Fetal Cardiology Unit, Institute of Cardiology/FUC, Avenida Princesa Isabel, 370, Porto Alegre, CEP 90620-000, Brazil.
Departament of Pediatrics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Sci Rep. 2021 May 11;11(1):9929. doi: 10.1038/s41598-021-89309-x.
Maternal consumption of polyphenol-rich foods has been associated with fetal ductus arteriosus constriction (DAC), but safety of chocolate exposure in fetal life has not been studied. This experimental study tested the hypothesis that maternal cocoa consumption in late pregnancy causes fetal DAC, with possible associated antioxidant effects. Pregnant Wistar rats, at the 21st gestational day, received by orogastric tube cocoa (720 mg/Kg) for 12 h, indomethacin (10 mg/Kg), for 8 h, or only water, before cesaren section. Immediately after withdrawal, every thorax was obtained and tissues were fixed and stained for histological analysis. The ratio of the narrowest part of the pulmonary artery to the fetal ductus inner diameter and increased ductal inner wall thickness characterized ductal constriction. Substances reactive to thiobarbituric acid were quantified. Statistical analysis used ANOVA and Tukey test. Cocoa (n = 33) and indomethacin (n = 7) reduced fetal internal ductus diameter when compared to control (water, n = 25) (p < 0.001) and cocoa alone increased ductus wall thickness (p < 0.001), but no change was noted in enzymes activity. This pharmacological study shows supporting evidences that there is a cause and effect relationship between maternal consumption of cocoa and fetal ductus arteriosus constriction. Habitual widespread use of chocolate during gestation could account for undetected ductus constriction and its potentially severe consequences, such as perinatal pulmonary hypertension, cardiac failure and even death. For this reason, dietary guidance in late pregnancy to avoid high chocolate intake, to prevent fetal ductal constriction, may represent the main translational aspect of this study.
母体摄入富含多酚的食物与胎儿动脉导管收缩(DAC)有关,但巧克力暴露在胎儿期的安全性尚未得到研究。这项实验研究检验了这样一个假设,即妊娠晚期母体可可摄入会导致胎儿 DAC,并可能伴有抗氧化作用。在妊娠第 21 天,通过口腔胃管给予怀孕的 Wistar 大鼠可可(720mg/Kg)12 小时、吲哚美辛(10mg/Kg)8 小时或仅给予水,然后进行剖腹产。取出后立即获得每个胸腔,并固定组织进行组织学分析。肺动脉最窄处与胎儿动脉导管内直径的比值和导管内壁厚度的增加特征为导管收缩。用硫代巴比妥酸定量测定反应物质。统计分析采用方差分析和 Tukey 检验。与对照组(水,n=25)相比,可可(n=33)和吲哚美辛(n=7)降低了胎儿内导管直径(p<0.001),且可可单独增加了导管壁厚度(p<0.001),但酶活性无变化。这项药理学研究提供了支持性证据,表明母体摄入可可与胎儿动脉导管收缩之间存在因果关系。妊娠期间习惯性广泛食用巧克力可能导致未被发现的导管收缩及其潜在的严重后果,如围产期肺动脉高压、心力衰竭甚至死亡。因此,妊娠晚期的饮食指导避免高巧克力摄入,以防止胎儿导管收缩,可能代表了这项研究的主要转化方面。