population levels were too low to show benefit in being omega-3 "replete"; or else omega-3 levels may be of lesser importance in recurrent early preterm birth.
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Affiliation(s)
- Laura Goodfellow
- Harris-Wellbeing Research Centre, University of Liverpool, Liverpool, KE, UK.,Liverpool Women's Hospital, Liverpool, KE, UK
| | - Angharad Care
- Harris-Wellbeing Research Centre, University of Liverpool, Liverpool, KE, UK.,Liverpool Women's Hospital, Liverpool, KE, UK
| | - Jane Harrold
- Harris-Wellbeing Research Centre, University of Liverpool, Liverpool, KE, UK
| | - Andrew Sharp
- Harris-Wellbeing Research Centre, University of Liverpool, Liverpool, KE, UK.,Liverpool Women's Hospital, Liverpool, KE, UK
| | | | | | | | - Ana Alfirevic
- Harris-Wellbeing Research Centre, University of Liverpool, Liverpool, KE, UK.,Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, KE, UK
| | - Bertram Müller-Myhsok
- Harris-Wellbeing Research Centre, University of Liverpool, Liverpool, KE, UK.,Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Robert Gibson
- School of Agriculture, Food and Wine, University of Adelaide, Adelaide, Australia
| | - Maria Makrides
- South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Zarko Alfirevic
- Harris-Wellbeing Research Centre, University of Liverpool, Liverpool, KE, UK.,Liverpool Women's Hospital, Liverpool, KE, UK
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14
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Pinot de Moira A, Haakma S, Strandberg-Larsen K, van Enckevort E, Kooijman M, Cadman T, Cardol M, Corpeleijn E, Crozier S, Duijts L, Elhakeem A, Eriksson JG, Felix JF, Fernández-Barrés S, Foong RE, Forhan A, Grote V, Guerlich K, Heude B, Huang RC, Järvelin MR, Jørgensen AC, Mikkola TM, Nader JLT, Pedersen M, Popovic M, Rautio N, Richiardi L, Ronkainen J, Roumeliotaki T, Salika T, Sebert S, Vinther JL, Voerman E, Vrijheid M, Wright J, Yang TC, Zariouh F, Charles MA, Inskip H, Jaddoe VWV, Swertz MA, Nybo Andersen AM. The EU Child Cohort Network's core data: establishing a set of findable, accessible, interoperable and re-usable (FAIR) variables. Eur J Epidemiol 2021; 36:565-580. [PMID: 33884544 PMCID: PMC8159791 DOI: 10.1007/s10654-021-00733-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 02/14/2021] [Indexed: 10/24/2022]
Abstract
The Horizon2020 LifeCycle Project is a cross-cohort collaboration which brings together data from multiple birth cohorts from across Europe and Australia to facilitate studies on the influence of early-life exposures on later health outcomes. A major product of this collaboration has been the establishment of a FAIR (findable, accessible, interoperable and reusable) data resource known as the EU Child Cohort Network. Here we focus on the EU Child Cohort Network's core variables. These are a set of basic variables, derivable by the majority of participating cohorts and frequently used as covariates or exposures in lifecourse research. First, we describe the process by which the list of core variables was established. Second, we explain the protocol according to which these variables were harmonised in order to make them interoperable. Third, we describe the catalogue developed to ensure that the network's data are findable and reusable. Finally, we describe the core data, including the proportion of variables harmonised by each cohort and the number of children for whom harmonised core data are available. EU Child Cohort Network data will be analysed using a federated analysis platform, removing the need to physically transfer data and thus making the data more accessible to researchers. The network will add value to participating cohorts by increasing statistical power and exposure heterogeneity, as well as facilitating cross-cohort comparisons, cross-validation and replication. Our aim is to motivate other cohorts to join the network and encourage the use of the EU Child Cohort Network by the wider research community.
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Affiliation(s)
- Angela Pinot de Moira
- Section for Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Sido Haakma
- Genomics Coordination Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Katrine Strandberg-Larsen
- Section for Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Esther van Enckevort
- Genomics Coordination Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marjolein Kooijman
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Tim Cadman
- Population Health Science, Bristol Medical School, Bristol, BS8 2BN, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2PS, UK
| | - Marloes Cardol
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Eva Corpeleijn
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sarah Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Applied Research Collaboration Wessex, Southampton Science Park, Innovation Centre, 2 Venture Road, Chilworth, Southampton, SO16 7NP, UK
| | - Liesbeth Duijts
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Ahmed Elhakeem
- Population Health Science, Bristol Medical School, Bristol, BS8 2BN, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2PS, UK
| | - Johan G Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
- Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
- Singapore Institute for Clinical Sciences (SICS), Agency for Science and Technology (A*STAR), Singapore, Singapore
| | - Janine F Felix
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Sílvia Fernández-Barrés
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Rachel E Foong
- Telethon Kids Institute, Perth, WA, Australia
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Anne Forhan
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, Paris, France
| | - Veit Grote
- Division of Metabolic and Nutritional Medicine, Department of Pediatrics, Dr. von Hauner Children's Hospital, LMU University Hospital Munich, Munich, Germany
| | - Kathrin Guerlich
- Division of Metabolic and Nutritional Medicine, Department of Pediatrics, Dr. von Hauner Children's Hospital, LMU University Hospital Munich, Munich, Germany
| | - Barbara Heude
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, Paris, France
| | | | - Marjo-Riitta Järvelin
- Faculty of Medicine, Center for Life-Course Health Research, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Anne Cathrine Jørgensen
- Section for Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Tuija M Mikkola
- Folkhälsan Research Center, Helsinki, Finland
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Johanna L T Nader
- Department of Genetics and Bioinformatics, Division of Health Data and Digitalisation, Norwegian Institute of Public Health, Oslo, Norway
| | - Marie Pedersen
- Section for Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Maja Popovic
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Nina Rautio
- Faculty of Medicine, Center for Life-Course Health Research, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Justiina Ronkainen
- Faculty of Medicine, Center for Life-Course Health Research, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
| | - Theano Roumeliotaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Theodosia Salika
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Sylvain Sebert
- Faculty of Medicine, Center for Life-Course Health Research, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
| | - Johan L Vinther
- Section for Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ellis Voerman
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Martine Vrijheid
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Tiffany C Yang
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Faryal Zariouh
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, Paris, France
| | - Marie-Aline Charles
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, Paris, France
- ELFE Joint Unit, French Institute for Demographic Studies (Ined), French Institute for Medical Research and Health (INSERM), French Blood Agency, Aubervilliers, France
| | - Hazel Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Vincent W V Jaddoe
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Morris A Swertz
- Genomics Coordination Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Anne-Marie Nybo Andersen
- Section for Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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15
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Seafood Intake as a Method of Non-Communicable Diseases (NCD) Prevention in Adults. Nutrients 2021; 13:nu13051422. [PMID: 33922600 PMCID: PMC8146377 DOI: 10.3390/nu13051422] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/17/2021] [Accepted: 04/21/2021] [Indexed: 12/21/2022] Open
Abstract
Seafood (fish in particular) is one of the main food groups in nutrition models with proven health benefits. Seafood has long been considered a very valuable dietary component, mainly due to presence of n-3 polyunsaturated fatty acids (n-3 PUFA) but it is also an important source of protein (including collagen), anserine, taurine, iodine, selenium, vitamin A, vitamin K, vitamin D, tocopherols, B vitamins and astaxanthin. Considering the beneficial effects of these ingredients on blood pressure, lipid profile and the inflammatory process, seafood should be an essential component of the diet. Non-communicable diseases (NCD) such as cardiovascular diseases, cancer, diabetes and mental disorder, chronic respiratory diseases are common diseases associated with advanced age. Promotion of a healthy lifestyle (including proper nutritional behavior) and prevention of diseases are the most effective and efficient ways to decrease premature mortality from NCD and to maintain mental health and well-being. This review article shows the potential preventive and therapeutic effects of seafood with an emphasis on fish. Our narrative review presents the results of systematic reviews and meta-analysis.
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16
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Papadopoulou E, Botton J, Caspersen IH, Alexander J, Eggesbø M, Haugen M, Iszatt N, Jacobsson B, Knutsen HK, Meltzer HM, Sengpiel V, Stratakis N, Vejrup K, Brantsæter AL. Maternal seafood intake during pregnancy, prenatal mercury exposure and child body mass index trajectories up to 8 years. Int J Epidemiol 2021; 50:1134-1146. [PMID: 33713119 PMCID: PMC8407875 DOI: 10.1093/ije/dyab035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 02/15/2021] [Indexed: 12/24/2022] Open
Abstract
Background Maternal seafood intake during pregnancy and prenatal mercury exposure may influence children’s growth trajectories. Methods This study, based on the Norwegian Mother, Father and Child Cohort Study (MoBa), includes 51 952 mother-child pairs recruited in pregnancy during 2002–08 and a subsample (n = 2277) with maternal mercury concentrations in whole blood. Individual growth trajectories were computed by modelling based on child’s reported weight and length/height from 1 month to 8 years. We used linear mixed-effects regression analysis and also conducted discordant-sibling analysis. Results Maternal lean fish was the main contributor to total seafood intake in pregnancy and was positively but weakly associated with child body mass index (BMI) growth trajectory. Higher prenatal mercury exposure (top decile) was associated with a reduction in child’s weight growth trajectory, with the estimates ranging from -130 g [95% Confidence Intervals (CI) = -247, -12 g] at 18 months to -608 g (95% CI = -1.102, -113 g) at 8 years. Maternal fatty fish consumption was positively associated with child weight and BMI growth trajectory, but only in the higher mercury-exposed children (P-interaction = 0.045). Other seafood consumption during pregnancy was negatively associated with child weight growth compared with no intake, and this association was stronger for higher mercury-exposed children (P-interaction = 0.004). No association was observed between discordant maternal seafood intake and child growth in the sibling analysis. Conclusions Within a population with moderate seafood consumption and low mercury exposure, we found that maternal seafood consumption in pregnancy was associated with child growth trajectories, and the direction of the association varied by seafood type and level of prenatal mercury exposure. Prenatal mercury exposure was negatively associated with child growth. Our findings on maternal seafood intake are likely non-causal.
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Affiliation(s)
| | - Jérémie Botton
- Faculty of Pharmacy, Univ. Paris-Sud, Université Paris-Saclay, Châtenay-Malabry, France
| | | | - Jan Alexander
- Norwegian Institute of Public Health, Skoyen, Oslo, Norway
| | - Merete Eggesbø
- Norwegian Institute of Public Health, Skoyen, Oslo, Norway
| | | | - Nina Iszatt
- Norwegian Institute of Public Health, Skoyen, Oslo, Norway
| | - Bo Jacobsson
- Norwegian Institute of Public Health, Skoyen, Oslo, Norway.,Department of Obstetrics and Gynecology, Sahlgrenska University Hospital Gothenburg/Östra, Gothenburg, Sweden
| | | | | | - Verena Sengpiel
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital Gothenburg/Östra, Gothenburg, Sweden
| | - Nikos Stratakis
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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17
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Best KP, Gomersall J, Makrides M. Prenatal Nutritional Strategies to Reduce the Risk of Preterm Birth. ANNALS OF NUTRITION AND METABOLISM 2021; 76 Suppl 3:31-39. [PMID: 33465767 DOI: 10.1159/000509901] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 07/02/2020] [Indexed: 11/19/2022]
Abstract
Worldwide, around 15 million preterm babies are born annually, and despite intensive research, the specific mechanisms triggering preterm birth (PTB) remain unclear. Cost-effective primary prevention strategies to reduce PTB are required, and nutritional interventions offer a promising alternative. Nutrients contribute to a variety of mechanisms that are potentially important to preterm delivery, such as infection, inflammation, oxidative stress, and muscle contractility. Several observational studies have explored the association between dietary nutrients and/or dietary patterns and PTB, often with contrasting results. Randomized trial evidence on the effects of supplementation with zinc, multiple micronutrients (iron and folic acid), and vitamin D is promising; however, results are inconsistent, and many studies are not adequately powered for outcomes of PTB. Large-scale clinical trials with PTB as the primary outcome are needed before any firm conclusions can be drawn for these nutrients. The strongest evidence to date for a nutritional solution exists for omega-3 long-chain polyunsaturated fatty acids (LCPUFAs), key nutrients in fish. In 2018, a Cochrane Review (including 70 studies) showed that prenatal supplementation with omega-3 LCPUFAs reduced the risk of PTB and early PTB (EPTB) compared with no omega-3 supplementation. However, the largest trial of omega-3 supplementation in pregnancy, the Omega-3 to Reduce the Incidence of Prematurity (ORIP) trial (n = 5,544), showed no reduction in EPTB and a reduction in PTB only in a prespecified analysis of singleton pregnancies. Exploratory analyses from the ORIP trial found that women with low baseline total omega-3 status were at higher risk of EPTB, and that this risk was substantially reduced with omega-3 supplementation. In contrast, women with replete or high baseline total omega-3 status were already at low risk of EPTB and additional omega-3 supplementation increased the risk of EPTB compared to control. These findings suggest that determining an individual woman's PUFA status may be the most precise way to inform recommendations to reduce her risk of PTB.
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Affiliation(s)
- Karen Patricia Best
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia, .,School of Medicine, University of Adelaide, Adelaide, South Australia, Australia,
| | - Judith Gomersall
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.,School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Maria Makrides
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.,School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
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18
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Leszko M, Keenan-Devlin L, Grobman WA, Smart B, Borders A, Mroczek DK. Is there a relationship between personality traits and fruit and vegetable intake among pregnant women? Health Psychol Open 2020; 7:2055102920974245. [PMID: 33282329 PMCID: PMC7691923 DOI: 10.1177/2055102920974245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Previous studies have shown that certain personality traits such as neuroticism
and conscientiousness influence dietary choices. Pregnancy is a unique period in
a woman’s life during which most women are highly intrinsically and
extrinsically motivated to start a diet rich in fruit and vegetables. Yet, an
adequate consumption of fruits and vegetables remains a challenge for many
women. The present study investigates the relationships between personality
traits and fish, dairy, fruit, and vegetable intake. Data was collected from 602
pregnant women and analyzed using descriptive statistics and hierarchical
regression analyses in order to examine predictive relationships between the
variables of interest. The results demonstrated that high scores in openness to
experience, older maternal age, higher income, and educational attainment were
positively associated with increased fish, vegetable, and fruit intake. These
findings have important implications for interventions that seek to improve
eating behaviors of pregnant women, thereby increasing the health of their
pregnancies.
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19
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Goodfellow L, Care A, Alfirevic Z. Controversies in the prevention of spontaneous preterm birth in asymptomatic women: an evidence summary and expert opinion. BJOG 2020; 128:177-194. [PMID: 32981206 DOI: 10.1111/1471-0528.16544] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2020] [Indexed: 01/11/2023]
Abstract
Preterm birth prevention is multifaceted and produces many nuanced questions. This review addresses six important clinical questions about preterm birth prevention as voted for by members of the UK Preterm Clinical Network. The questions cover the following areas: preterm birth prevention in 'low-risk' populations; screening for asymptomatic genital tract infection in women at high risk of preterm birth; cervical length screening with cerclage or vaginal pessary in situ; cervical shortening whilst using progesterone; use of vaginal progesterone in combination with cervical cerclage; and optimal advice about intercourse for women at high risk of preterm birth.
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Affiliation(s)
- Laura Goodfellow
- Harris-Wellbeing Research Centre, University of Liverpool, Liverpool, UK
| | - Angharad Care
- Harris-Wellbeing Research Centre, University of Liverpool, Liverpool, UK
| | - Zarko Alfirevic
- Harris-Wellbeing Research Centre, University of Liverpool, Liverpool, UK
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20
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Zhao R, Gao Q, Wang S, Yang X, Hao L. The effect of maternal seafood consumption on perinatal outcomes: a systematic review and dose-response meta-analysis. Crit Rev Food Sci Nutr 2020; 61:3504-3517. [DOI: 10.1080/10408398.2020.1802573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Rui Zhao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qin Gao
- Department of Public Health, Jining Medical University, Jining, Shandong, China
| | - Shanshan Wang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xuefeng Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Liping Hao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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21
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Early life risk and resiliency factors and their influences on developmental outcomes and disease pathways: a rapid evidence review of systematic reviews and meta-analyses. J Dev Orig Health Dis 2020; 12:357-372. [PMID: 32746960 DOI: 10.1017/s2040174420000689] [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] [Indexed: 01/26/2023]
Abstract
The Developmental Origins of Health and Disease (DOHaD) framework aims to understand how environmental exposures in early life shape lifecycle health. Our understanding and the ability to prevent poor health outcomes and enrich for resiliency remain limited, in part, because exposure-outcome relationships are complex and poorly defined. We, therefore, aimed to determine the major DOHaD risk and resilience factors. A systematic approach with a 3-level screening process was used to conduct our Rapid Evidence Review following the established guidelines. Scientific databases using DOHaD-related keywords were searched to capture articles between January 1, 2009 and April 19, 2019. A final total of 56 systematic reviews/meta-analyses were obtained. Studies were categorized into domains based on primary exposures and outcomes investigated. Primary summary statistics and extracted data from the studies are presented in Graphical Overview for Evidence Reviews diagrams. There was substantial heterogeneity within and between studies. While global trends showed an increase in DOHaD publications over the last decade, the majority of data reported were from high-income countries. Articles were categorized under six exposure domains: Early Life Nutrition, Maternal/Paternal Health, Maternal/Paternal Psychological Exposure, Toxicants/Environment, Social Determinants, and Others. Studies examining social determinants of health and paternal influences were underrepresented. Only 23% of the articles explored resiliency factors. We synthesized major evidence on relationships between early life exposures and developmental and health outcomes, identifying risk and resiliency factors that influence later life health. Our findings provide insight into important trends and gaps in knowledge within many exposures and outcome domains.
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22
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Næss S, Kjellevold M, Dahl L, Nerhus I, Midtbø LK, Bank MS, Rasinger JD, Markhus MW. Effects of seafood consumption on mercury exposure in Norwegian pregnant women: A randomized controlled trial. ENVIRONMENT INTERNATIONAL 2020; 141:105759. [PMID: 32388274 DOI: 10.1016/j.envint.2020.105759] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 04/03/2020] [Accepted: 04/21/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Seafood provides nutrients that are important for optimal development of the unborn child. However, seafood is also a source of contaminants including mercury (Hg) and methylmercury (MeHg) that may have adverse effects on neurodevelopment of the fetus. Humans are predominantly exposed to MeHg through seafood consumption, however, levels of MeHg vary considerably between species. OBJECTIVES Investigate, in a randomized controlled trial (RCT) during pregnancy, if an increased intake of Atlantic cod (Gadus morhua), a fish species with relatively low levels of MeHg contamination, influences total hair Hg (THHg) concentrations in humans. METHODS Pregnant women (n = 137) were enrolled in the RCT "Mommy's Food" (2016-2017), which was designed to increase iodine status. Participants were randomly assigned to intervention (400 g of cod fillets per week) or control (continued habitual diet) groups for 16 weeks (gestational week 20-36). THHg concentrations were measured at baseline and post-intervention using thermal decomposition, amalgamation, and atomic absorption spectrophotometry (US EPA method 7473). The trial is registered in ClinicalTrials.gov, NCT02610959. RESULTS Post-intervention, the intervention group had median (inter-quartile range) THHg concentrations of 554 (392-805) µg/kg, and the control group 485 (341-740) µg/kg (p = 0.186). When adjusting for baseline THHg concentrations, there was a significant difference between the groups in those participants with baseline THHg concentrations below 534 µg/kg. Post-intervention, 8% of the study population exceeded the US EPA reference dose in hair (1,000 µg/kg) (intervention group: n = 6, control group: n = 4). CONCLUSION THHg concentrations were generally low in both study groups of pregnant women, despite the relatively high seafood intake. While the intervention with 400 g of cod per week slightly increased THHg concentrations, it did not lead to an increase in number of subjects exceeding the US EPA reference dose; a dose level at which no adverse effects are expected to occur over a period of lifetime exposure.
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Affiliation(s)
- Synnøve Næss
- Institute of Marine Research (IMR), 5817 Bergen, Norway.
| | | | - Lisbeth Dahl
- Institute of Marine Research (IMR), 5817 Bergen, Norway
| | - Ive Nerhus
- Institute of Marine Research (IMR), 5817 Bergen, Norway
| | | | - Michael S Bank
- Institute of Marine Research (IMR), 5817 Bergen, Norway; University of Massachusetts, Amherst, MA, USA
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23
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Jaddoe VWV, Felix JF, Andersen AMN, Charles MA, Chatzi L, Corpeleijn E, Donner N, Elhakeem A, Eriksson JG, Foong R, Grote V, Haakma S, Hanson M, Harris JR, Heude B, Huang RC, Inskip H, Järvelin MR, Koletzko B, Lawlor DA, Lindeboom M, McEachan RRC, Mikkola TM, Nader JLT, de Moira AP, Pizzi C, Richiardi L, Sebert S, Schwalber A, Sunyer J, Swertz MA, Vafeiadi M, Vrijheid M, Wright J, Duijts L. The LifeCycle Project-EU Child Cohort Network: a federated analysis infrastructure and harmonized data of more than 250,000 children and parents. Eur J Epidemiol 2020; 35:709-724. [PMID: 32705500 PMCID: PMC7387322 DOI: 10.1007/s10654-020-00662-z] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 07/04/2020] [Indexed: 12/15/2022]
Abstract
Early life is an important window of opportunity to improve health across the full lifecycle. An accumulating body of evidence suggests that exposure to adverse stressors during early life leads to developmental adaptations, which subsequently affect disease risk in later life. Also, geographical, socio-economic, and ethnic differences are related to health inequalities from early life onwards. To address these important public health challenges, many European pregnancy and childhood cohorts have been established over the last 30 years. The enormous wealth of data of these cohorts has led to important new biological insights and important impact for health from early life onwards. The impact of these cohorts and their data could be further increased by combining data from different cohorts. Combining data will lead to the possibility of identifying smaller effect estimates, and the opportunity to better identify risk groups and risk factors leading to disease across the lifecycle across countries. Also, it enables research on better causal understanding and modelling of life course health trajectories. The EU Child Cohort Network, established by the Horizon2020-funded LifeCycle Project, brings together nineteen pregnancy and childhood cohorts, together including more than 250,000 children and their parents. A large set of variables has been harmonised and standardized across these cohorts. The harmonized data are kept within each institution and can be accessed by external researchers through a shared federated data analysis platform using the R-based platform DataSHIELD, which takes relevant national and international data regulations into account. The EU Child Cohort Network has an open character. All protocols for data harmonization and setting up the data analysis platform are available online. The EU Child Cohort Network creates great opportunities for researchers to use data from different cohorts, during and beyond the LifeCycle Project duration. It also provides a novel model for collaborative research in large research infrastructures with individual-level data. The LifeCycle Project will translate results from research using the EU Child Cohort Network into recommendations for targeted prevention strategies to improve health trajectories for current and future generations by optimizing their earliest phases of life.
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Affiliation(s)
- Vincent W V Jaddoe
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, The Generation R Study Group, (Na 29-18), PO Box 2040, 3000 CA, Rotterdam, The Netherlands. .,Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
| | - Janine F Felix
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, The Generation R Study Group, (Na 29-18), PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Anne-Marie Nybo Andersen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Marie-Aline Charles
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, Paris, France.,ELFE Joint Unit, French Institute for Demographic Studies (Ined), French Institute for Medical Research and Health (INSERM), French Blood Agency, Aubervilliers, France
| | - Leda Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Eva Corpeleijn
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nina Donner
- Concentris Research Management GmbH, Fürstenfeldbruck, Germany
| | - Ahmed Elhakeem
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Johan G Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland.,Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore.,Singapore Institute for Clinical Sciences (SICS), Agency for Science and Technology (A*STAR), Singapore, Singapore
| | - Rachel Foong
- Telethon Kids Institute, Perth, WA, Australia.,School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Veit Grote
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU, Munich, Germany
| | - Sido Haakma
- University of Groningen, University Medical Center Groningen, Genomics Coordination Center, Groningen, The Netherlands
| | - Mark Hanson
- Institute of Developmental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Jennifer R Harris
- Centre for Fertility and Health, The Norwegian Institute of Public Health, Oslo, Norway.,Division of Health Data and Digitalization, Norwegian Institute of Public Health, Oslo, Norway
| | - Barbara Heude
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, Paris, France
| | | | - Hazel Inskip
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.,MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Marjo-Riitta Järvelin
- Center for Life-Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.,Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK.,Department of Life Sciences, College of Health and Life Sciences, Brunel University London, London, UK.,Unit of Primary Health Care, Oulu University Hospital, OYS, Oulu, Finland
| | - Berthold Koletzko
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU, Munich, Germany
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,NIHR Bristol Biomedical Research Centre, Bristol, UK
| | - Maarten Lindeboom
- Department of Economics, VU University Amsterdam, Amsterdam, The Netherlands
| | - Rosemary R C McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | | | - Johanna L T Nader
- Department of Genetics and Bioinformatics, Division of Health Data and Digitalisation, Norwegian Institute of Public Health, Oslo, Norway
| | - Angela Pinot de Moira
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Costanza Pizzi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Sylvain Sebert
- Center for Life-Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Ameli Schwalber
- Concentris Research Management GmbH, Fürstenfeldbruck, Germany
| | - Jordi Sunyer
- ISGlobal, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Morris A Swertz
- University of Groningen, University Medical Center Groningen, Genomics Coordination Center, Groningen, The Netherlands.,Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marina Vafeiadi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Martine Vrijheid
- ISGlobal, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Liesbeth Duijts
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, The Generation R Study Group, (Na 29-18), PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Basak S, Vilasagaram S, Duttaroy AK. Maternal dietary deficiency of n-3 fatty acids affects metabolic and epigenetic phenotypes of the developing fetus. Prostaglandins Leukot Essent Fatty Acids 2020; 158:102109. [PMID: 32474355 DOI: 10.1016/j.plefa.2020.102109] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 04/13/2020] [Indexed: 02/07/2023]
Abstract
Polyunsaturated fatty acids (PUFAs) play multiple physiological roles. They regulate the structure and function of cell membranes and cell growth and proliferation, and apoptosis. In addition, PUFAs are involved in cellular signaling, gene expression and serve as precursors to second messengers such as eicosanoids, docosanoids etc. and regulate several physiological processes including placentation, inflammation, immunity, angiogenesis, platelet function, synaptic plasticity, neurogenesis, bone formation, energy homeostasis, pain sensitivity, stress, and cognitive functions. Linoleic acid, 18:2n-6 (LA) and alpha-linolenic acid, 18:3n-3 (ALA) are the two essential fatty acids obtained from the diets and subsequently their long-chain polyunsaturated fatty acids (LCPUFAs) are accumulated in the body. The maternal plasma LCPUFAs especially accumulated in larger amounts in the brain during the third trimester of pregnancy via the placenta and postnatally from mother's breast milk. Various studies, including ours, suggest PUFA's important role in placentation, as well as in growth and development of the offspring. However, intakes of maternal n-3 PUFAs during pregnancy and lactation are much lower in India compared with the Western population. In India, n-3 fatty acid status is further reduced by higher intake of n-6 PUFA rich oils and trans fats. More data on the impacts of long term maternal n-3 PUFA deficiency on placental structure and function, gene expression, epigenetic changes and resultant cognitive function of fetus & infants are emerging. This review summarizes the impacts of n-3 PUFA deficiency in utero on fetal growth and development, adiposity, energy metabolism, musculoskeletal development, and epigenetic changes in feto-placental axis from the recently available pre-clinical and clinical data.
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Affiliation(s)
- Sanjay Basak
- Molecular Biology Division, National Institute of Nutrition, Indian Council of Medical Research, Hyderabad 500007, India.
| | - Srinivas Vilasagaram
- Molecular Biology Division, National Institute of Nutrition, Indian Council of Medical Research, Hyderabad 500007, India
| | - Asim K Duttaroy
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
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25
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Li N, Wu X, Zhuang W, Xia L, Chen Y, Wu C, Rao Z, Du L, Zhao R, Yi M, Wan Q, Zhou Y. Fish consumption and multiple health outcomes: Umbrella review. Trends Food Sci Technol 2020. [DOI: 10.1016/j.tifs.2020.02.033] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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26
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Simmonds LA, Sullivan TR, Skubisz M, Middleton PF, Best KP, Yelland LN, Quinlivan J, Zhou SJ, Liu G, McPhee AJ, Gibson RA, Makrides M. Omega-3 fatty acid supplementation in pregnancy-baseline omega-3 status and early preterm birth: exploratory analysis of a randomised controlled trial. BJOG 2020; 127:975-981. [PMID: 32034969 DOI: 10.1111/1471-0528.16168] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To identify a polyunsaturated fatty acid (PUFA) biomarker able to detect which women with singleton pregnancies are most likely to benefit from omega-3 supplementation to reduce their risk of early preterm birth. DESIGN Exploratory analysis of a randomised controlled trial. SETTING Six Australian hospitals. POPULATION Women with a singleton pregnancy enrolled in the ORIP trial. METHODS Using maternal capillary whole blood collected ~14 weeks' gestation, the fatty acids in total blood lipids were quantified using gas chromatography. Interaction tests examined whether baseline PUFA status modified the effect of omega-3 supplementation on birth outcomes. MAIN OUTCOME MEASURE Early preterm birth (<34 weeks' gestation). RESULTS A low total omega-3 PUFA status in early pregnancy was associated with a higher risk of early preterm birth. Among women with a total omega-3 status ≤4.1% of total fatty acids, omega-3 supplementation substantially reduced the risk of early preterm birth compared with control (0.73 versus 3.16%; relative risk = 0.23, 95% confidence interval [CI] 0.07-0.79). Conversely, women with higher total omega-3 status in early pregnancy were at lower risk of early preterm birth. Supplementing women with a baseline status above 4.9% increased early preterm birth (2.20 versus 0.97%; relative risk = 2.27, 95% CI 1.13-4.58). CONCLUSIONS Women with singleton pregnancies and low total omega-3 PUFA status early in pregnancy have an increased risk of early preterm birth and are most likely to benefit from omega-3 supplementation to reduce this risk. Women with higher total omega-3 status are at lower risk and additional omega-3 supplementation may increase their risk. TWEETABLE ABSTRACT Low total omega-3 fat status helps identify which women benefit from extra omega-3 to reduce early prematurity.
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Affiliation(s)
- L A Simmonds
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - T R Sullivan
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - M Skubisz
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.,Department of Obstetrics and Gynaecology, Women's and Children's Hospital, North Adelaide, SA, Australia
| | - P F Middleton
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.,School of Medicine, The University of Adelaide, Adelaide, SA, Australia
| | - K P Best
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.,School of Medicine, The University of Adelaide, Adelaide, SA, Australia
| | - L N Yelland
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.,School of Public Health, The University of Adelaide, Adelaide, SA, Australia
| | - J Quinlivan
- The Institute of Health Research, University of Notre Dame, Fremantle, WA, Australia
| | - S J Zhou
- The School of Agriculture, Food and Wine, The University of Adelaide, Adelaide, SA, Australia
| | - G Liu
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.,The School of Agriculture, Food and Wine, The University of Adelaide, Adelaide, SA, Australia
| | - A J McPhee
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.,Neonatal Services, Women's and Children's Hospital, North Adelaide, SA, Australia
| | - R A Gibson
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.,The School of Agriculture, Food and Wine, The University of Adelaide, Adelaide, SA, Australia
| | - M Makrides
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.,School of Medicine, The University of Adelaide, Adelaide, SA, Australia
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27
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Impact of erythrocyte long-chain omega-3 polyunsaturated fatty acid levels in early pregnancy on birth outcomes: findings from a Belgian cohort study. J Perinatol 2020; 40:488-496. [PMID: 31913325 DOI: 10.1038/s41372-019-0573-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 11/15/2019] [Accepted: 12/18/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To examine the association between maternal erythrocyte long-chain omega-3 PUFA (n-3 LCPUFA), measured in early pregnancy, and pregnancy and birth outcomes. STUDY DESIGN One hundred and eight healthy women with a singleton pregnancy were included. Erythrocyte fatty acids were analyzed using gas chromatography. Gestational length, birth anthropometric measures, and pregnancy-associated complications were collected from hospital medical records. RESULTS We observed significant positive associations between maternal docosahexaenoic acid (DHA) levels (p = 0.024) and omega-3 index values (p = 0.021) and gestational length in adjusted linear regression models. Each point in maternal DHA level was associated with 2.19 days longer gestational duration (β = 2.19; 95% CI 0.29-4.09). No consistent associations were found between n-3 PUFA levels and composite pregnancy outcome. CONCLUSION These findings suggest that the gestational length is positively affected by maternal n-3 LCPUFA status as soon as the early stages of pregnancy.
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Bienkiewicz G, Tokarczyk G, Czerniejewska-Surma B, Suryn J. Changes in the EPA and DHA content and lipids quality parameters of rainbow trout ( Oncorhynchus mykiss, Walbaum) and carp ( Cyprinus carpio, L.) at individual stages of hot smoking. Heliyon 2019; 5:e02964. [PMID: 31879706 PMCID: PMC6920263 DOI: 10.1016/j.heliyon.2019.e02964] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 11/12/2019] [Accepted: 11/27/2019] [Indexed: 11/30/2022] Open
Abstract
The aim of this study was to evaluate qualitative changes in lipids of two most popular freshwater farmed fish (rainbow trout and carp) at particular stages of hot smoking process (brining, drying, smoking and heating). In order to characterize qualitative changes, the amount of peroxides (PV), secondary oxidation products (AsV) and the degree of hydrolysis of lipids (AV) was determined during the smoking process. The studies were carried out both in the fraction of lipids extracted using chloroform-based method (free lipids), as well as the fraction extracted by Bligh and Dyer method of the 1:1 chloroform: methanol ratio (bound lipids). Heat smoking results in loss of fat, especially at the last two stages of the process and the final contents of lipids were about 18% lower in the carp samples and about 10% lower in the trout samples. The dynamics of free lipid oxidation (Ch-lipids) was much smaller than the lipids extracted using B-D method, but the trend of lipid changes was similar. There was no significant difference in the anisidine value between two species, both for free lipids (Ch-lipids) and bound lipids (B-D-lipids), except for the last stage of smoking. No statistically significant differences between the studied species were found also in the case of lipid hydrolysis level, but after the smoking process an amount of free fatty acids increased. Subsequent stages of smoking process resulted in statistically significant losses of EPA and DHA in both fish species and in both types of lipids, i.e. B-D-lipids and Ch-lipids.
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Affiliation(s)
- Grzegorz Bienkiewicz
- Department of Food Quality, West Pomeranian University of Technology, Szczecin, Papieża Pawła VI nr 3, 71-459, Szczecin, Poland
| | - Grzegorz Tokarczyk
- Department of Food Sciences and Technology, West Pomeranian University of Technology, Szczecin, Papieża Pawła VI nr 3, 71-459, Szczecin, Poland
| | - Barbara Czerniejewska-Surma
- Department of Food Quality, West Pomeranian University of Technology, Szczecin, Papieża Pawła VI nr 3, 71-459, Szczecin, Poland
| | - Jacek Suryn
- Lisner Sp. z o.o., Poznań, Strzeszyńska 38/42, 60-479, Poznań, Poland
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Diet as a counteracting agent of the effect of some well-known risk factors for small for gestational age. Nutrition 2019; 72:110665. [PMID: 31982727 DOI: 10.1016/j.nut.2019.110665] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 09/10/2019] [Accepted: 11/18/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The aim of this study was to assess whether diet variables can neutralize the risk produced by three well-known risk factors for being small for gestational age: smoking, body mass index (BMI) ˂20 kg/m2, and having a previous preterm/low birth weight (LBW) newborn. METHODS A matched case control study was conducted (518 cases and 518 controls of pregnant women) in Spain. We collected data on demographic characteristics, socioeconomic status, toxic habits, and diet. Dietary intake during pregnancy was assessed using a validated food frequency questionnaire, categorized into quintiles. Adjusted odds ratios (aORs) and their 95% confidence intervals (CI) were estimated by conditional regression logistic models. RESULTS Women who smoked during pregnancy had a 78% increased risk for having an SGA newborn (aOR, 1.78; 95% CI, 1.28-2.74). Lean women (BMI ˂ 20 kg/m2 before pregnancy) augmented the risk 139% (aOR, 2.39; 95% CI, 1.68-3.40), and those with a previous SGA-LBW an increase of 160% (aOR, 2.60; 95% CI, 1.53-4.37). Smoking in women with a fruit intake of ≥421 g/d was not associated with a higher risk for SGA versus non-smoking women with the same fruit intake (aOR, 0.98; 95% CI, 0.41-2.33). A BMI <20 kg/m2 with an intake of ≥33 g/d of legumes did not increase the risk for SGA versus women with a BMI ≥20 kg/m2 with the same legume intake (aOR, 1.35; 95% CI, 0.54-3.37). Diet did not modify the risk by having a previous SGA-LBW newborn. CONCLUSIONS Smoking and leanness increased the SGA risk; nevertheless foods such as fruit, fish, and legumes, as well as intake of vitamins D and B3 and ω-3 marine fatty acids, may "at" least partially counteract this increase.
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Abstract
Current evidence indicates that maternal diets before and during pregnancy could influence rates of preterm birth, low birth weight (LBW) and small for gestational age (SGA) births. However, findings have been inconsistent. This review summarised evidence concerning the effects of maternal diets before and during pregnancy on preterm birth, LBW and SGA. Systematic electronic database searches were carried out using PubMed, Embase, Scopus and Cochrane library using the preferred reporting items for systematic reviews and meta-analyses guidelines. The review included forty eligible articles, comprising mostly of prospective cohort studies, with five randomised controlled trials. The dietary patterns during pregnancy associated with a lower risk of preterm birth were commonly characterised by high consumption of vegetables, fruits, whole grains, fish and dairy products. Those associated with a lower risk of SGA also had similar characteristics, including high consumption of vegetables, fruits, legumes, seafood/fish and milk products. Results from a limited number of studies suggested there was a beneficial effect on the risk of preterm birth of pre-pregnancy diet quality characterised by a high intake of fruits and proteins and less intake of added sugars, saturated fats and fast foods. The evidence was mixed for the relationship between maternal dietary patterns during pregnancy and LBW. These findings indicate that better maternal diet quality during pregnancy, characterised by a high intake of vegetables, fruits, whole grains, dairy products and protein diets, may have a synergistic effect on reducing the risk of preterm birth and SGA.
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Collins CT, Gibson RA, McPhee AJ, Makrides M. The role of long chain polyunsaturated fatty acids in perinatal nutrition. Semin Perinatol 2019; 43:151156. [PMID: 31326100 DOI: 10.1053/j.semperi.2019.06.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The importance of omega-3 long chain polyunsaturated fatty acids in the perinatal period has been the focus of research for several decades. Infants born preterm miss out on the last trimester in utero transfer of omega-3 fatty acids and consequently have lower blood levels than infants born at term. Preterm infant formula was supplemented with the omega-3 docosahexaenoic acid and the omega-6 arachidonic acid from 2000 (to the level found in the breast milk of women consuming a western diet) based on trials reporting improvements in visual acuity. Docosahexaenoic acid supplementation beyond this level has not shown improvements in clinical or developmental outcomes, however the effect on childhood development in the most preterm infants remains to be resolved. Maternal omega-3 supplementation during pregnancy has the potential to reduce the incidence of preterm birth but may also, in some pregnancies, prolong gestation beyond term and increase fetal size.
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Affiliation(s)
- Carmel T Collins
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia; Discipline of Paediatrics, Adelaide Medical School, Adelaide, South Australia, Australia.
| | - Robert A Gibson
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia; School of Agriculture Food and Wine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Andrew J McPhee
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia; Neonatal Medicine, Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - Maria Makrides
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia; Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
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Makrides M, Best K, Yelland L, McPhee A, Zhou S, Quinlivan J, Dodd J, Atkinson E, Safa H, van Dam J, Khot N, Dekker G, Skubisz M, Anderson A, Kean B, Bowman A, McCallum C, Cashman K, Gibson R. A Randomized Trial of Prenatal n-3 Fatty Acid Supplementation and Preterm Delivery. N Engl J Med 2019; 381:1035-1045. [PMID: 31509674 DOI: 10.1056/nejmoa1816832] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Previous studies have suggested that maternal supplementation with n-3 long-chain polyunsaturated fatty acids may reduce the incidence of preterm delivery but may also prolong gestation beyond term; however, more data are needed regarding the role of n-3 long-chain polyunsaturated fatty acids in pregnancy. METHODS We performed a multicenter, double-blind, randomized trial in which women who were pregnant with single or multiple fetuses were assigned to receive either fish-oil capsules that contained 900 mg of n-3 long-chain polyunsaturated fatty acids (n-3 group) or vegetable-oil capsules that contained trace n-3 long-chain polyunsaturated fatty acids (control group) daily, beginning before 20 weeks of gestation and continuing to 34 weeks of gestation or delivery, whichever occurred first. The primary outcome was early preterm delivery, defined as delivery before 34 completed weeks of gestation. Other pregnancy and neonatal outcomes were also assessed. RESULTS A total of 5544 pregnancies in 5517 women were randomly assigned at six centers in Australia; 5486 pregnancies were included in the primary analysis. Early preterm delivery occurred in the case of 61 of 2734 pregnancies (2.2%) in the n-3 group and 55 of 2752 pregnancies (2.0%) in the control group; the between-group difference was not significant (adjusted relative risk, 1.13; 95% confidence interval [CI], 0.79 to 1.63; P = 0.50). There were no significant differences between the groups in the incidence of interventions in post-term (>41 weeks of gestation) deliveries, in adverse events, or in other pregnancy or neonatal outcomes, except that a higher percentage of infants born to women in the n-3 group than in the control group were very large for gestational age at birth (adjusted relative risk, 1.30; 95% CI, 1.02 to 1.65). Percentages of serious adverse events did not differ between the groups. Minor gastrointestinal disturbances were more commonly reported in the n-3 group than in the control group. CONCLUSIONS Supplementation with n-3 long-chain polyunsaturated fatty acids from early pregnancy (<20 weeks of gestation) until 34 weeks of gestation did not result in a lower incidence of early preterm delivery or a higher incidence of interventions in post-term deliveries than control. (Funded by the Australian National Health and Medical Research Council and the Thyne Reid Foundation; ORIP Australian New Zealand Clinical Trials Registry number, ACTRN12613001142729.).
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Affiliation(s)
- Maria Makrides
- From the South Australian Health and Medical Research Institute (M.M., K.B., L.Y., A.M., M.S., A.A., B.K., A.B., C.M., R.G.), School of Medicine (M.M., K.B.), School of Public Health (L.Y., K.C.), and School of Agriculture, Food, and Wine (S.Z., R.G.), University of Adelaide, Neonatal Services (A.M.) and the Department of Obstetrics and Gynaecology (J. Dodd, M.S.), Women's and Children's Hospital, the Departments of Obstetrics and Gynaecology, Flinders Medical Centre (E.A.), and the Northern Adelaide Local Health Network (G.D.), Adelaide, SA, the Institute of Health Research, University of Notre Dame, Fremantle, WA (J.Q.), Mater Mothers' Hospital, Brisbane, QLD (H.S.), and Werribee Mercy Health, Melbourne, VIC (J. van Dam, N.K.) - all in Australia
| | - Karen Best
- From the South Australian Health and Medical Research Institute (M.M., K.B., L.Y., A.M., M.S., A.A., B.K., A.B., C.M., R.G.), School of Medicine (M.M., K.B.), School of Public Health (L.Y., K.C.), and School of Agriculture, Food, and Wine (S.Z., R.G.), University of Adelaide, Neonatal Services (A.M.) and the Department of Obstetrics and Gynaecology (J. Dodd, M.S.), Women's and Children's Hospital, the Departments of Obstetrics and Gynaecology, Flinders Medical Centre (E.A.), and the Northern Adelaide Local Health Network (G.D.), Adelaide, SA, the Institute of Health Research, University of Notre Dame, Fremantle, WA (J.Q.), Mater Mothers' Hospital, Brisbane, QLD (H.S.), and Werribee Mercy Health, Melbourne, VIC (J. van Dam, N.K.) - all in Australia
| | - Lisa Yelland
- From the South Australian Health and Medical Research Institute (M.M., K.B., L.Y., A.M., M.S., A.A., B.K., A.B., C.M., R.G.), School of Medicine (M.M., K.B.), School of Public Health (L.Y., K.C.), and School of Agriculture, Food, and Wine (S.Z., R.G.), University of Adelaide, Neonatal Services (A.M.) and the Department of Obstetrics and Gynaecology (J. Dodd, M.S.), Women's and Children's Hospital, the Departments of Obstetrics and Gynaecology, Flinders Medical Centre (E.A.), and the Northern Adelaide Local Health Network (G.D.), Adelaide, SA, the Institute of Health Research, University of Notre Dame, Fremantle, WA (J.Q.), Mater Mothers' Hospital, Brisbane, QLD (H.S.), and Werribee Mercy Health, Melbourne, VIC (J. van Dam, N.K.) - all in Australia
| | - Andrew McPhee
- From the South Australian Health and Medical Research Institute (M.M., K.B., L.Y., A.M., M.S., A.A., B.K., A.B., C.M., R.G.), School of Medicine (M.M., K.B.), School of Public Health (L.Y., K.C.), and School of Agriculture, Food, and Wine (S.Z., R.G.), University of Adelaide, Neonatal Services (A.M.) and the Department of Obstetrics and Gynaecology (J. Dodd, M.S.), Women's and Children's Hospital, the Departments of Obstetrics and Gynaecology, Flinders Medical Centre (E.A.), and the Northern Adelaide Local Health Network (G.D.), Adelaide, SA, the Institute of Health Research, University of Notre Dame, Fremantle, WA (J.Q.), Mater Mothers' Hospital, Brisbane, QLD (H.S.), and Werribee Mercy Health, Melbourne, VIC (J. van Dam, N.K.) - all in Australia
| | - Shao Zhou
- From the South Australian Health and Medical Research Institute (M.M., K.B., L.Y., A.M., M.S., A.A., B.K., A.B., C.M., R.G.), School of Medicine (M.M., K.B.), School of Public Health (L.Y., K.C.), and School of Agriculture, Food, and Wine (S.Z., R.G.), University of Adelaide, Neonatal Services (A.M.) and the Department of Obstetrics and Gynaecology (J. Dodd, M.S.), Women's and Children's Hospital, the Departments of Obstetrics and Gynaecology, Flinders Medical Centre (E.A.), and the Northern Adelaide Local Health Network (G.D.), Adelaide, SA, the Institute of Health Research, University of Notre Dame, Fremantle, WA (J.Q.), Mater Mothers' Hospital, Brisbane, QLD (H.S.), and Werribee Mercy Health, Melbourne, VIC (J. van Dam, N.K.) - all in Australia
| | - Julie Quinlivan
- From the South Australian Health and Medical Research Institute (M.M., K.B., L.Y., A.M., M.S., A.A., B.K., A.B., C.M., R.G.), School of Medicine (M.M., K.B.), School of Public Health (L.Y., K.C.), and School of Agriculture, Food, and Wine (S.Z., R.G.), University of Adelaide, Neonatal Services (A.M.) and the Department of Obstetrics and Gynaecology (J. Dodd, M.S.), Women's and Children's Hospital, the Departments of Obstetrics and Gynaecology, Flinders Medical Centre (E.A.), and the Northern Adelaide Local Health Network (G.D.), Adelaide, SA, the Institute of Health Research, University of Notre Dame, Fremantle, WA (J.Q.), Mater Mothers' Hospital, Brisbane, QLD (H.S.), and Werribee Mercy Health, Melbourne, VIC (J. van Dam, N.K.) - all in Australia
| | - Jodie Dodd
- From the South Australian Health and Medical Research Institute (M.M., K.B., L.Y., A.M., M.S., A.A., B.K., A.B., C.M., R.G.), School of Medicine (M.M., K.B.), School of Public Health (L.Y., K.C.), and School of Agriculture, Food, and Wine (S.Z., R.G.), University of Adelaide, Neonatal Services (A.M.) and the Department of Obstetrics and Gynaecology (J. Dodd, M.S.), Women's and Children's Hospital, the Departments of Obstetrics and Gynaecology, Flinders Medical Centre (E.A.), and the Northern Adelaide Local Health Network (G.D.), Adelaide, SA, the Institute of Health Research, University of Notre Dame, Fremantle, WA (J.Q.), Mater Mothers' Hospital, Brisbane, QLD (H.S.), and Werribee Mercy Health, Melbourne, VIC (J. van Dam, N.K.) - all in Australia
| | - Elinor Atkinson
- From the South Australian Health and Medical Research Institute (M.M., K.B., L.Y., A.M., M.S., A.A., B.K., A.B., C.M., R.G.), School of Medicine (M.M., K.B.), School of Public Health (L.Y., K.C.), and School of Agriculture, Food, and Wine (S.Z., R.G.), University of Adelaide, Neonatal Services (A.M.) and the Department of Obstetrics and Gynaecology (J. Dodd, M.S.), Women's and Children's Hospital, the Departments of Obstetrics and Gynaecology, Flinders Medical Centre (E.A.), and the Northern Adelaide Local Health Network (G.D.), Adelaide, SA, the Institute of Health Research, University of Notre Dame, Fremantle, WA (J.Q.), Mater Mothers' Hospital, Brisbane, QLD (H.S.), and Werribee Mercy Health, Melbourne, VIC (J. van Dam, N.K.) - all in Australia
| | - Huda Safa
- From the South Australian Health and Medical Research Institute (M.M., K.B., L.Y., A.M., M.S., A.A., B.K., A.B., C.M., R.G.), School of Medicine (M.M., K.B.), School of Public Health (L.Y., K.C.), and School of Agriculture, Food, and Wine (S.Z., R.G.), University of Adelaide, Neonatal Services (A.M.) and the Department of Obstetrics and Gynaecology (J. Dodd, M.S.), Women's and Children's Hospital, the Departments of Obstetrics and Gynaecology, Flinders Medical Centre (E.A.), and the Northern Adelaide Local Health Network (G.D.), Adelaide, SA, the Institute of Health Research, University of Notre Dame, Fremantle, WA (J.Q.), Mater Mothers' Hospital, Brisbane, QLD (H.S.), and Werribee Mercy Health, Melbourne, VIC (J. van Dam, N.K.) - all in Australia
| | - Jacqueline van Dam
- From the South Australian Health and Medical Research Institute (M.M., K.B., L.Y., A.M., M.S., A.A., B.K., A.B., C.M., R.G.), School of Medicine (M.M., K.B.), School of Public Health (L.Y., K.C.), and School of Agriculture, Food, and Wine (S.Z., R.G.), University of Adelaide, Neonatal Services (A.M.) and the Department of Obstetrics and Gynaecology (J. Dodd, M.S.), Women's and Children's Hospital, the Departments of Obstetrics and Gynaecology, Flinders Medical Centre (E.A.), and the Northern Adelaide Local Health Network (G.D.), Adelaide, SA, the Institute of Health Research, University of Notre Dame, Fremantle, WA (J.Q.), Mater Mothers' Hospital, Brisbane, QLD (H.S.), and Werribee Mercy Health, Melbourne, VIC (J. van Dam, N.K.) - all in Australia
| | - Nisha Khot
- From the South Australian Health and Medical Research Institute (M.M., K.B., L.Y., A.M., M.S., A.A., B.K., A.B., C.M., R.G.), School of Medicine (M.M., K.B.), School of Public Health (L.Y., K.C.), and School of Agriculture, Food, and Wine (S.Z., R.G.), University of Adelaide, Neonatal Services (A.M.) and the Department of Obstetrics and Gynaecology (J. Dodd, M.S.), Women's and Children's Hospital, the Departments of Obstetrics and Gynaecology, Flinders Medical Centre (E.A.), and the Northern Adelaide Local Health Network (G.D.), Adelaide, SA, the Institute of Health Research, University of Notre Dame, Fremantle, WA (J.Q.), Mater Mothers' Hospital, Brisbane, QLD (H.S.), and Werribee Mercy Health, Melbourne, VIC (J. van Dam, N.K.) - all in Australia
| | - Gustaaf Dekker
- From the South Australian Health and Medical Research Institute (M.M., K.B., L.Y., A.M., M.S., A.A., B.K., A.B., C.M., R.G.), School of Medicine (M.M., K.B.), School of Public Health (L.Y., K.C.), and School of Agriculture, Food, and Wine (S.Z., R.G.), University of Adelaide, Neonatal Services (A.M.) and the Department of Obstetrics and Gynaecology (J. Dodd, M.S.), Women's and Children's Hospital, the Departments of Obstetrics and Gynaecology, Flinders Medical Centre (E.A.), and the Northern Adelaide Local Health Network (G.D.), Adelaide, SA, the Institute of Health Research, University of Notre Dame, Fremantle, WA (J.Q.), Mater Mothers' Hospital, Brisbane, QLD (H.S.), and Werribee Mercy Health, Melbourne, VIC (J. van Dam, N.K.) - all in Australia
| | - Monika Skubisz
- From the South Australian Health and Medical Research Institute (M.M., K.B., L.Y., A.M., M.S., A.A., B.K., A.B., C.M., R.G.), School of Medicine (M.M., K.B.), School of Public Health (L.Y., K.C.), and School of Agriculture, Food, and Wine (S.Z., R.G.), University of Adelaide, Neonatal Services (A.M.) and the Department of Obstetrics and Gynaecology (J. Dodd, M.S.), Women's and Children's Hospital, the Departments of Obstetrics and Gynaecology, Flinders Medical Centre (E.A.), and the Northern Adelaide Local Health Network (G.D.), Adelaide, SA, the Institute of Health Research, University of Notre Dame, Fremantle, WA (J.Q.), Mater Mothers' Hospital, Brisbane, QLD (H.S.), and Werribee Mercy Health, Melbourne, VIC (J. van Dam, N.K.) - all in Australia
| | - Amanda Anderson
- From the South Australian Health and Medical Research Institute (M.M., K.B., L.Y., A.M., M.S., A.A., B.K., A.B., C.M., R.G.), School of Medicine (M.M., K.B.), School of Public Health (L.Y., K.C.), and School of Agriculture, Food, and Wine (S.Z., R.G.), University of Adelaide, Neonatal Services (A.M.) and the Department of Obstetrics and Gynaecology (J. Dodd, M.S.), Women's and Children's Hospital, the Departments of Obstetrics and Gynaecology, Flinders Medical Centre (E.A.), and the Northern Adelaide Local Health Network (G.D.), Adelaide, SA, the Institute of Health Research, University of Notre Dame, Fremantle, WA (J.Q.), Mater Mothers' Hospital, Brisbane, QLD (H.S.), and Werribee Mercy Health, Melbourne, VIC (J. van Dam, N.K.) - all in Australia
| | - Beth Kean
- From the South Australian Health and Medical Research Institute (M.M., K.B., L.Y., A.M., M.S., A.A., B.K., A.B., C.M., R.G.), School of Medicine (M.M., K.B.), School of Public Health (L.Y., K.C.), and School of Agriculture, Food, and Wine (S.Z., R.G.), University of Adelaide, Neonatal Services (A.M.) and the Department of Obstetrics and Gynaecology (J. Dodd, M.S.), Women's and Children's Hospital, the Departments of Obstetrics and Gynaecology, Flinders Medical Centre (E.A.), and the Northern Adelaide Local Health Network (G.D.), Adelaide, SA, the Institute of Health Research, University of Notre Dame, Fremantle, WA (J.Q.), Mater Mothers' Hospital, Brisbane, QLD (H.S.), and Werribee Mercy Health, Melbourne, VIC (J. van Dam, N.K.) - all in Australia
| | - Anneka Bowman
- From the South Australian Health and Medical Research Institute (M.M., K.B., L.Y., A.M., M.S., A.A., B.K., A.B., C.M., R.G.), School of Medicine (M.M., K.B.), School of Public Health (L.Y., K.C.), and School of Agriculture, Food, and Wine (S.Z., R.G.), University of Adelaide, Neonatal Services (A.M.) and the Department of Obstetrics and Gynaecology (J. Dodd, M.S.), Women's and Children's Hospital, the Departments of Obstetrics and Gynaecology, Flinders Medical Centre (E.A.), and the Northern Adelaide Local Health Network (G.D.), Adelaide, SA, the Institute of Health Research, University of Notre Dame, Fremantle, WA (J.Q.), Mater Mothers' Hospital, Brisbane, QLD (H.S.), and Werribee Mercy Health, Melbourne, VIC (J. van Dam, N.K.) - all in Australia
| | - Carly McCallum
- From the South Australian Health and Medical Research Institute (M.M., K.B., L.Y., A.M., M.S., A.A., B.K., A.B., C.M., R.G.), School of Medicine (M.M., K.B.), School of Public Health (L.Y., K.C.), and School of Agriculture, Food, and Wine (S.Z., R.G.), University of Adelaide, Neonatal Services (A.M.) and the Department of Obstetrics and Gynaecology (J. Dodd, M.S.), Women's and Children's Hospital, the Departments of Obstetrics and Gynaecology, Flinders Medical Centre (E.A.), and the Northern Adelaide Local Health Network (G.D.), Adelaide, SA, the Institute of Health Research, University of Notre Dame, Fremantle, WA (J.Q.), Mater Mothers' Hospital, Brisbane, QLD (H.S.), and Werribee Mercy Health, Melbourne, VIC (J. van Dam, N.K.) - all in Australia
| | - Kara Cashman
- From the South Australian Health and Medical Research Institute (M.M., K.B., L.Y., A.M., M.S., A.A., B.K., A.B., C.M., R.G.), School of Medicine (M.M., K.B.), School of Public Health (L.Y., K.C.), and School of Agriculture, Food, and Wine (S.Z., R.G.), University of Adelaide, Neonatal Services (A.M.) and the Department of Obstetrics and Gynaecology (J. Dodd, M.S.), Women's and Children's Hospital, the Departments of Obstetrics and Gynaecology, Flinders Medical Centre (E.A.), and the Northern Adelaide Local Health Network (G.D.), Adelaide, SA, the Institute of Health Research, University of Notre Dame, Fremantle, WA (J.Q.), Mater Mothers' Hospital, Brisbane, QLD (H.S.), and Werribee Mercy Health, Melbourne, VIC (J. van Dam, N.K.) - all in Australia
| | - Robert Gibson
- From the South Australian Health and Medical Research Institute (M.M., K.B., L.Y., A.M., M.S., A.A., B.K., A.B., C.M., R.G.), School of Medicine (M.M., K.B.), School of Public Health (L.Y., K.C.), and School of Agriculture, Food, and Wine (S.Z., R.G.), University of Adelaide, Neonatal Services (A.M.) and the Department of Obstetrics and Gynaecology (J. Dodd, M.S.), Women's and Children's Hospital, the Departments of Obstetrics and Gynaecology, Flinders Medical Centre (E.A.), and the Northern Adelaide Local Health Network (G.D.), Adelaide, SA, the Institute of Health Research, University of Notre Dame, Fremantle, WA (J.Q.), Mater Mothers' Hospital, Brisbane, QLD (H.S.), and Werribee Mercy Health, Melbourne, VIC (J. van Dam, N.K.) - all in Australia
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Günther J, Hoffmann J, Spies M, Meyer D, Kunath J, Stecher L, Rosenfeld E, Kick L, Rauh K, Hauner H. Associations between the Prenatal Diet and Neonatal Outcomes-A Secondary Analysis of the Cluster-Randomised GeliS Trial. Nutrients 2019; 11:E1889. [PMID: 31412688 PMCID: PMC6723267 DOI: 10.3390/nu11081889] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 07/31/2019] [Accepted: 08/09/2019] [Indexed: 01/14/2023] Open
Abstract
The prenatal lifestyle, including maternal dietary behaviour, is an important determinant of offspring health. This secondary cohort analysis of the GeliS ("healthy living in pregnancy") trial investigated associations between antenatal dietary factors and neonatal weight parameters. The cluster-randomised GeliS trial included 2286 pregnant women. Dietary information was collected with food frequency questionnaires before or in the 12th (T0) and after the 29th week of gestation (T1). Consumption of vegetables (41.28 g per portion at T0, p = 0.001; 36.67 g per portion at T1, p = 0.001), fruit (15.25 g per portion at T1, p = 0.010) and dietary quality, measured with a Healthy Eating Index (39.26 g per 10 points at T0, p = 0.004; 42.76 g per 10 points at T1, p = 0.002) were positively associated with birth weight. In contrast, sugar-sweetened beverages (10.90 g per portion at T0, p = 0.003; 8.19 g per portion at T1, p = 0.047), higher sugar consumption at T0 (8.27 g per 10 g, p = 0.032) and early pregnancy alcohol intake (15.32 g per g, p = 0.039) were inversely associated with birth weight. Most other dietary factors were not associated with neonatal weight. Some components reflecting a healthy maternal diet were associated with a modest increase in offspring birth weight, whereas some unhealthy components slightly reduced neonatal weight.
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Affiliation(s)
- Julia Günther
- Else Kröner-Fresenius-Centre for Nutritional Medicine, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Georg-Brauchle-Ring 62, 80992, Munich, Germany
| | - Julia Hoffmann
- Else Kröner-Fresenius-Centre for Nutritional Medicine, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Georg-Brauchle-Ring 62, 80992, Munich, Germany
| | - Monika Spies
- Else Kröner-Fresenius-Centre for Nutritional Medicine, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Georg-Brauchle-Ring 62, 80992, Munich, Germany
| | - Dorothy Meyer
- Else Kröner-Fresenius-Centre for Nutritional Medicine, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Georg-Brauchle-Ring 62, 80992, Munich, Germany
| | - Julia Kunath
- Else Kröner-Fresenius-Centre for Nutritional Medicine, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Georg-Brauchle-Ring 62, 80992, Munich, Germany
| | - Lynne Stecher
- Else Kröner-Fresenius-Centre for Nutritional Medicine, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Georg-Brauchle-Ring 62, 80992, Munich, Germany
| | - Eva Rosenfeld
- Competence Centre for Nutrition (KErn), Am Gereuth 4, 85354, Freising, Germany
| | - Luzia Kick
- Competence Centre for Nutrition (KErn), Am Gereuth 4, 85354, Freising, Germany
| | - Kathrin Rauh
- Else Kröner-Fresenius-Centre for Nutritional Medicine, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Georg-Brauchle-Ring 62, 80992, Munich, Germany
- Competence Centre for Nutrition (KErn), Am Gereuth 4, 85354, Freising, Germany
| | - Hans Hauner
- Else Kröner-Fresenius-Centre for Nutritional Medicine, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Georg-Brauchle-Ring 62, 80992, Munich, Germany.
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Mullaney L, Cawley S, Kennedy R, O'Higgins AC, McCartney D, Turner MJ. Maternal nutrient intakes from food and drinks consumed in early pregnancy in Ireland. J Public Health (Oxf) 2019; 39:754-762. [PMID: 27679659 DOI: 10.1093/pubmed/fdw106] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 08/15/2016] [Indexed: 11/13/2022] Open
Abstract
Background The aim of this observational study was to measure food, macronutrient and micronutrient intakes of women presenting for antenatal care and assess compliance with current nutritional recommendations. Methods Women were recruited in the first trimester of pregnancy. Maternal weight and height were measured and body mass index (BMI) calculated. Body composition was measured using bioelectrical impedance analysis. Maternal energy and nutrient intakes were estimated using a validated Willett Food Frequency Questionnaire and misreporting of energy intakes (EI) determined. Results Plausible EIs were reported in 402 women. Mean age, weight and BMI were 30.8 years, 67.1 kg and 24.6 kg/m2 respectively. Median EIs were 2111 kcal, and median protein, carbohydrate and fat intakes were 17.3, 48.1 and 36.2 g/MJ/day, respectively. More than 90% of women exceeded the recommended daily allowance for saturated fat. Nearly all of the women (99%) did not meet estimated average requirements (EAR) for vitamin D. One in three women failed to achieve a dietary folate intake of 400 µg/day. Over one in five women failed to meet the EAR for iron, and 14% failed to achieve the EAR for calcium. Conclusions Our findings highlight concerning deficits in nutrient intakes among women and will help guide professional dietary advice to women attending for future obstetric care in Ireland.
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Affiliation(s)
- Laura Mullaney
- School of Biological Sciences, Dublin Institute of Technology, Dublin 8, Republic of Ireland
| | - Shona Cawley
- School of Biological Sciences, Dublin Institute of Technology, Dublin 8, Republic of Ireland
| | - Rachel Kennedy
- School of Biological Sciences, Dublin Institute of Technology, Dublin 8, Republic of Ireland
| | - Amy C O'Higgins
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin 8, Republic of Ireland
| | - Daniel McCartney
- School of Biological Sciences, Dublin Institute of Technology, Dublin 8, Republic of Ireland
| | - Michael J Turner
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin 8, Republic of Ireland
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Translational challenges for the developmental origins of health and disease: time to fulfill the promises for innovative prevention strategies. J Dev Orig Health Dis 2019; 10:260-262. [DOI: 10.1017/s2040174419000242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Wu霞吴义 Y, Wang 烟王 Y, Tian敏田慧 H, Lu逯通 T, Yu苗于 M, Xu慧徐文 W, Liu良刘国 G, Xie林谢 L. DHA intake interacts with ELOVL2 and ELOVL5 genetic variants to influence polyunsaturated fatty acids in human milk. J Lipid Res 2019; 60:1043-1049. [PMID: 30914501 PMCID: PMC6495163 DOI: 10.1194/jlr.m090951] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 03/25/2019] [Indexed: 11/20/2022] Open
Abstract
Endogenous synthesis of PUFAs is mediated by genes controlling fatty acid elongases 2 and 5 (ELOVL2 and ELOVL5) and by exogenous DHA intake. Associations between elongases and PUFA levels probably involve genetic variants of ELOVL and changes in DHA intake, but data about their combined effect on PUFA levels are sparse. We hypothesized that each factor would directly affect PUFAs and that interactions between haplotypes and DHA intake would influence PUFAs. We explored four levels of DHA intake in pregnant Chinese Han women and 10 SNPs in the ELOVL genes to determine associations with PUFAs in breast milk. The SNP rs3798713 and 3-SNP haplotype (rs2281591, rs12332786, and rs3798713) in ELOVL2 were associated with linoleic acid (LA) concentrations. However, carriers of the 3-SNP haplotype with higher DHA intake (second quartile: 14.58-43.15 mg/day) had higher concentrations of LA, arachidonic acid, EPA, and DHA compared with the interaction baseline. In ELOVL5, five SNPs (rs2294867, rs9357760, rs2397142, rs209512, and rs12207094) correlated with PUFA changes. Compared with those who had the 5-SNP haplotype C-A-C-G-A and low DHA intake (<14.58 mg/day), carriers with other haplotypes (A-A-C-A-A or C-A-C-A-A) and high DHA intake (≥118.82 mg/day) had increased EPA levels after adjustments for age and BMI. This study showed that maternal genetic variants in ELOVL2 and ELOVL5 were associated with PUFA levels in breast milk and that the combination of SNP haplotypes and higher DHA intake increased PUFA concentrations.
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Affiliation(s)
- Yixia Wu霞吴义
- Department of Nutrition and Food Hygiene Jilin University, Changchun, 130021 China
| | - Yan Wang 烟王
- Department of Nutrition and Food Hygiene Jilin University, Changchun, 130021 China
| | - Huimin Tian敏田慧
- Department of Nutrition and Food Hygiene Jilin University, Changchun, 130021 China
| | - Tong Lu逯通
- Department of Nutrition and Food Hygiene Jilin University, Changchun, 130021 China
| | - Miao Yu苗于
- Department of Nutrition and Food Hygiene Jilin University, Changchun, 130021 China
| | - Wenhui Xu慧徐文
- Department of Nutrition and Food Hygiene Jilin University, Changchun, 130021 China
| | - Guoliang Liu良刘国
- Experimental Center of Prevention School of Public Health, Jilin University, Changchun, 130021 China
| | - Lin Xie林谢
- Department of Nutrition and Food Hygiene Jilin University, Changchun, 130021 China.
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Nykjaer C, Higgs C, Greenwood DC, Simpson NAB, Cade JE, Alwan NA. Maternal Fatty Fish Intake Prior to and during Pregnancy and Risks of Adverse Birth Outcomes: Findings from a British Cohort. Nutrients 2019; 11:nu11030643. [PMID: 30884831 PMCID: PMC6471030 DOI: 10.3390/nu11030643] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 03/11/2019] [Accepted: 03/13/2019] [Indexed: 11/16/2022] Open
Abstract
Fish is an important source of the essential fatty acids contributing to foetal growth and development, but the evidence linking maternal fatty fish consumption with birth outcomes is inconsistent. In the UK, pregnant women are recommended to consume no more than two 140 g portions of fatty fish per week. This study aimed to investigate the association between fatty fish consumption before and during pregnancy with preterm birth and size at birth in a prospective birth cohort. Dietary intake data were acquired from a cohort of 1208 pregnant women in Leeds, UK (CARE Study) to assess preconception and trimester-specific fatty fish consumption using questionnaires. Multiple 24-h recalls during pregnancy were used to estimate an average fatty fish portion size. Intake was classified as ≤2, >2 portions/week and no fish categories. Following the exclusion of women taking cod liver oil and/or omega-3 supplements, the associations between fatty fish intake with size at birth and preterm delivery (<37 weeks gestation) were examined in multivariable regression models adjusting for confounders including salivary cotinine as a biomarker of smoking status.. The proportion of women reporting any fatty fish intake decreased throughout pregnancy, with the lowest proportion observed in trimester 3 (43%). Mean intakes amongst consumers were considerably lower than that recommended, with the lowest intake amongst consumers observed in the 1st trimester (106 g/week, 95% CI: 99, 113). This was partly due to small portion sizes when consumed, with the mean portion size of fatty fish being 101 g. After adjusting for confounders, no association was observed between fatty fish intake before or during pregnancy with size at birth and preterm delivery.
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Affiliation(s)
- Camilla Nykjaer
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK.
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK.
| | - Charlotte Higgs
- Department of Obstetrics and Gynaecology, University of Leeds, Leeds LS2 9JT, UK.
| | - Darren C Greenwood
- Division of Biostatistics, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds LS2 9JT, UK.
| | - Nigel A B Simpson
- Department of Obstetrics and Gynaecology, University of Leeds, Leeds LS2 9JT, UK.
| | - Janet E Cade
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK.
| | - Nisreen A Alwan
- School of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK.
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK.
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Jackson KH, Harris WS. A Prenatal DHA Test to Help Identify Women at Increased Risk for Early Preterm Birth: A Proposal. Nutrients 2018; 10:E1933. [PMID: 30563193 PMCID: PMC6316227 DOI: 10.3390/nu10121933] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 11/26/2018] [Accepted: 11/30/2018] [Indexed: 12/11/2022] Open
Abstract
Fish intake and docosahexaenoic acid (DHA), a nutrient found in fish, have been favorably linked to several pregnancy outcomes. The risk of early preterm birth (ePT, <34 weeks gestation) is associated with low fish intake and DHA blood levels and can be reduced by supplemental DHA. Here, we summarize the evidence linking blood DHA levels with risk for ePT birth, and based on the available studies, propose that women who are pregnant or trying to become pregnant aim for a red blood cell (RBC) DHA value of at least 5% (of total RBC fatty acids). In the US, ~70% of women of childbearing age are likely below this cut-point, and dietary intake data suggest that this group, including pregnant women, consumes ~60 mg/day DHA and that >90% of this group do not take an omega-3 supplement. Since the recommendations for women to consume fish and to take a 200 mg DHA supplement during pregnancy are not being heeded generally, there is a need to motivate practitioners and pregnant women to attend to these recommendations. Having an objective prenatal blood DHA test could provide such motivation. More research is needed to test the clinical utility of this proposed target prenatal DHA level.
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Affiliation(s)
| | - William S Harris
- OmegaQuant, LLC, 5009 W. 12th St., Suite 8, Sioux Falls, SD 57106, USA.
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Middleton P, Gomersall JC, Gould JF, Shepherd E, Olsen SF, Makrides M. Omega-3 fatty acid addition during pregnancy. Cochrane Database Syst Rev 2018; 11:CD003402. [PMID: 30480773 PMCID: PMC6516961 DOI: 10.1002/14651858.cd003402.pub3] [Citation(s) in RCA: 132] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Higher intakes of foods containing omega-3 long-chain polyunsaturated fatty acids (LCPUFA), such as fish, during pregnancy have been associated with longer gestations and improved perinatal outcomes. This is an update of a review that was first published in 2006. OBJECTIVES To assess the effects of omega-3 LCPUFA, as supplements or as dietary additions, during pregnancy on maternal, perinatal, and neonatal outcomes and longer-term outcomes for mother and child. SEARCH METHODS For this update, we searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (16 August 2018), and reference lists of retrieved studies. SELECTION CRITERIA Randomised controlled trials (RCTs) comparing omega-3 fatty acids (as supplements or as foods, stand-alone interventions, or with a co-intervention) during pregnancy with placebo or no omega-3, and studies or study arms directly comparing omega-3 LCPUFA doses or types. Trials published in abstract form were eligible for inclusion. DATA COLLECTION AND ANALYSIS Two review authors independently assessed study eligibility, extracted data, assessed risk of bias in trials and assessed quality of evidence for prespecified birth/infant, maternal, child/adult and health service outcomes using the GRADE approach. MAIN RESULTS In this update, we included 70 RCTs (involving 19,927 women at low, mixed or high risk of poor pregnancy outcomes) which compared omega-3 LCPUFA interventions (supplements and food) compared with placebo or no omega-3. Overall study-level risk of bias was mixed, with selection and performance bias mostly at low risk, but there was high risk of attrition bias in some trials. Most trials were conducted in upper-middle or high-income countries; and nearly half the trials included women at increased/high risk for factors which might increase the risk of adverse maternal and birth outcomes.Preterm birth < 37 weeks (13.4% versus 11.9%; risk ratio (RR) 0.89, 95% confidence interval (CI) 0.81 to 0.97; 26 RCTs, 10,304 participants; high-quality evidence) and early preterm birth < 34 weeks (4.6% versus 2.7%; RR 0.58, 95% CI 0.44 to 0.77; 9 RCTs, 5204 participants; high-quality evidence) were both lower in women who received omega-3 LCPUFA compared with no omega-3. Prolonged gestation > 42 weeks was probably increased from 1.6% to 2.6% in women who received omega-3 LCPUFA compared with no omega-3 (RR 1.61 95% CI 1.11 to 2.33; 5141 participants; 6 RCTs; moderate-quality evidence).For infants, there was a possibly reduced risk of perinatal death (RR 0.75, 95% CI 0.54 to 1.03; 10 RCTs, 7416 participants; moderate-quality evidence: 62/3715 versus 83/3701 infants) and possibly fewer neonatal care admissions (RR 0.92, 95% CI 0.83 to 1.03; 9 RCTs, 6920 participants; moderate-quality evidence - 483/3475 infants versus 519/3445 infants). There was a reduced risk of low birthweight (LBW) babies (15.6% versus 14%; RR 0.90, 95% CI 0.82 to 0.99; 15 trials, 8449 participants; high-quality evidence); but a possible small increase in large-for-gestational age (LGA) babies (RR 1.15, 95% CI 0.97 to 1.36; 6 RCTs, 3722 participants; moderate-quality evidence, for omega-3 LCPUFA compared with no omega-3. Little or no difference in small-for-gestational age or intrauterine growth restriction (RR 1.01, 95% CI 0.90 to 1.13; 8 RCTs, 6907 participants; moderate-quality evidence) was seen.For the maternal outcomes, there is insufficient evidence to determine the effects of omega-3 on induction post-term (average RR 0.82, 95% CI 0.22 to 2.98; 3 trials, 2900 participants; low-quality evidence), maternal serious adverse events (RR 1.04, 95% CI 0.40 to 2.72; 2 trials, 2690 participants; low-quality evidence), maternal admission to intensive care (RR 0.56, 95% CI 0.12 to 2.63; 2 trials, 2458 participants; low-quality evidence), or postnatal depression (average RR 0.99, 95% CI 0.56 to 1.77; 2 trials, 2431 participants; low-quality evidence). Mean gestational length was greater in women who received omega-3 LCPUFA (mean difference (MD) 1.67 days, 95% CI 0.95 to 2.39; 41 trials, 12,517 participants; moderate-quality evidence), and pre-eclampsia may possibly be reduced with omega-3 LCPUFA (RR 0.84, 95% CI 0.69 to 1.01; 20 trials, 8306 participants; low-quality evidence).For the child/adult outcomes, very few differences between antenatal omega-3 LCPUFA supplementation and no omega-3 were observed in cognition, IQ, vision, other neurodevelopment and growth outcomes, language and behaviour (mostly low-quality to very low-quality evidence). The effect of omega-3 LCPUFA on body mass index at 19 years (MD 0, 95% CI -0.83 to 0.83; 1 trial, 243 participants; very low-quality evidence) was uncertain. No data were reported for development of diabetes in the children of study participants. AUTHORS' CONCLUSIONS In the overall analysis, preterm birth < 37 weeks and early preterm birth < 34 weeks were reduced in women receiving omega-3 LCPUFA compared with no omega-3. There was a possibly reduced risk of perinatal death and of neonatal care admission, a reduced risk of LBW babies; and possibly a small increased risk of LGA babies with omega-3 LCPUFA.For our GRADE quality assessments, we assessed most of the important perinatal outcomes as high-quality (e.g. preterm birth) or moderate-quality evidence (e.g. perinatal death). For the other outcome domains (maternal, child/adult and health service outcomes) GRADE ratings ranged from moderate to very low, with over half rated as low. Reasons for downgrading across the domain were mostly due to design limitations and imprecision.Omega-3 LCPUFA supplementation during pregnancy is an effective strategy for reducing the incidence of preterm birth, although it probably increases the incidence of post-term pregnancies. More studies comparing omega-3 LCPUFA and placebo (to establish causality in relation to preterm birth) are not needed at this stage. A further 23 ongoing trials are still to report on over 5000 women, so no more RCTs are needed that compare omega-3 LCPUFA against placebo or no intervention. However, further follow-up of completed trials is needed to assess longer-term outcomes for mother and child, to improve understanding of metabolic, growth and neurodevelopment pathways in particular, and to establish if, and how, outcomes vary by different types of omega-3 LCPUFA, timing and doses; or by characteristics of women.
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Affiliation(s)
- Philippa Middleton
- Healthy Mothers, Babies and Children, South Australian Health and Medical Research InstituteWomen's and Children's Hospital72 King William RoadAdelaideSouth AustraliaAustralia5006
| | - Judith C Gomersall
- Healthy Mothers, Babies and Children, South Australian Health and Medical Research InstituteWomen's and Children's Hospital72 King William RoadAdelaideSouth AustraliaAustralia5006
| | - Jacqueline F Gould
- The University of AdelaideSchool of PsychologyNorth Terrace, AdelaideAdelaideSouth AustraliaAustralia5001
| | - Emily Shepherd
- The University of AdelaideARCH: Australian Research Centre for Health of Women and Babies, Robinson Research Institute, Discipline of Obstetrics and GynaecologyAdelaideSouth AustraliaAustralia5006
| | - Sjurdur F Olsen
- Statens Serum InstitutCentre for Fetal Programming, Department of EpidemiologyCopenhagenDenmark
| | - Maria Makrides
- Healthy Mothers, Babies and Children, South Australian Health and Medical Research InstituteWomen's and Children's Hospital72 King William RoadAdelaideSouth AustraliaAustralia5006
- The University of AdelaideSchool of Paediatrics and Reproductive HealthAdelaideAustraliaAustralia
- Women's and Children's Health Research InstituteNorth AdelaideAustralia
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Fish consumption prior to pregnancy and pregnancy outcomes in the National Birth Defects Prevention Study, 1997-2011. Public Health Nutr 2018; 22:336-343. [PMID: 30326983 DOI: 10.1017/s1368980018002641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To evaluate the relationships between maternal fish consumption and pregnancy outcomes in a large, population-based sample of women in the USA. DESIGN We collected average fish consumption prior to pregnancy using a modified version of the semi-quantitative Willett FFQ. We estimated adjusted OR (aOR) and 95 % CI for associations between different levels of fish consumption and preterm birth (<37 weeks), early preterm birth (<32 and <35 weeks) and small-for-gestational-age infants (SGA; <10th percentile). SETTING The National Birth Defects Prevention Study (NBDPS). SUBJECTS Control mother-infant pairs with estimated delivery dates between 1997 and 2011 (n 10 919). RESULTS No significant associations were observed between fish consumption and preterm birth or early preterm birth (aOR = 0·7-1·0 and 0·7-0·9, respectively). The odds of having an SGA infant were elevated (aOR = 2·1; 95 % CI 1·2, 3·4) among women with daily fish consumption compared with women consuming fish less than once per month. No associations were observed between other levels of fish consumption and SGA (aOR = 0·8-1·0). CONCLUSIONS High intake of fish was associated with twofold higher odds of having an SGA infant, while moderate fish consumption prior to pregnancy was not associated with preterm or SGA. Our study, like many other studies in this area, lacked information regarding preparation methods and the specific types of fish consumed. Future studies should incorporate information on nutrient and contaminant contents, preparation methods and biomarkers to assess these relationships.
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Influence of Maternal Fish Intake on the Anthropometric Indices of Children in the Western Amazon. Nutrients 2018; 10:nu10091146. [PMID: 30142890 PMCID: PMC6164537 DOI: 10.3390/nu10091146] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 08/19/2018] [Accepted: 08/20/2018] [Indexed: 12/19/2022] Open
Abstract
We studied trends in fish intake among pregnant women living in the Madeira River Basin in Rondônia State, Brazil, to investigate the influence of maternal fish intake on anthropometric indices of children followed up to 5 years. Maternal fish intake was assessed using hair mercury concentrations of mothers and children at delivery and 6, 24, and 59 months. Data analysis was performed using a linear mixed-effect model. Mothers were predominantly young, had low incomes and limited schooling, and breastfed for >6 months. Only 1.9% of children had low birth weight. Anthropometric indices in approximately 80% of the study population showed Z-score values ranging from ≥-2 to ≤1. The influence of maternal fish intake on anthropometric indices, including height-to-age (H/A), weight-to-age (W/A), and weight-to-height (W/H) were not statistically significant after model adjustments. However, higher income and larger birth weight had a positive influence on H/A and W/A, whereas W/H gain was favored by higher maternal educational status and breastfeeding duration. Other variables (hemoglobin concentration and maternal age) had a positive significant influence on anthropometric indices. Maternal fish intake (or its attendant MeHg exposure) did not affect children growth. Nevertheless, it is advisable to avoid mercury-contaminated fish during pregnancy and childhood.
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Amezcua-Prieto C, Martínez-Galiano JM, Salcedo-Bellido I, Olmedo-Requena R, Bueno-Cavanillas A, Delgado-Rodríguez M. Maternal seafood intake and the risk of small for gestational age newborns: a case-control study in Spanish women. BMJ Open 2018; 8:e020424. [PMID: 30121592 PMCID: PMC6104785 DOI: 10.1136/bmjopen-2017-020424] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE To investigate the relationship between seafood consumption during pregnancy and the risk of delivering a small for gestational age (SGA) newborn. DESIGN This case-control study included women with SGA newborns and controls matched 1:1 for maternal age (±2 years) and hospital. SETTING Five hospitals in Eastern Andalusia, Spain. PARTICIPANTS 518 pairs of pregnant Spanish women. The SGA group included women who delivered SGA newborns: SGA was defined as a birth weight below the 10th percentile of infants at a given gestational age. Controls were women who delivered newborns with adequate birth weights. INTERVENTIONS We collected data on demographic characteristics, socioeconomic status, toxic habits and diet. Midwives administered a 137-item Food Frequency Questionnaire. OUTCOME MEASURES We calculated quintiles of seafood intake and applied conditional logistic regression to estimate ORs and 95% CIs. RESULTS Shellfish intake more than once/week yielded a significant protective effect against an SGA newborn (OR 0.25, 95% CI 0.08 to 0.76, after adjusting for energy, educational level, smoking, prepregnancy body mass index, weight and a history of preterm or low birthweight newborn). The risk of an SGA newborn was lower among women who consumed >121 g/day fish compared with women who consumed ≤56 g (adjusted OR 0.63, 95% CI 0.41 to 0.98; p=0.025 for a trend). Similarly, the risk of an SGA newborn was lower among women who consumed >1 g/day of marine n-3 polyunsaturated fatty acids compared with those who consumed ≤0.4 g/day (adjusted OR 0.58, 95% CI 0.38 to 0.90; p=0.025 for a trend). CONCLUSION An average seafood intake of at least 121 g/day during pregnancy, equivalent to 3-4 servings/week, reduced the risk of an SGA newborn, compared with an average seafood intake of less than 56 g/day.
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Affiliation(s)
- Carmen Amezcua-Prieto
- Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, Granada, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP, Spain), Madrid, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.Granada), Granada, Spain
| | - Juan Miguel Martínez-Galiano
- CIBER de Epidemiología y Salud Pública (CIBERESP, Spain), Madrid, Spain
- Department of Health Sciences, University of Jaen, Jaén, Spain
| | - Inmaculada Salcedo-Bellido
- Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, Granada, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP, Spain), Madrid, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.Granada), Granada, Spain
| | - Rocío Olmedo-Requena
- Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, Granada, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP, Spain), Madrid, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.Granada), Granada, Spain
| | - Aurora Bueno-Cavanillas
- Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, Granada, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP, Spain), Madrid, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.Granada), Granada, Spain
| | - Miguel Delgado-Rodríguez
- CIBER de Epidemiología y Salud Pública (CIBERESP, Spain), Madrid, Spain
- Department of Health Sciences, University of Jaen, Jaén, Spain
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Stratakis N, Roumeliotaki T, Oken E, Ballester F, Barros H, Basterrechea M, Cordier S, de Groot R, den Dekker HT, Duijts L, Eggesbø M, Fantini MP, Forastiere F, Gehring U, Gielen M, Gori D, Govarts E, Inskip HM, Iszatt N, Jansen M, Kelleher C, Mehegan J, Moltó-Puigmartí C, Mommers M, Oliveira A, Olsen SF, Pelé F, Pizzi C, Porta D, Richiardi L, Rifas-Shiman SL, Robinson SM, Schoeters G, Strøm M, Sunyer J, Thijs C, Vrijheid M, Vrijkotte TGM, Wijga AH, Kogevinas M, Zeegers MP, Chatzi L. Fish and seafood consumption during pregnancy and the risk of asthma and allergic rhinitis in childhood: a pooled analysis of 18 European and US birth cohorts. Int J Epidemiol 2018; 46:1465-1477. [PMID: 28338907 DOI: 10.1093/ije/dyx007] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2017] [Indexed: 12/27/2022] Open
Abstract
Background It has been suggested that prenatal exposure to n-3 long-chain fatty acids protects against asthma and other allergy-related diseases later in childhood. The extent to which fish intake in pregnancy protects against child asthma and rhinitis symptoms remains unclear. We aimed to assess whether fish and seafood consumption in pregnancy is associated with childhood wheeze, asthma and allergic rhinitis. Methods We pooled individual data from 60 774 mother-child pairs participating in 18 European and US birth cohort studies. Information on wheeze, asthma and allergic rhinitis prevalence was collected using validated questionnaires. The time periods of interest were: infancy (0-2 years), preschool age (3-4 years), and school age (5-8 years). We used multivariable generalized models to assess associations of fish and seafood (other than fish) consumption during pregnancy with child respiratory outcomes in cohort-specific analyses, with subsequent random-effects meta-analyses. Results The median fish consumption during pregnancy ranged from 0.44 times/week in The Netherlands to 4.46 times/week in Spain. Maternal fish intake during pregnancy was not associated with offspring wheeze symptoms in any age group nor with the risk of child asthma [adjusted meta-analysis relative risk (RR) per 1-time/week = 1.01, 95% confidence interval 0.97-1.05)] and allergic rhinitis at school age (RR = 1.01, 0.99-1.03). These results were consistently found in further analyses by type of fish and seafood consumption and in sensitivity analyses. Conclusion We found no evidence supporting a protective association of fish and seafood consumption during pregnancy with offspring symptoms of wheeze, asthma and allergic rhinitis from infancy to mid childhood.
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Affiliation(s)
- Nikos Stratakis
- Department of Social Medicine, University of Crete, Heraklion, Greece.,NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | | | - Emily Oken
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Ferran Ballester
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,FISABIO-Universitat Jaume I-Universitat de València Joint Research Unit of Epidemiology and Environmental Health, Valencia, Spain
| | - Henrique Barros
- Department of Clinical Epidemiology, University of Porto Medical School, Porto, Portugal.,EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal
| | - Mikel Basterrechea
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Public Health Division of Gipuzkoa, Basque Government, San Sebastián, Spain
| | - Sylvaine Cordier
- Epidemiological Research in Environment, Reproduction and Child Development, University of Rennes I, Rennes, France
| | - Renate de Groot
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.,Welten Institute, Open University of the Netherlands, Heerlen, The Netherlands
| | - Herman T den Dekker
- Generation R Study Group, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Liesbeth Duijts
- Generation R Study Group, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | | | - Maria Pia Fantini
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | | | - Ulrike Gehring
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Marij Gielen
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Davide Gori
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Eva Govarts
- Environmental Risk and Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Hazel M Inskip
- Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Nina Iszatt
- Norwegian Institute of Public Health, Oslo, Norway
| | - Maria Jansen
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.,Academic Collaborative Center for Public Health Limburg, Public Health Services, Geleen, The Netherlands
| | - Cecily Kelleher
- Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - John Mehegan
- Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Carolina Moltó-Puigmartí
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Monique Mommers
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Andreia Oliveira
- Department of Clinical Epidemiology, University of Porto Medical School, Porto, Portugal.,EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal
| | - Sjurdur F Olsen
- Centre for Fetal Programming, Statens Serum Institut, Copenhagen, Denmark.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Fabienne Pelé
- Epidemiological Research in Environment, Reproduction and Child Development, University of Rennes I, Rennes, France
| | - Costanza Pizzi
- Cancer Epidemiology Unit, University of Turin and CPO-Piemonte, Turin, Italy
| | - Daniela Porta
- Department of Epidemiology, Lazio Regional Health System, Rome, Italy
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit, University of Turin and CPO-Piemonte, Turin, Italy
| | - Sheryl L Rifas-Shiman
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Sian M Robinson
- Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,National Institute for Health Research (NIHR), University of Southampton and University Hospital, Southampton, UK
| | - Greet Schoeters
- Environmental Risk and Health, Flemish Institute for Technological Research (VITO), Mol, Belgium.,Department of BiomedicalSciences, University of Antwerp, Antwerp, Belgium.,Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Marin Strøm
- Centre for Fetal Programming, Statens Serum Institut, Copenhagen, Denmark.,Faculty of Natural and Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Jordi Sunyer
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Department of Preventive Medicine and Public Health, Pompeu Fabra University, Barcelona, Spain
| | - Carel Thijs
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Martine Vrijheid
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Department of Preventive Medicine and Public Health, Pompeu Fabra University, Barcelona, Spain
| | - Tanja G M Vrijkotte
- Department of Public Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Alet H Wijga
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Manolis Kogevinas
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,IMIM Hospital del Mar Medicine Research Institute, Barcelona, Spain
| | - Maurice P Zeegers
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.,CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Leda Chatzi
- Department of Social Medicine, University of Crete, Heraklion, Greece.,NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
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44
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Bernard JY, Pan H, Aris IM, Moreno-Betancur M, Soh SE, Yap F, Tan KH, Shek LP, Chong YS, Gluckman PD, Calder PC, Godfrey KM, Chong MFF, Kramer MS, Karnani N, Lee YS. Long-chain polyunsaturated fatty acids, gestation duration, and birth size: a Mendelian randomization study using fatty acid desaturase variants. Am J Clin Nutr 2018; 108:92-100. [PMID: 29878044 PMCID: PMC6038907 DOI: 10.1093/ajcn/nqy079] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 03/23/2018] [Indexed: 11/12/2022] Open
Abstract
Background In randomized trials, supplementation of n-3 (ω-3) long-chain polyunsaturated fatty acids (LC-PUFAs) during pregnancy has resulted in increased size at birth, which is attributable to longer gestation. Objective We examined this finding by using a Mendelian randomization approach utilizing fatty acid desaturase (FADS) gene variants affecting LC-PUFA metabolism. Design As part of a tri-ethnic mother-offspring cohort in Singapore, 35 genetic variants in FADS1, FADS2, and FADS3 were genotyped in 898 mothers and 1103 offspring. Maternal plasma n-3 and n-6 PUFA concentrations at 26-28 wk of gestation were measured. Gestation duration was derived from an ultrasound dating scan in early pregnancy and from birth date. Birth length and weight were measured. Eight FADS variants were selected through a tagging-SNP approach and examined in association with PUFA concentrations, gestation duration among spontaneous labors, and birth size with the use of ethnicity-adjusted linear regressions and survival models that accounted for the competing risks of induced labor and prelabor cesarean delivery. Results Maternal FADS1 variant rs174546, tagging for 8 other variants located on FADS1 and FADS2, was strongly related to plasma n-6 but not n-3 LC-PUFA concentrations. Offspring and maternal FADS3 variants were associated with gestation duration among women who had spontaneous labor: each copy of rs174450 minor allele C was associated with a shorter gestation by 2.2 d (95% CI: 0.9, 3.4 d) and 1.9 d (0.7, 3.0 d) for maternal and offspring variants, respectively. In survival models, rs174450 minor allele homozygotes had reduced time to delivery after spontaneous labor compared with major allele homozygotes [HR (95% CI): 1.51 (1.18, 1.95) and 1.51 (1.20, 1.89) for mothers and offspring, respectively]. Conclusions With the use of a Mendelian randomization approach, we observed associations between FADS variants and gestation duration. This suggests a potential role of LC-PUFAs in gestation duration. This trial was registered at http://www.clinicaltrials.gov as NCT01174875.
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Affiliation(s)
- Jonathan Y. Bernard
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore (JYB, HP, IMA, SES, LPS, YSC, PDG, MFFC, NK, YSL)
| | - Hong Pan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore (JYB, HP, IMA, SES, LPS, YSC, PDG, MFFC, NK, YSL)
| | - Izzuddin M. Aris
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore (JYB, HP, IMA, SES, LPS, YSC, PDG, MFFC, NK, YSL)
| | - Margarita Moreno-Betancur
- Clinical Epidemiology and Biostatistics Unit, Murdoch Childrens Research Institute, Melbourne, Australia (MMB),Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia (MMB)
| | - Shu-E Soh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore (JYB, HP, IMA, SES, LPS, YSC, PDG, MFFC, NK, YSL),Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (SES, LPS, YSL)
| | - Fabian Yap
- Department of Paediatric Endocrinology, KK Women's and Children's Hospital, Singapore (FY)
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore (KHT),Duke-NUS Medical School, Singapore (KHT)
| | - Lynette P. Shek
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore (JYB, HP, IMA, SES, LPS, YSC, PDG, MFFC, NK, YSL),Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (SES, LPS, YSL),Khoo Teck Puat - National University Children’s Medical Institute, National University Health System, Singapore (LPS, YSL)
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore (JYB, HP, IMA, SES, LPS, YSC, PDG, MFFC, NK, YSL),Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (YSC, MSK)
| | - Peter D. Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore (JYB, HP, IMA, SES, LPS, YSC, PDG, MFFC, NK, YSL),Liggins Institute, University of Auckland, Auckland, New Zealand (PDG)
| | - Philip C. Calder
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom (PCC, KMG),NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (PCC, KMG)
| | - Keith M. Godfrey
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom (PCC, KMG),NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (PCC, KMG),Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom (KMG)
| | - Mary Foong-Fong Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore (JYB, HP, IMA, SES, LPS, YSC, PDG, MFFC, NK, YSL),Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences, Centre for Translational Medicine, Singapore (MFFC),Saw Swee Hock School of Public Health, National University of Singapore, Singapore (MFFC)
| | - Michael S. Kramer
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (YSC, MSK),Departments of Pediatrics and of Epidemiology, Biostatistics and Occupational Health, McGill University Faculty of Medicine, Montreal, Quebec, Canada (MSK)
| | - Neerja Karnani
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore (JYB, HP, IMA, SES, LPS, YSC, PDG, MFFC, NK, YSL),Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (NK)
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore (JYB, HP, IMA, SES, LPS, YSC, PDG, MFFC, NK, YSL),Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (SES, LPS, YSL),Khoo Teck Puat - National University Children’s Medical Institute, National University Health System, Singapore (LPS, YSL)
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45
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Abstract
OBJECTIVE Public health messages to reduce Hg exposure for pregnant women have focused exclusively on advice on fish consumption to limit Hg exposure, with little account being taken of the positive contribution of fish to nutritional quality. The aim of the present review was to compare and contrast the content and presentation of national guidelines on fish consumption in pregnancy, and comment on their evidence base and impact on consumption. DESIGN We searched for national and international guidelines on fish consumption in pregnancy using Internet search strategies. The detailed content and style of presentation of the guidelines were compared. The evidence base for the guidelines, and evidence for the impact of the guidelines on fish consumption levels, were assessed. RESULTS We identified nineteen national guidelines and three international guidelines. There was great variation in the content, complexity and presentation style. The guidelines were based largely on the Hg content of fish with far less consideration being given to the positive beneficial effects of nutrients provided by fish. The complexity of the guidelines may lead to pregnant women reducing their fish intake, or not eating fish at all. CONCLUSIONS Guidelines on fish consumption in pregnancy should take the beneficial effects of fish into account. Guidelines need to be clear and memorable, and appropriately disseminated, to achieve impact. Guidelines could include visual rather than narrative content. Use of technology, for example apps, could enable women to record their fish consumption in real time and log compliance with guidance over a week or other time period.
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46
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Baron R, Te Velde SJ, Heymans MW, Klomp T, Hutton EK, Brug J. The Relationships of Health Behaviour and Psychological Characteristics with Spontaneous Preterm Birth in Nulliparous Women. Matern Child Health J 2018; 21:873-882. [PMID: 27581004 PMCID: PMC5378731 DOI: 10.1007/s10995-016-2160-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Objectives Preterm birth is the leading pregnancy outcome associated with perinatal morbidity and mortality and remains difficult to prevent. There is evidence that some modifiable maternal health characteristics may influence the risk of preterm birth. Our aim was to investigate the relationships of self-reported maternal health behaviour and psychological characteristics in nulliparous women with spontaneous preterm birth in prenatal primary care. Methods The data of our prospective study was obtained from the nationwide DELIVER multicentre cohort study (September 2009–March 2011), which was designed to examine perinatal primary care in the Netherlands. In our study, consisting of 2768 nulliparous women, we estimated the relationships of various self-reported health behaviours (smoking, alcohol consumption, folic acid supplementation, daily fruit, daily fresh vegetables, daily hot meal and daily breakfast consumption) and psychological characteristics (anxious/depressed mood and health control beliefs) with spontaneous preterm birth as a dichotomous outcome. Due to the clustering of clients within midwife practices, Generalized Estimating Equations was used for these analyses. Results Low health control beliefs was the sole characteristic significantly associated with spontaneous preterm birth (odds ratio 2.26; 95 % confidence interval 1.51, 3.39) after being adjusted for socio-demographics, anthropometrics and the remaining health behaviour and psychological characteristics. The other characteristics were not significantly associated with spontaneous preterm birth. Conclusions for Practice Maternal low health control beliefs need to be explored further as a possible marker for women at risk for preterm birth, and as a potentially modifiable characteristic to be used in interventions which are designed to reduce the risk of spontaneous preterm birth.
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Affiliation(s)
- Ruth Baron
- Department of Midwifery Science, Midwifery Academy Amsterdam Groningen (AVAG) and the EMGO Institute for Health and Care Research, VU University Medical Centre, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
| | - Saskia J Te Velde
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Centre, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Martijn W Heymans
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Centre, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
- Department of Methodology and Applied Biostatistics, Faculty of Earth and Life Sciences, VU University Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
| | - Trudy Klomp
- Department of Midwifery Science, Midwifery Academy Amsterdam Groningen (AVAG) and the EMGO Institute for Health and Care Research, VU University Medical Centre, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Eileen K Hutton
- Department of Midwifery Science, Midwifery Academy Amsterdam Groningen (AVAG) and the EMGO Institute for Health and Care Research, VU University Medical Centre, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
- Department of Obstetrics and Gynecology, McMaster University, 1280 Main Street West, MDCL 2210, Hamilton, ON, L8S 4K1, Canada
| | - Johannes Brug
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Centre, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
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47
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Wells JCK, Figueiroa JN, Alves JG. Maternal pelvic dimensions and neonatal size: Implications for growth plasticity in early life as adaptation. Evol Med Public Health 2018; 2017:191-200. [PMID: 29423225 PMCID: PMC5798154 DOI: 10.1093/emph/eox016] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 10/02/2017] [Indexed: 01/05/2023] Open
Abstract
Patterns of fetal growth predict non-communicable disease risk in adult life, but fetal growth variability appears to have a relatively weak association with maternal nutritional dynamics during pregnancy. This challenges the interpretation of fetal growth variability as 'adaptation'. We hypothesized that associations of maternal size and nutritional status with neonatal size are mediated by the dimensions of the maternal pelvis. We analysed data on maternal height, body mass index (BMI) and pelvic dimensions (conjugate, inter-spinous and inter-cristal diameters) and neonatal gestational age, weight, length, thorax girth and head girth (n = 224). Multiple regression analysis was used to identify independent maternal predictors of neonatal size, and the mediating role of neonatal head girth in these associations. Pelvic dimensions displaced maternal BMI as a predictor of birth weight, explaining 11.6% of the variance. Maternal conjugate and inter-spinous diameters predicted neonatal length, thorax girth and head girth, whereas inter-cristal diameter only predicted neonatal length. Associations of pelvic dimensions with birth length, but not birth weight, were mediated by neonatal head girth. Pelvic dimensions predicted neonatal size better than maternal BMI, and these associations were mostly independent of maternal height. Sensitivity of fetal growth to pelvic dimensions reduces the risk of cephalo-pelvic disproportion, potentially a strong selective pressure during secular trends in height. Selection on fetal adaptation to relatively inflexible components of maternal phenotype, rather than directly to external ecological conditions, may help explain high levels of growth plasticity during late fetal life and early infancy.
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Affiliation(s)
- Jonathan C K Wells
- Population, Policy and Practice Programme, Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
| | - José N Figueiroa
- Department of Pediatrics and Statistics Unit, Faculdade Pernambucana de Saúde (FPS), Medical School, Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Rua dos Coelhos 300, Boa Vista, Recife, PE Brazil CEP 52050-080, Brazil
| | - Joao G Alves
- Department of Pediatrics and Statistics Unit, Faculdade Pernambucana de Saúde (FPS), Medical School, Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Rua dos Coelhos 300, Boa Vista, Recife, PE Brazil CEP 52050-080, Brazil
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48
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Ballester F, Iñiguez C, Murcia M, Guxens M, Basterretxea M, Rebagliato M, Vioque J, Lertxundi A, Fernandez-Somoano A, Tardon A, Sunyer J, Llop S. Prenatal exposure to mercury and longitudinally assessed fetal growth: Relation and effect modifiers. ENVIRONMENTAL RESEARCH 2018; 160:97-106. [PMID: 28968527 DOI: 10.1016/j.envres.2017.09.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 07/06/2017] [Accepted: 09/16/2017] [Indexed: 05/20/2023]
Abstract
BACKGROUND Prenatal mercury exposure has been related to reductions in anthropometry at birth. Levels of mercury have been reported as being relatively elevated in the Spanish population. OBJECTIVE To investigate the relation between prenatal exposure to mercury and fetal growth. METHODS Study subjects were pregnant women and their newborns (n:1867) participating in a population-based birth cohort study set up in four Spanish regions from the INMA Project. Biparietal diameter (BPD), femur length (FL), abdominal circumference (AC), and estimated fetal weight (EFW) were measured by ultrasounds at 12, 20, and 34 weeks of gestation. Size at and growth between these points were assessed by standard deviation (SD) scores adjusted for constitutional characteristics. Total mercury (T-Hg) was determined in cord blood. Associations were investigated by linear regression models, adjusted by sociodemographic, environmental, nutritional - including four seafood groups - and lifestyle-related variables in each sub-cohort. Final estimates were obtained using meta-analysis. Effect modification by sex, seafood intake and polychlorinated biphenyl (PCB) congener 153 concentration was assessed. RESULTS Geometric mean of cord blood T-Hg was 8.2μg/L. All the estimates of the association between prenatal Hg and growth from 0 to 12 weeks showed reductions in SD-scores, which were only statistically significant for BPD. A doubling of cord blood T-Hg was associated with a 0.58% reduction in size of BPD at week 12 (95% confidence interval -CI-: - 1.10, - 0.07). Size at week 34 showed estimates suggestive of a small reduction in EFW, i.e., a doubling of T-Hg levels was associated with a reduction of 0.38% (95% CI: - 0.91, 0.15). An interaction between PCB153 and T-Hg was found, with statistically significant negative associations of T-Hg with AC and EFW in late pregnancy among participants with PCB153 below the median. CONCLUSIONS Exposure to mercury during pregnancy was associated with early reductions in BPD. Moreover, an antagonism with PCB 153 was observed with noteworthy reductions late in pregnancy in AC and EFW in the group with lower PCB153.
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Affiliation(s)
- Ferran Ballester
- Nursing School, Universitat de València, Valencia, Spain; FISABIO-Universitat Jaume I-Universitat de València Joint Research Unit of Epidemiology and Environmental Health, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain.
| | - Carmen Iñiguez
- FISABIO-Universitat Jaume I-Universitat de València Joint Research Unit of Epidemiology and Environmental Health, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
| | - Mario Murcia
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; FISABIO-Universitat Jaume I-Universitat de València Joint Research Unit of Epidemiology and Environmental Health, Valencia, Spain
| | - Mònica Guxens
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain; ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Mikel Basterretxea
- Public Health Division of Gipuzkoa, San Sebastián, Spain; Health Research Institute (BIODONOSTIA), San Sebastián, Spain
| | - Marisa Rebagliato
- FISABIO-Universitat Jaume I-Universitat de València Joint Research Unit of Epidemiology and Environmental Health, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Medicine Department, Universitat Jaume I, Castelló de la Plana, Spain
| | - Jesús Vioque
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universidad Miguel Hernández, San Juan de Alicante, Spain
| | - Aitana Lertxundi
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universidad del País Vasco, Spain
| | - Ana Fernandez-Somoano
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; IUOPA, Departamento de Medicina, Universidad de Oviedo, Spain
| | - Adonina Tardon
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
| | - Jordi Sunyer
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain; ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
| | - Sabrina Llop
- FISABIO-Universitat Jaume I-Universitat de València Joint Research Unit of Epidemiology and Environmental Health, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
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Cunha MPL, Marques RC, Dórea JG. Child Nutritional Status in the Changing Socioeconomic Region of the Northern Amazon, Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 15:E15. [PMID: 29295489 PMCID: PMC5800115 DOI: 10.3390/ijerph15010015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 12/08/2017] [Accepted: 12/20/2017] [Indexed: 11/25/2022]
Abstract
The living conditions (i.e., socioeconomic, healthcare-related, nutritional, and environmental) to which children are exposed may influence their ability to reach their optimal growth potential. This review focuses on the relationship between the nutritional status of children under five years of age and social and environmental factors in Northern Brazil. Children living in this region have limited access to healthcare and face precarious socioeconomic and environmental conditions. This analysis was based on data from national health surveys, the consolidated food, nutrition surveillance system (SISVAN), and indicators of the DPSEEA (driving force, pressure, state, exposures, health effects, and actions) framework. The northern region has the worst living conditions in the country, and children under five years of age have significant height-for-age, weight-for-age, and weight-for-height deficits. Concomitantly, the prevalence of children who are overweight has increased significantly, although it remains lower than that in more developed Brazilian regions. Insufficient and/or inadequate dietary practices and early exposure to unfavorable living conditions are risk factors for nutritional deviations. Further advances in public health policies that consider regional characteristics, particularly in the north, where progress has been slower, are needed.
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Affiliation(s)
- Mônica P L Cunha
- Fundação Universidade Federal de Rondônia, Porto Velho CEP 76801-059, RO, Brasil.
- Department of Nutrition, Faculty of Health Sciences, Universidade de Brasilia, Brasília CEP 70919-970, DF, Brasil.
| | - Rejane C Marques
- Universidade Federal do Rio de Janeiro, Campus Macaé, Rio de Janeiro CEP 27930-560, RJ, Brasil.
| | - José G Dórea
- Department of Nutrition, Faculty of Health Sciences, Universidade de Brasilia, Brasília CEP 70919-970, DF, Brasil.
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50
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Parisi F, Rousian M, Huijgen NA, Koning AHJ, Willemsen SP, de Vries JHM, Cetin I, Steegers EAP, Steegers-Theunissen RPM. Periconceptional maternal 'high fish and olive oil, low meat' dietary pattern is associated with increased embryonic growth: The Rotterdam Periconceptional Cohort (Predict) Study. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2017; 50:709-716. [PMID: 28078758 DOI: 10.1002/uog.17408] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 01/02/2017] [Accepted: 01/10/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To investigate the association between periconceptional maternal dietary pattern and first-trimester embryonic growth. METHODS This was a prospective cohort study of 228 women with a singleton ongoing pregnancy, of which 135 were strictly dated spontaneous pregnancies and 93 were pregnancies achieved after in-vitro fertilization or intracytoplasmatic sperm injection (IVF/ICSI). All women underwent serial transvaginal three-dimensional ultrasound (3D-US) examinations from 6 + 0 to 13 + 0 weeks' gestation. Crown-rump length (CRL) and embryonic volume (EV) measurements were performed using a virtual reality system. Information on periconceptional maternal dietary intake was collected via food frequency questionnaires. Principal component analysis was performed to identify dietary patterns. Associations between dietary patterns and CRL and EV trajectories were investigated using linear mixed models adjusted for potential confounders. RESULTS A median of five (range, one to seven) 3D-US scans per pregnancy were performed. Of 1162 datasets, quality was sufficient to perform CRL measurements in 991 (85.3%) and EV measurements in 899 (77.4%). A dietary pattern comprising high intake of fish and olive oil and a very low intake of meat was identified as beneficial for embryonic growth. In strictly dated spontaneous pregnancies, strong adherence to the 'high fish and olive oil, low meat' dietary pattern was associated with a 1.9 mm (95% CI, 0.1-3.63 mm) increase in CRL (+14.6%) at 7 weeks and a 3.4 mm (95% CI, 0.2-7.81 mm) increase (+6.9%) at 11 weeks, whereas EV increased by 0.06 cm3 (95% CI, 0.01-0.13 cm3 ) (+20.4%) at 7 weeks and 1.43 cm3 (95% CI, 0.99-1.87 cm3 ) (+14.4%) at 11 weeks. No significant association was observed in the total study population or in the IVF/ICSI subgroup. CONCLUSION Periconceptional maternal adherence to a high fish and olive oil, low meat dietary pattern is positively associated with embryonic growth in spontaneously conceived pregnancies. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- F Parisi
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - M Rousian
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - N A Huijgen
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - A H J Koning
- Department of Bioinformatics, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - S P Willemsen
- Department of Biostatistics, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - J H M de Vries
- Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - I Cetin
- Center for Fetal Research Giorgio Pardi, Department of Biomedical and Clinical Sciences, Hospital Luigi Sacco, Università degli Studi di Milano, Milan, Italy
| | - E A P Steegers
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - R P M Steegers-Theunissen
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
- Department of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
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