Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Department of Biostatistics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
PLoS One. 2018 May 23;13(5):e0197901. doi: 10.1371/journal.pone.0197901. eCollection 2018.
Maternal nutrition during pregnancy has been related to intrauterine brain development and neurodevelopmental disabilities in adult life. We aim to investigate associations between periconceptional maternal dietary patterns and prenatal cerebellar growth from the first trimester onwards.
126 women with singleton non-malformed pregnancies were enrolled before 8 weeks of gestation in the Rotterdam periconceptional cohort between 2013 and 2015. Periconceptional maternal dietary patterns were extracted from food frequency questionnaires and associated with blood biomarkers and micronutrient intakes. Serial two-dimensional and three-dimensional ultrasound scans were performed at 9, 11, 22, 26 and 32 weeks of gestation for transcerebellar diameter (TCD) measurement. Linear mixed models were estimated to investigate associations between periconceptional maternal dietary patterns and longitudinal TCD measurements as a function of gestational age.
We performed a median of 4 scans per pregnancy, resulting in 570 total datasets. The success rate of TCD measurements was 87% (range 65-100%), depending on gestational age. The Mediterranean, Western, egg-rich and dairy-rich dietary patterns were extracted, explaining 37.2% of the overall variance of food intake in this population. The dairy-rich dietary pattern was positively associated with cerebellar growth trajectories (β = 0.02 (95% CI: 0.01; 0.03) √mm, p = 0.01). Maternal strong adherence to this dietary pattern increased TCD measurements by 0.8 standard deviation scores (SDs) compared to weak adherence, reflected in increased TCD estimates of 0.44 mm at 9 weeks (+6.8%), 0.88 mm at 22 weeks (+3.6%), and 1.17 mm at 32 weeks (+2.8%). No significant associations were detected for the Mediterranean, Western and egg-rich dietary patterns.
This study shows a positive association between periconceptional maternal adherence to a dairy-rich dietary pattern and human prenatal TCD measurements as a proxy of cerebellar growth. Next step is the investigation of the impact on neurodevelopmental outcomes in the offspring.
孕期母体营养与宫内脑发育和成年后神经发育障碍有关。我们旨在研究从妊娠早期开始，围孕期母体饮食模式与产前小脑生长之间的关系。
2013 年至 2015 年，在鹿特丹围孕期队列中，在妊娠 8 周前纳入了 126 名患有单胎非畸形妊娠的女性。围孕期母体饮食模式从食物频率问卷中提取，并与血液生物标志物和微量营养素摄入相关联。在妊娠 9、11、22、26 和 32 周时进行二维和三维超声扫描，以测量颅后窝直径（TCD）。使用线性混合模型估计围孕期母体饮食模式与作为妊娠年龄函数的纵向 TCD 测量值之间的关系。
我们对每个妊娠进行了中位数为 4 次扫描，总共获得了 570 个数据集。TCD 测量的成功率为 87%（范围为 65-100%），取决于妊娠年龄。提取出地中海、西方、富含鸡蛋和富含奶制品的饮食模式，解释了该人群中食物摄入总方差的 37.2%。富含奶制品的饮食模式与小脑生长轨迹呈正相关（β=0.02（95%CI：0.01；0.03）√mm，p=0.01）。与弱依从性相比，母体对这种饮食模式的强烈依从性使 TCD 测量值增加了 0.8 个标准差分数（SD），这反映在 9 周时 TCD 估计值增加了 0.44mm（增加 6.8%）、22 周时增加了 0.88mm（增加 3.6%）和 32 周时增加了 1.17mm（增加 2.8%）。没有发现地中海、西方和富含鸡蛋的饮食模式与 TCD 之间存在显著相关性。
本研究显示，围孕期母体对富含奶制品的饮食模式的依从性与人类产前 TCD 测量值呈正相关，TCD 测量值是小脑生长的替代指标。下一步是研究其对后代神经发育结果的影响。
