Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, 3015 GD Rotterdam, the Netherlands.
Department of Biostatistics, Erasmus MC, University Medical Centre, 3015 GD Rotterdam, the Netherlands.
Clin Nutr. 2022 Aug;41(8):1667-1675. doi: 10.1016/j.clnu.2022.06.006. Epub 2022 Jun 9.
BACKGROUND & AIMS: Periconceptional maternal dietary patterns contribute to embryonic growth and development. No knowledge is available about the impact of periconceptional maternal ultra-processed food consumption on embryonic growth. Therefore, the aim of the present study is to investigate the impact of periconceptional maternal ultra-processed food consumption on embryonic growth using repeated crown-rump length (CRL) and embryonic volume (EV) measurements.
This study is embedded in the ongoing prospective observational Rotterdam periconceptional cohort (Predict Study). A total of 701 pregnancies, of which 446 were conceived after natural conception and 255 after IVF or ICSI treatment were included. Women were at least 18 years of age and were recruited at the outpatient clinic before 13 weeks of gestation. CRL and EV were measured using three-dimensional ultrasound datasets and virtual reality techniques at the 7th, 9th and 11th week of gestation. The food frequency questionnaire of each participant was used to calculate the percentage of maternal energy consumed from ultra-processed foods (PEI-UPF) for each participant. The association between PEI-UPF and the first trimester CRL and EV measurements was studied with linear mixed models and adjusted for potential confounders including maternal factors, gestational age, foetal sex, and total energy intake.
PEI-UPF ranged from 16% to 88%. In fully adjusted linear mixed models, a 10% increase in maternal PEI-UPF was significantly associated with smaller growth trajectories of CRL and EV (b -0.041 √mm (95% confidence interval (CI) -0.074 to -0.008), P = 0.02 and b -0.016 ∛cm (95% CI -0.030 to -0.001), P = 0.04, respectively). When additionally adjusted for micronutrient content of diet (vitamins B1, B2, B6, B11 and B12, and zinc), the associations for the CRL and EV measurements lost significance.
Periconceptional maternal consumption of ultra-processed foods is associated with smaller embryonic growth. Interventions promoting healthy food practices during pregnancy could be beneficial for embryonic growth.
围孕期母体的饮食模式会影响胚胎的生长和发育。目前还没有研究表明围孕期母体超加工食品的摄入量会对胚胎生长产生影响。因此，本研究旨在通过重复测量胎儿头臀长（CRL）和胚胎体积（EV）来探讨围孕期母体超加工食品的摄入量对胚胎生长的影响。
本研究嵌入了正在进行的前瞻性观察性鹿特丹围孕期队列研究（Predict 研究）。共纳入了 701 例妊娠，其中 446 例为自然受孕，255 例为体外受精或卵胞浆内单精子注射治疗受孕。这些女性的年龄均至少为 18 岁，在妊娠 13 周前于门诊招募。在妊娠第 7、9 和 11 周，使用三维超声数据集和虚拟现实技术测量 CRL 和 EV。每位参与者的食物频率问卷用于计算每位参与者的母体能量来源于超加工食品的百分比（PEI-UPF）。使用线性混合模型研究了 PEI-UPF 与妊娠早期 CRL 和 EV 测量值之间的关系，并对包括母体因素、胎龄、胎儿性别和总能量摄入等潜在混杂因素进行了调整。
PEI-UPF 范围为 16%至 88%。在完全调整的线性混合模型中，母体 PEI-UPF 增加 10%与 CRL 和 EV 的生长轨迹变小显著相关（b -0.041 √mm（95%置信区间（CI）-0.074 至 -0.008），P = 0.02 和 b -0.016 ∛cm（95%CI -0.030 至 -0.001），P = 0.04）。当进一步调整饮食中微量营养素的含量（维生素 B1、B2、B6、B11 和 B12 以及锌）时，CRL 和 EV 测量值的关联不再具有统计学意义。
围孕期母体摄入超加工食品与胚胎生长较小有关。在妊娠期间促进健康饮食实践的干预措施可能有益于胚胎生长。
