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The Role of Pregnancy Nutrition in Maternal and Offspring Health

A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (1 April 2019) | Viewed by 209016

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Special Issue Editor

1. ICON Clinical Research, 80 Wood Lane, White City, London W12 0BZ, UK
2. Department of Primary Care and Public Health, Imperial College London, Charing Cross Campus, The Reynolds Building, St Dunstan's Road, London W6 8RP, UK
Interests: pregnancy nutrition; lifecourse epidemiology; metabolic disease; gestational diabetes mellitus; child obesity; sex differences
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Special Issue Information

Dear Colleagues,

In pregnancy, maternal nutrition sustains and nourishes the developing fetus. Imbalances in either the direction of nutritional excess or deficiency can have detrimental consequences for offspring health. Furthermore, a cumulation of research now points to the importance of good pregnancy nutrition beyond immediate fetal outcomes. This includes modifying the risk of offspring outcomes as they enter childhood and adulthood through influences on placental development, hormonal pathways, and organ structure and function. Suboptimal nutrition during the gestational period may also compromise maternal outcomes during pregnancy, some of which have long-term consequences for women’s health. There is a clear need to understand the biological and social mechanisms that underpin the development of these outcomes to better target clinical and public health interventions. It is also important to gather insight into population sub-groups that may be especially vulnerable to nutritional insults during pregnancy to further personalize any future interventions.

This Special Issue on “The Role of Pregnancy Nutrition in Maternal and Offspring Health” welcomes submissions on etiological and mechanistic studies of pregnancy nutrition with short- and long-term maternal and offspring outcomes, including original research, narrative reviews, and systematic reviews and meta-analyses.

Dr. Ekaterina Maslova
Guest Editor

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Keywords

  • Pregnancy nutrition
  • Dietary patterns
  • Food groups
  • Macronutrients
  • Micronutrients
  • Pregnancy complications
  • Fetal growth
  • Child growth
  • Metabolic disease
  • Adiposity
  • Neurocognitive development
  • Respiratory health
  • Diabetes
  • Cardiovascular health

Published Papers (18 papers)

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Research

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21 pages, 309 KiB  
Communication
Supplementation of Plants with Immunomodulatory Properties during Pregnancy and Lactation—Maternal and Offspring Health Effects
by Aneta Lewicka, Łukasz Szymański, Kamila Rusiecka, Anna Kucza, Anna Jakubczyk, Robert Zdanowski and Sławomir Lewicki
Nutrients 2019, 11(8), 1958; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11081958 - 20 Aug 2019
Cited by 14 | Viewed by 7212
Abstract
A pregnant woman’s diet consists of many products, such as fruits, vegetables, cocoa, tea, chocolate, coffee, herbal and fruit teas, and various commercially available dietary supplements, which contain a high number of biological active plant-derived compounds. Generally, these compounds play beneficial roles in [...] Read more.
A pregnant woman’s diet consists of many products, such as fruits, vegetables, cocoa, tea, chocolate, coffee, herbal and fruit teas, and various commercially available dietary supplements, which contain a high number of biological active plant-derived compounds. Generally, these compounds play beneficial roles in women’s health and the development of fetus health. There are, however, some authors who report that consuming excessive amounts of plants that contain high concentrations of polyphenols may negatively affect the development of the fetus and the offspring’s health. Important and problematic issues during pregnancy and lactation are bacterial infections treatment. In the treatment are proposals to use plant immunomodulators, which are generally considered safe for women and their offspring. Additional consumption of biologically active compounds from plants, however, may increase the risk of occurrences to irreversible changes in the offspring’s health. Therefore, it is necessary to carry out safety tests for immunomodulators before introducing them into a maternal diet. Here, we present data from animal experiments for the four most-studied plants immunomodulators genus: Rhodiola, Echinacea, Panax, and Camellia, which were used in maternal nutrition. Full article
(This article belongs to the Special Issue The Role of Pregnancy Nutrition in Maternal and Offspring Health)
13 pages, 584 KiB  
Article
Associations between the Prenatal Diet and Neonatal Outcomes—A Secondary Analysis of the Cluster-Randomised GeliS Trial
by Julia Günther, Julia Hoffmann, Monika Spies, Dorothy Meyer, Julia Kunath, Lynne Stecher, Eva Rosenfeld, Luzia Kick, Kathrin Rauh and Hans Hauner
Nutrients 2019, 11(8), 1889; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11081889 - 13 Aug 2019
Cited by 16 | Viewed by 3868
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue The Role of Pregnancy Nutrition in Maternal and Offspring Health)
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12 pages, 581 KiB  
Article
Can a Simple Dietary Screening in Early Pregnancy Identify Dietary Habits Associated with Gestational Diabetes?
by Laufey Hrolfsdottir, Ingibjorg Gunnarsdottir, Bryndis Eva Birgisdottir, Ingibjorg Th Hreidarsdottir, Alexander Kr. Smarason, Hildur Hardardottir and Thorhallur I. Halldorsson
Nutrients 2019, 11(8), 1868; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11081868 - 11 Aug 2019
Cited by 9 | Viewed by 6024
Abstract
Gestational diabetes mellitus (GDM) is predominantly a lifestyle disease, with diet being an important modifiable risk factor. A major obstacle for the prevention in clinical practice is the complexity of assessing diet. In a cohort of 1651 Icelandic women, this study examined whether [...] Read more.
Gestational diabetes mellitus (GDM) is predominantly a lifestyle disease, with diet being an important modifiable risk factor. A major obstacle for the prevention in clinical practice is the complexity of assessing diet. In a cohort of 1651 Icelandic women, this study examined whether a short 40-item dietary screening questionnaire administered in the 1st trimester could identify dietary habits associated with GDM. The dietary variables were aggregated into predefined binary factors reflecting inadequate or optimal intake and stepwise backward elimination was used to identify a reduced set of factors that best predicted GDM. Those binary factors were then aggregated into a risk score (range: 0–7), that was mostly characterised by frequent consumption of soft drinks, sweets, cookies, ice creams and processed meat. The women with poor dietary habits (score ≥ 5, n = 302), had a higher risk of GDM (RR = 1.38; 95%CI = 3, 85) compared with women with a more optimal diet (score ≤ 2, n = 407). In parallel, a pilot (n = 100) intervention was conducted among overweight and obese women examining the effect of internet-based personalized feedback on diet quality. Simple feedback was given in accordance with the answers provided in the screening questionnaire in 1st trimester. At the endpoint, the improvements in diet quality were observed by, as an example, soft drink consumption being reduced by ~1 L/week on average in the intervention group compared to the controls. Our results suggest that a simple dietary screening tool administered in the 1st trimester could identify dietary habits associated with GMD. This tool should be easy to use in a clinical setting, and with simple individualized feedback, improvements in diet may be achieved. Full article
(This article belongs to the Special Issue The Role of Pregnancy Nutrition in Maternal and Offspring Health)
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17 pages, 5098 KiB  
Article
Priming of Hypothalamic Ghrelin Signaling and Microglia Activation Exacerbate Feeding in Rats’ Offspring Following Maternal Overnutrition
by Roger Maldonado-Ruiz, Marcela Cárdenas-Tueme, Larisa Montalvo-Martínez, Roman Vidaltamayo, Lourdes Garza-Ocañas, Diana Reséndez-Perez and Alberto Camacho
Nutrients 2019, 11(6), 1241; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11061241 - 31 May 2019
Cited by 23 | Viewed by 4806
Abstract
Maternal overnutrition during pregnancy leads to metabolic alterations, including obesity, hyperphagia, and inflammation in the offspring. Nutritional priming of central inflammation and its role in ghrelin sensitivity during fed and fasted states have not been analyzed. The current study aims to identify the [...] Read more.
Maternal overnutrition during pregnancy leads to metabolic alterations, including obesity, hyperphagia, and inflammation in the offspring. Nutritional priming of central inflammation and its role in ghrelin sensitivity during fed and fasted states have not been analyzed. The current study aims to identify the effect of maternal programming on microglia activation and ghrelin-induced activation of hypothalamic neurons leading to food intake response. We employed a nutritional programming model exposing female Wistar rats to a cafeteria diet (CAF) from pre-pregnancy to weaning. Food intake in male offspring was determined daily after fasting and subcutaneous injection of ghrelin. Hypothalamic ghrelin sensitivity and microglia activation was evaluated using immunodetection for Iba-1 and c-Fos markers, and Western blot for TBK1 signaling. Release of TNF-alpha, IL-6, and IL-1β after stimulation with palmitic, oleic, linoleic acid, or C6 ceramide in primary microglia culture were quantified using ELISA. We found that programmed offspring by CAF diet exhibits overfeeding after fasting and peripheral ghrelin administration, which correlates with an increase in the hypothalamic Iba-1 microglia marker and c-Fos cell activation. Additionally, in contrast to oleic, linoleic, or C6 ceramide stimulation in primary microglia culture, stimulation with palmitic acid for 24 h promotes TNF-alpha, IL-6, and IL-1β release and TBK1 activation. Notably, intracerebroventricular (i.c.v.) palmitic acid or LPS inoculation for five days promotes daily increase in food intake and food consumption after ghrelin administration. Finally, we found that i.c.v. palmitic acid substantially activates hypothalamic Iba-1 microglia marker and c-Fos. Together, our results suggest that maternal nutritional programing primes ghrelin sensitivity and microglia activation, which potentially might mirror hypothalamic administration of the saturated palmitic acid. Full article
(This article belongs to the Special Issue The Role of Pregnancy Nutrition in Maternal and Offspring Health)
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16 pages, 264 KiB  
Communication
Choline and DHA in Maternal and Infant Nutrition: Synergistic Implications in Brain and Eye Health
by Jonathan G. Mun, LeeCole L. Legette, Chioma J. Ikonte and Susan H. Mitmesser
Nutrients 2019, 11(5), 1125; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11051125 - 21 May 2019
Cited by 47 | Viewed by 17708
Abstract
The aim of this review is to highlight current insights into the roles of choline and docosahexaenoic acid (DHA) in maternal and infant nutrition, with special emphasis on dietary recommendations, gaps in dietary intake, and synergistic implications of both nutrients in infant brain [...] Read more.
The aim of this review is to highlight current insights into the roles of choline and docosahexaenoic acid (DHA) in maternal and infant nutrition, with special emphasis on dietary recommendations, gaps in dietary intake, and synergistic implications of both nutrients in infant brain and eye development. Adequate choline and DHA intakes are not being met by the vast majority of US adults, and even more so by women of child-bearing age. Choline and DHA play a significant role in infant brain and eye development, with inadequate intakes leading to visual and neurocognitive deficits. Emerging findings illustrate synergistic interactions between choline and DHA, indicating that insufficient intakes of one or both could have lifelong deleterious impacts on both maternal and infant health. Full article
(This article belongs to the Special Issue The Role of Pregnancy Nutrition in Maternal and Offspring Health)
12 pages, 258 KiB  
Communication
Maternal Omega-3 Nutrition, Placental Transfer and Fetal Brain Development in Gestational Diabetes and Preeclampsia
by Prasad P. Devarshi, Ryan W. Grant, Chioma J. Ikonte and Susan Hazels Mitmesser
Nutrients 2019, 11(5), 1107; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11051107 - 18 May 2019
Cited by 59 | Viewed by 11492
Abstract
Omega-3 fatty acids, particularly docosahexaenoic fatty acid (DHA), are widely recognized to impact fetal and infant neurodevelopment. The impact of DHA on brain development, and its inefficient synthesis from the essential alpha-linolenic acid (ALA), has led to recommended DHA intakes of 250–375 mg [...] Read more.
Omega-3 fatty acids, particularly docosahexaenoic fatty acid (DHA), are widely recognized to impact fetal and infant neurodevelopment. The impact of DHA on brain development, and its inefficient synthesis from the essential alpha-linolenic acid (ALA), has led to recommended DHA intakes of 250–375 mg eicosapentaenoic acid + DHA/day for pregnant and lactating women by the Dietary Guidelines for Americans. Despite these recommendations, the intake of omega-3s in women of child-bearing age in the US remains very low. The low maternal status of DHA prior to pregnancy could impair fetal neurodevelopment. This review focuses on maternal omega-3 status in conditions of gestational diabetes mellitus (GDM) and preeclampsia, and the subsequent impact on placental transfer and cord blood concentration of omega-3s. Both GDM and preeclampsia are associated with altered maternal omega-3 status, altered placental omega-3 metabolism, reduced cord blood omega-3 levels and have an impact on neurodevelopment in the infant and on brain health later in life. These findings indicate lower DHA exposure of the developing baby may be driven by lower placental transfer in both conditions. Thus, determining approaches which facilitate increased delivery of DHA during pregnancy and early development might positively impact brain development in infants born to mothers with these diseases. Full article
(This article belongs to the Special Issue The Role of Pregnancy Nutrition in Maternal and Offspring Health)
9 pages, 980 KiB  
Article
Blind Analysis of Food-Related IgG Identifies Five Possible Nutritional Clusters for the Italian Population: Future Implications for Pregnancy and Lactation
by Gabriele Piuri, Enrico Ferrazzi and Attilio Francesco Speciani
Nutrients 2019, 11(5), 1096; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11051096 - 17 May 2019
Cited by 1 | Viewed by 4632
Abstract
Background: The influence of diet in pregnant women on the immune tolerance process is intricate. Food-specific immunoglobulin G (IgG) was associated with exposure to particular food antigens. The IgG antibodies can cross the placental barrier and enter into the colostrum, and maternal IgG [...] Read more.
Background: The influence of diet in pregnant women on the immune tolerance process is intricate. Food-specific immunoglobulin G (IgG) was associated with exposure to particular food antigens. The IgG antibodies can cross the placental barrier and enter into the colostrum, and maternal IgG is amply present in breast milk. This justifies studying the immunological connection between food-specific IgG antibodies and the mother–fetus relationship. This study was designed to analyze food-specific IgG concentrations and possible food-specific IgG concentration clusters in a large cohort of subjects with a common food culture. Methods: Food-specific IgG antibody concentrations were detected in 18,012 Caucasian or Southern European subjects over 18 years of age. We used an unsupervised hierarchical clustering algorithm to explore varying degrees of similarity among food-specific IgG antibodies. Results: We identified five food groups by the evaluation of food-specific IgG values: one includes foods with a high nickel content, the second cluster is associated with gluten, the third cluster includes dairy products, the fourth one is connected to fermented foods, and the last group is correlated with cooked oils. Discussion: The knowledge derived from studying a large sample allows us to determine food-specific IgG values from a single pregnant woman, compare it to an epidemic standard, and establish modifications required in her lifestyle to modulate her nutritional habits. Full article
(This article belongs to the Special Issue The Role of Pregnancy Nutrition in Maternal and Offspring Health)
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13 pages, 1060 KiB  
Article
Exposure to Vitamin D Fortification Policy in Prenatal Life and the Risk of Childhood Asthma: Results from the D-Tect Study
by Fanney Thorsteinsdottir, Ekaterina Maslova, Ramune Jacobsen, Peder Frederiksen, Amélie Keller, Vibeke Backer and Berit Lilienthal Heitmann
Nutrients 2019, 11(4), 924; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11040924 - 24 Apr 2019
Cited by 7 | Viewed by 4269
Abstract
Prenatal vitamin D insufficiency may be associated with an increased risk of developing childhood asthma. Results from epidemiological studies are conflicting and limited by short follow-up and small sample sizes. The objective of this study was to examine if children born to women [...] Read more.
Prenatal vitamin D insufficiency may be associated with an increased risk of developing childhood asthma. Results from epidemiological studies are conflicting and limited by short follow-up and small sample sizes. The objective of this study was to examine if children born to women exposed to the margarine fortification policy with a small dose of extra vitamin D during pregnancy had a reduced risk of developing asthma until age 9 years, compared to children born to unexposed women. The termination of a Danish mandatory vitamin D fortification policy constituted the basis for the study design. We compared the risk of inpatient asthma diagnoses in all Danish children born two years before (n = 106,347, exposed) and two years after (n = 115,900, unexposed) the termination of the policy. The children were followed in the register from 0–9 years of age. Data were analyzed using Cox proportional hazards regression. The Hazard Ratio for the first inpatient asthma admission among exposed versus unexposed children was 0.96 (95%CI: 0.90–1.04). When stratifying by sex and age, 0–3 years old boys exposed to vitamin D fortification showed a lower asthma risk compared to unexposed boys (HR 0.78, 95%CI: 0.67–0.92). Prenatal exposure to margarine fortification policy with extra vitamin D did not affect the overall risk of developing asthma among children aged 0–9 years but seemed to reduce the risk among 0–3 years old boys. Taking aside study design limitations, this could be explained by different sensitivity to vitamin D from different sex-related asthma phenotypes in children with early onset, and sex differences in lung development or immune responses. Full article
(This article belongs to the Special Issue The Role of Pregnancy Nutrition in Maternal and Offspring Health)
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14 pages, 271 KiB  
Article
Maternal Fatty Fish Intake Prior to and during Pregnancy and Risks of Adverse Birth Outcomes: Findings from a British Cohort
by Camilla Nykjaer, Charlotte Higgs, Darren C. Greenwood, Nigel A.B. Simpson, Janet E. Cade and Nisreen A. Alwan
Nutrients 2019, 11(3), 643; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11030643 - 16 Mar 2019
Cited by 12 | Viewed by 4825
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue The Role of Pregnancy Nutrition in Maternal and Offspring Health)
12 pages, 255 KiB  
Article
Maternal Iodine Status and Associations with Birth Outcomes in Three Major Cities in the United Kingdom
by Charles J. P. Snart, Claire Keeble, Elizabeth Taylor, Janet E. Cade, Paul M. Stewart, Michael Zimmermann, Stephen Reid, Diane E. Threapleton, Lucilla Poston, Jenny E. Myers, Nigel A. B. Simpson, Darren C. Greenwood and Laura J. Hardie
Nutrients 2019, 11(2), 441; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11020441 - 20 Feb 2019
Cited by 25 | Viewed by 4725
Abstract
Severe iodine deficiency in mothers is known to impair foetal development. Pregnant women in the UK may be iodine insufficient, but recent assessments of iodine status are limited. This study assessed maternal urinary iodine concentrations (UIC) and birth outcomes in three UK cities. [...] Read more.
Severe iodine deficiency in mothers is known to impair foetal development. Pregnant women in the UK may be iodine insufficient, but recent assessments of iodine status are limited. This study assessed maternal urinary iodine concentrations (UIC) and birth outcomes in three UK cities. Spot urines were collected from 541 women in London, Manchester and Leeds from 2004–2008 as part of the Screening for Pregnancy End points (SCOPE) study. UIC at 15 and 20 weeks’ gestation was estimated using inductively coupled plasma-mass spectrometry (ICP-MS). Associations were estimated between iodine status (UIC and iodine-to-creatinine ratio) and birth weight, birth weight centile (primary outcome), small for gestational age (SGA) and spontaneous preterm birth. Median UIC was highest in Manchester (139 μg/L, 95% confidence intervals (CI): 126, 158) and London (130 μg/L, 95% CI: 114, 177) and lowest in Leeds (116 μg/L, 95% CI: 99, 135), but the proportion with UIC <50 µg/L was <20% in all three cities. No evidence of an association was observed between UIC and birth weight centile (−0.2% per 50 μg/L increase in UIC, 95% CI: −1.3, 0.8), nor with odds of spontaneous preterm birth (odds ratio = 1.00, 95% CI: 0.84, 1.20). Given the finding of iodine concentrations being insufficient according to World Health Organization (WHO) guidelines amongst pregnant women across all three cities, further studies may be needed to explore implications for maternal thyroid function and longer-term child health outcomes. Full article
(This article belongs to the Special Issue The Role of Pregnancy Nutrition in Maternal and Offspring Health)
13 pages, 2388 KiB  
Article
Maternal Choline Supplementation Modulates Placental Markers of Inflammation, Angiogenesis, and Apoptosis in a Mouse Model of Placental Insufficiency
by Julia H. King, Sze Ting (Cecilia) Kwan, Jian Yan, Xinyin Jiang, Vladislav G. Fomin, Samantha P. Levine, Emily Wei, Mark S. Roberson and Marie A. Caudill
Nutrients 2019, 11(2), 374; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11020374 - 12 Feb 2019
Cited by 18 | Viewed by 4311
Abstract
Dlx3 (distal-less homeobox 3) haploinsufficiency in mice has been shown to result in restricted fetal growth and placental defects. We previously showed that maternal choline supplementation (4X versus 1X choline) in the Dlx3+/− mouse increased fetal and placental growth in mid-gestation. The [...] Read more.
Dlx3 (distal-less homeobox 3) haploinsufficiency in mice has been shown to result in restricted fetal growth and placental defects. We previously showed that maternal choline supplementation (4X versus 1X choline) in the Dlx3+/− mouse increased fetal and placental growth in mid-gestation. The current study sought to test the hypothesis that prenatal choline would modulate indicators of placenta function and development. Pregnant Dlx3+/− mice consuming 1X (control), 2X, or 4X choline from conception were sacrificed at embryonic (E) days E10.5, E12.5, E15.5, and E18.5, and placentas and embryos were harvested. Data were analyzed separately for each gestational day controlling for litter size, fetal genotype (except for models including only +/− pups), and fetal sex (except when data were stratified by this variable). 4X choline tended to increase (p < 0.1) placental labyrinth size at E10.5 and decrease (p < 0.05) placental apoptosis at E12.5. Choline supplementation decreased (p < 0.05) expression of pro-angiogenic genes Eng (E10.5, E12.5, and E15.5), and Vegf (E12.5, E15.5); and pro-inflammatory genes Il1b (at E15.5 and 18.5), Tnfα (at E12.5) and Nfκb (at E15.5) in a fetal sex-dependent manner. These findings provide support for a modulatory effect of maternal choline supplementation on biomarkers of placental function and development in a mouse model of placental insufficiency. Full article
(This article belongs to the Special Issue The Role of Pregnancy Nutrition in Maternal and Offspring Health)
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14 pages, 3942 KiB  
Article
SIRT1 Attenuates Kidney Disorders in Male Offspring Due to Maternal High-Fat Diet
by Long T. Nguyen, Crystal H. Mak, Hui Chen, Amgad A. Zaky, Muh G. Wong, Carol A. Pollock and Sonia Saad
Nutrients 2019, 11(1), 146; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11010146 - 11 Jan 2019
Cited by 20 | Viewed by 4405
Abstract
Maternal obesity has been associated with kidney disorders in male offspring. Our previous studies have demonstrated that Sirtuin (SIRT)1, an essential regulator of metabolic stress responses, is suppressed in the offspring as the result of maternal high-fat diet (HFD) consumption, which is likely [...] Read more.
Maternal obesity has been associated with kidney disorders in male offspring. Our previous studies have demonstrated that Sirtuin (SIRT)1, an essential regulator of metabolic stress responses, is suppressed in the offspring as the result of maternal high-fat diet (HFD) consumption, which is likely to underpin the adverse metabolic and renal outcomes. To examine if SIRT1 overexpression or activation early in life can protect the offspring kidney, wild-type (WT) and transgenic (Tg) offspring were born to the same diet-induced obese female C57BL/6 mice through breeding with hemizygous SIRT1-transgenic (Tg) male mice and examined for renal pathological changes. In separate experiments, SIRT1 activator SRT1720 (25 mg/kg/2 days i.p) was administrated in WT offspring over 6 weeks of postnatal high-fat diet exposure. The results show that offspring born to obese dams have increased kidney weight, higher levels of renal triglycerides, and increased expression of oxidative stress, inflammatory, and fibrotic markers, as well as increased albuminuria compared to offspring of control dams. Both SIRT1 overexpression and SRT1720 treatment attenuated renal lipid contents and expression of lipogenesis, oxidative stress, and inflammatory markers; however, fibrosis was modestly reduced and albuminuria was not affected. The findings suggest that SIRT1 therapy can ameliorate some pathological mechanisms of kidney programming due to maternal obesity but may not be sufficient to prevent the resulting chronic kidney injury. Full article
(This article belongs to the Special Issue The Role of Pregnancy Nutrition in Maternal and Offspring Health)
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Review

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26 pages, 668 KiB  
Review
Preterm Birth: A Narrative Review of the Current Evidence on Nutritional and Bioactive Solutions for Risk Reduction
by Tinu M. Samuel, Olga Sakwinska, Kimmo Makinen, Graham C. Burdge, Keith M. Godfrey and Irma Silva-Zolezzi
Nutrients 2019, 11(8), 1811; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11081811 - 06 Aug 2019
Cited by 21 | Viewed by 7975
Abstract
Preterm birth (PTB) (<37 weeks of gestation) is the leading cause of newborn death and a risk factor for short and long-term adverse health outcomes. Most cases are of unknown cause. Although the mechanisms triggering PTB remain unclear, an inappropriate increase in net [...] Read more.
Preterm birth (PTB) (<37 weeks of gestation) is the leading cause of newborn death and a risk factor for short and long-term adverse health outcomes. Most cases are of unknown cause. Although the mechanisms triggering PTB remain unclear, an inappropriate increase in net inflammatory load seems to be key. To date, interventions that reduce the risk of PTB are effective only in specific groups of women, probably due to the heterogeneity of its etiopathogenesis. Use of progesterone is the most effective, but only in singleton pregnancies with history of PTB. Thus, primary prevention is greatly needed and nutritional and bioactive solutions are a promising alternative. Among these, docosahexaenoic acid (DHA) is the most promising to reduce the risk for early PTB. Other potential nutrient interventions include the administration of zinc (possibly limited to populations with low nutritional status or poor zinc status) and vitamin D; additional preliminary evidence exists for vitamin A, calcium, iron, folic acid, combined iron-folate, magnesium, multiple micronutrients, and probiotics. Considering the public health relevance of PTB, promising interventions should be studied in large and well-designed clinical trials. The objective of this review is to describe, summarize, and discuss the existing evidence on nutritional and bioactive solutions for reducing the risk of PTB. Full article
(This article belongs to the Special Issue The Role of Pregnancy Nutrition in Maternal and Offspring Health)
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34 pages, 1576 KiB  
Review
Preconception and Prenatal Nutrition and Neurodevelopmental Disorders: A Systematic Review and Meta-Analysis
by Mengying Li, Ellen Francis, Stefanie N. Hinkle, Aparna S. Ajjarapu and Cuilin Zhang
Nutrients 2019, 11(7), 1628; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11071628 - 17 Jul 2019
Cited by 55 | Viewed by 13012
Abstract
Preconception and prenatal nutrition is critical for fetal brain development. However, its associations with offspring neurodevelopmental disorders are not well understood. This study aims to systematically review the associations of preconception and prenatal nutrition with offspring risk of neurodevelopmental disorders. We searched the [...] Read more.
Preconception and prenatal nutrition is critical for fetal brain development. However, its associations with offspring neurodevelopmental disorders are not well understood. This study aims to systematically review the associations of preconception and prenatal nutrition with offspring risk of neurodevelopmental disorders. We searched the PubMed and Embase for articles published through March 2019. Nutritional exposures included nutrient intake or status, food intake, or dietary patterns. Neurodevelopmental outcomes included autism spectrum disorders (ASD), attention deficit disorder-hyperactivity (ADHD) and intellectual disabilities. A total of 2169 articles were screened, and 20 articles on ASD and 17 on ADHD were eventually reviewed. We found an overall inverse association between maternal folic acid or multivitamin supplementation and children’s risk of ASD; a meta-analysis including six prospective cohort studies estimated an RR of ASD of 0.64 (95% CI: 0.46, 0.90). Data on associations of other dietary factors and ASD, ADHD and related outcomes were inconclusive and warrant future investigation. Future studies should integrate comprehensive and more objective methods to quantify the nutritional exposures and explore alternative study design such as Mendelian randomization to evaluate potential causal effects. Full article
(This article belongs to the Special Issue The Role of Pregnancy Nutrition in Maternal and Offspring Health)
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20 pages, 1169 KiB  
Review
The Impact of Mediterranean Dietary Patterns During Pregnancy on Maternal and Offspring Health
by Federica Amati, Sondus Hassounah and Alexandra Swaka
Nutrients 2019, 11(5), 1098; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11051098 - 17 May 2019
Cited by 83 | Viewed by 10997
Abstract
(1) Background: Pregnancy outcomes for both mother and child are affected by many environmental factors. The importance of pregnancy for ‘early life programming’ is well established and maternal nutrition is an important factor contributing to a favourable environment for developing offspring. We aim [...] Read more.
(1) Background: Pregnancy outcomes for both mother and child are affected by many environmental factors. The importance of pregnancy for ‘early life programming’ is well established and maternal nutrition is an important factor contributing to a favourable environment for developing offspring. We aim to assess whether following a Mediterranean Diet during pregnancy is beneficial for maternal and offspring outcomes; (2) Methods: a systematic review was performed using standardized reporting guidelines with the National Heart Lung and Blood Iinstitute quality assessment tool for selection and extraction; (3) Results: results show that being on a Mediterranean Diet during pregnancy is associated with favourable outcomes for both maternal and offspring health, particularly for gestational diabetes in mothers and congenital defects in offspring (4) Conclusions: Following a Mediterranean dietary pattern during gestation is beneficial for the health of both the mother and offspring. Pregnant women and those trying to conceive should be advised to follow a Mediterranean Diet to potentially decrease, for example, the likelihood of atopy (OR 0.55) in the offspring and Gestational Diabetes Mellitus in the mother (OR 0.73). Full article
(This article belongs to the Special Issue The Role of Pregnancy Nutrition in Maternal and Offspring Health)
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17 pages, 521 KiB  
Review
The Impact of Maternal Eating Disorders on Dietary Intake and Eating Patterns during Pregnancy: A Systematic Review
by Annica F. Dörsam, Hubert Preißl, Nadia Micali, Sophia B. Lörcher, Stephan Zipfel and Katrin E. Giel
Nutrients 2019, 11(4), 840; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11040840 - 13 Apr 2019
Cited by 32 | Viewed by 11372
Abstract
Maternal nutrition in pregnancy has a key influence on optimum fetal health. Eating disorders (EDs) during pregnancy may have detrimental effects on fetal growth and the child’s early development. There is limited knowledge concerning the eating behavior, dietary intake and derived nutritional biomarkers [...] Read more.
Maternal nutrition in pregnancy has a key influence on optimum fetal health. Eating disorders (EDs) during pregnancy may have detrimental effects on fetal growth and the child’s early development. There is limited knowledge concerning the eating behavior, dietary intake and derived nutritional biomarkers as well as the nutrient supplementation in women with EDs during pregnancy. We performed a systematic review according to the PRISMA statement to synthesize current evidence in this field. Of N = 1203 hits, 13 full-texts were included in the qualitative synthesis. While women with current Binge Eating Disorder (BED) showed higher energy and fat intakes during pregnancy, women with a lifetime Anorexia Nervosa (AN), Bulimia Nervosa (BN) or both (AN + BN) had similar patterns of nutrient intake and dietary supplement use as healthy women. There is evidence, that women with a history of EDs have a sufficient diet quality and are more likely to be vegetarian. Dieting and bingeing improved substantially with pregnancy. The highlighted differences in the consumption of coffee/caffeine and artificially sweetened beverages as well as the elevated prevalence of iron deficiency anemia in women with a past or active ED during pregnancy might have an important impact on fetal development. Full article
(This article belongs to the Special Issue The Role of Pregnancy Nutrition in Maternal and Offspring Health)
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29 pages, 453 KiB  
Review
The Effects of Vegetarian and Vegan Diet during Pregnancy on the Health of Mothers and Offspring
by Giorgia Sebastiani, Ana Herranz Barbero, Cristina Borrás-Novell, Miguel Alsina Casanova, Victoria Aldecoa-Bilbao, Vicente Andreu-Fernández, Mireia Pascual Tutusaus, Silvia Ferrero Martínez, María Dolores Gómez Roig and Oscar García-Algar
Nutrients 2019, 11(3), 557; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11030557 - 06 Mar 2019
Cited by 133 | Viewed by 78190
Abstract
Vegetarian and vegan diets have increased worldwide in the last decades, according to the knowledge that they might prevent coronary heart disease, cancer, and type 2 diabetes. Althought plant-based diets are at risk of nutritional deficiencies such as proteins, iron, vitamin D, calcium, [...] Read more.
Vegetarian and vegan diets have increased worldwide in the last decades, according to the knowledge that they might prevent coronary heart disease, cancer, and type 2 diabetes. Althought plant-based diets are at risk of nutritional deficiencies such as proteins, iron, vitamin D, calcium, iodine, omega-3, and vitamin B12, the available evidence shows that well planned vegetarian and vegan diets may be considered safe during pregnancy and lactation, but they require a strong awareness for a balanced intake of key nutrients. A review of the scientific literature in this field was performed, focusing specifically on observational studies in humans, in order to investigate protective effects elicited by maternal diets enriched in plant-derived foods and possible unfavorable outcomes related to micronutrients deficiencies and their impact on fetal development. A design of pregestational nutrition intervention is required in order to avoid maternal undernutrition and consequent impaired fetal growth. Full article
(This article belongs to the Special Issue The Role of Pregnancy Nutrition in Maternal and Offspring Health)
16 pages, 2143 KiB  
Review
Effects of Vitamin D Supplementation During Pregnancy on Birth Size: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
by Andrea Maugeri, Martina Barchitta, Isabella Blanco and Antonella Agodi
Nutrients 2019, 11(2), 442; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11020442 - 20 Feb 2019
Cited by 41 | Viewed by 6419
Abstract
During pregnancy, vitamin D supplementation may be a feasible strategy to help prevent low birthweight (LBW) and small for gestational age (SGA) births. However, evidence from randomized controlled trials (RCTs) is inconclusive, probably due to heterogeneity in study design and type of intervention. [...] Read more.
During pregnancy, vitamin D supplementation may be a feasible strategy to help prevent low birthweight (LBW) and small for gestational age (SGA) births. However, evidence from randomized controlled trials (RCTs) is inconclusive, probably due to heterogeneity in study design and type of intervention. A systematic literature search in the PubMed-Medline, EMBASE, and Cochrane Central Register of Controlled Trials databases was carried out to evaluate the effects of oral vitamin D supplementation during pregnancy on birthweight, birth length, head circumference, LBW, and SGA. The fixed-effects or random-effects models were used to calculate mean difference (MD), risk ratio (RR), and 95% Confidence Interval (CI). On a total of 13 RCTs, maternal vitamin D supplementation had a positive effect on birthweight (12 RCTs; MD = 103.17 g, 95% CI 62.29–144.04 g), length (6 RCTs; MD = 0.22 cm, 95% CI 0.11–0.33 cm), and head circumference (6 RCTs; MD:0.19 cm, 95% CI 0.13–0.24 cm). In line with these findings, we also demonstrated that maternal vitamin D supplementation reduced the risk of LBW (3 RCTs; RR = 0.40, 95% CI 0.22–0.74) and SGA (5 RCTS; RR = 0.69, 95% CI 0.51–0.92). The present systematic review and meta-analysis confirmed the well-established effect of maternal vitamin D supplementation on birth size. However, further research is required to better define risks and benefits associated with such interventions and the potential implications for public health. Full article
(This article belongs to the Special Issue The Role of Pregnancy Nutrition in Maternal and Offspring Health)
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