Arq Bras Cardiol. 2013 Sep;101(3):217-25. doi: 10.5935/abc.20130166. Epub 2013 Aug 14.
We have recently demonstrated reversal of fetal ductal constriction after dietary maternal restriction of polyphenol-rich foods (PRF), due to its inhibitory action on prostaglandin synthesis.
To test the hyphotesis that normal third trimester fetuses also improve ductus arteriosus dynamics after maternal restriction of polyphenols.
Open clinical trial with 46 fetuses with gestational age (GA) > 28 weeks submitted to 2 Doppler echocardiographic studies with an interval of at least 2 weeks, being the examiners blinded to maternal dietary habits. A validated food frequency questionnaire was applied and a diet based on polyphenol-poor foods (<30 mg/100 mg) was recommended. A control group of 26 third trimester fetuses was submitted to the same protocol. Statistics used t test for independent samples.
Mean GA was 33 ± 2 weeks. Mean daily maternal estimated polyphenol intake (DMPI) was 1277 mg, decreasing to 126 mg after dietary orientation (p=0.0001). Significant decreases in systolic (SDV) and diastolic (DDV) ductal velocities, and RV/LV diameters ratio, as well as increase in ductal PI were observed [DSV = 1.2 ± 0.4 m/s (0.7-1.6) to 0.9 ± 0.3 m/s (0.6-1.3) (p = 0.018); DDV = 0.21 ± 0.09 m/s (0.15-0.32) to 0.18 ± 0.06 m/s (0.11-0.25) (p = 0.016); RV/LV ratio = 1.3 ± 0.2 (0.9-1.4) to 1.1 ± 0.2 (0.8-1.3) (p=0.004); ductal PI = 2.2 ± 0.03 (2.0-2.7) to 2.4 ± 0.4(2.2-2.9) (p = 0.04)]. In the control group, with GA of 32 ± 4 weeks, there were no significant differences in DMPI, mean SDV, DDV, PI and RV/LV ratio.
The oriented restriction of third trimester maternal ingestion of polyphenol-rich foods for a period of 2 weeks or more improve fetal ductus arteriosus flow dynamics and right ventricular dimensions.
我们最近发现，由于多酚对前列腺素合成的抑制作用，限制富含多酚的食物（PRF）后，胎儿的导管收缩得到逆转。
检验假设，即正常的第三个三个月胎儿在限制母亲多酚后，也能改善动脉导管的动力学。
这是一项开放性临床试验，共纳入 46 名孕龄（GA）>28 周的胎儿，进行 2 次多普勒超声心动图检查，间隔至少 2 周，检查者对母亲的饮食习惯不知情。应用了一种经过验证的食物频率问卷，并推荐了一种基于多酚含量低的食物（<30 毫克/100 毫克）的饮食。对 26 名第三个三个月的胎儿进行了相同的方案。统计学采用独立样本 t 检验。
平均 GA 为 33±2 周。平均每日母亲估计多酚摄入量（DMPI）为 1277 毫克，饮食指导后降至 126 毫克（p=0.0001）。收缩期（SDV）和舒张期（DDV）导管速度、RV/LV 直径比以及导管 PI 增加均有显著下降[SDV=1.2±0.4m/s（0.7-1.6）至 0.9±0.3m/s（0.6-1.3）（p=0.018）；DDV=0.21±0.09m/s（0.15-0.32）至 0.18±0.06m/s（0.11-0.25）（p=0.016）；RV/LV 比=1.3±0.2（0.9-1.4）至 1.1±0.2（0.8-1.3）（p=0.004）；导管 PI=2.2±0.03（2.0-2.7）至 2.4±0.4（2.2-2.9）（p=0.04）]。在对照组中，GA 为 32±4 周，DMPI、平均 SDV、DDV、PI 和 RV/LV 比值无显著差异。
限制第三个三个月母亲摄入富含多酚的食物 2 周或更长时间，可改善胎儿动脉导管的血流动力学和右心室的大小。
