Department of Psychology, Durham University, South Road, Durham, DH13LE, UK.
Department of Archaeology, Durham University, South Road, Durham, DH1 3LE, UK.
Arch Gynecol Obstet. 2020 Jul;302(1):65-75. doi: 10.1007/s00404-020-05571-w. Epub 2020 May 14.
Prenatal sub-optimal nutrition and exposure to maternal stress, anxiety and depression in pregnancy have been linked to increased postnatal morbidity and mortality. Fetal growth is most vulnerable to maternal dietary deficiencies, such as those evident in hyperemesis gravidarum (HG), early in pregnancy. The purpose of this pilot study was to examine the effects of HG on fetal movement profiles as a measure of fetal healthy development in the 3rd trimester of pregnancy, and to assess whether nutritional stress on the mother can be evaluated using isotopic analysis of hair.
We analyzed fetal movement profiles using 4D ultrasound scans at 32- and 36-weeks' gestation. Fetuses of women (N = 6) diagnosed with HG, having lost more than 10% of their body weight in the first trimester of pregnancy were compared to a healthy group (N = 6), controlling for stress, depression and anxiety. We tested carbon and nitrogen isotope ratios in maternal hair as a measure of both diet and nutritional changes due to catabolism of body proteins and fats.
HG and catabolism were significantly correlated (p = 0.02). Furthermore, at 32-weeks' gestation movement profiles of fetuses of mothers with HG differed significantly from the movement profiles of fetuses of healthy mothers. Fetuses of mothers suffering from HG showed a significantly increased ratio of fine-grained movements at 32 weeks (p = 0.008); however, there were no significant differences detectable at 36-weeks' gestation.
The effect of HG on fetal development as expressed by variations in fetal movement profiles in this pilot study suggest that prenatal effects of HG can be measured using movement profiles. Isotope analysis of hair can supplement this with information on nutritional imbalances early in pregnancy.
产前营养不足和孕期母亲压力、焦虑和抑郁与产后发病率和死亡率增加有关。胎儿生长最容易受到母亲饮食缺乏的影响，例如在妊娠早期严重的妊娠剧吐（HG）中就会出现这种情况。本研究旨在探讨 HG 对胎儿运动模式的影响，作为评估妊娠晚期胎儿健康发育的指标，并评估是否可以通过头发的同位素分析来评估母亲的营养压力。
我们在 32 至 36 孕周时使用 4D 超声扫描分析胎儿运动模式。与健康组（N=6）相比，我们比较了在妊娠早期体重减轻超过 10%的患有 HG 的孕妇（N=6）的胎儿运动模式，同时控制了压力、抑郁和焦虑。我们测试了母亲头发中的碳和氮同位素比值，以评估由于身体蛋白质和脂肪分解而导致的饮食和营养变化。
HG 和分解代谢呈显著相关（p=0.02）。此外，在 32 孕周时，患有 HG 的母亲的胎儿运动模式与健康母亲的胎儿运动模式明显不同。患有 HG 的母亲的胎儿在 32 周时表现出明显增加的细粒度运动比例（p=0.008）；然而，在 36 孕周时没有检测到显著差异。
在这项初步研究中，HG 对胎儿发育的影响表现为胎儿运动模式的变化，这表明可以使用运动模式来测量 HG 的产前影响。头发的同位素分析可以补充有关妊娠早期营养失衡的信息。
