Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, Italy.
Department of Woman, Mother and Child, Luigi Sacco and Vittore Buzzi Children Hospitals, ASST Fatebenefratelli-Sacco, Università degli Studi di Milano, 20154 Milan, Italy.
Nutrients. 2022 Sep 2;14(17):3631. doi: 10.3390/nu14173631.
Maternal nutrition represents a critical risk factor for adverse health outcomes in both mother and offspring. We aimed to investigate associations between maternal nutritional habits, biomarker status, and pregnancy outcome among Italian healthy normal-weight pregnancies. Multicenter prospective cohort study recruiting Italian healthy normal-weight women with singleton spontaneous pregnancies at 20 ± 2 weeks (T1) in Milan and Naples. All patients underwent nutritional evaluations by our collecting a 7-day weighed dietary record at 25 ± 1 weeks (T2) and a Food Frequency Questionnaire at 29 ± 2 weeks (T3). Maternal venous blood samples were collected at T3 to assess nutritional, inflammatory and oxidative biomarker concentrations (RBCs folate, vitamin D, hepcidin, total antioxidant capacity). Pregnancy outcomes were collected at delivery (T4). General linear models adjusted for confounding factors were estimated to investigate associations between maternal dietary pattern adherence, nutrient intakes, biomarker concentrations and delivery outcomes. 219 healthy normal-weight pregnant women were enrolled. Vitamin D and RBCs folate concentrations, as well as micronutrient intakes, were consistently below the recommended range. In a multi-adjusted model, maternal adherence to the most prevalent 'high meat, animal fats, grains' dietary pattern was positively associated with hepcidin concentrations and negatively associated with gestational age at delivery in pregnancies carrying female fetuses. Hepcidin plasma levels were further negatively associated to placental weight, whereas vitamin D concentrations were positively associated to neonatal weight. A high adherence to an unbalanced 'high meat, animal fats, grains' pattern was detected among Italian normal-weight low-risk pregnancies, further associated with maternal pro-inflammatory status and gestational age at delivery. This evidence underlines the need for a dedicated nutritional counseling even among low-risk pregnancies.
母体营养是母亲和后代不良健康结果的一个关键危险因素。我们旨在研究意大利健康正常体重孕妇的母体营养习惯、生物标志物状况与妊娠结局之间的关联。
这是一项多中心前瞻性队列研究,在米兰和那不勒斯招募了 20 ± 2 周(T1)时患有单胎自发性妊娠的健康正常体重意大利女性。所有患者在 25 ± 1 周(T2)和 29 ± 2 周(T3)时通过我们的收集 7 天称重饮食记录和食物频率问卷进行营养评估。在 T3 时采集母体静脉血样,以评估营养、炎症和氧化生物标志物浓度(RBC 叶酸、维生素 D、hepcidin、总抗氧化能力)。在分娩时(T4)收集妊娠结局。为了研究母体饮食模式依从性、营养素摄入量、生物标志物浓度与分娩结局之间的关系,我们使用调整混杂因素的一般线性模型进行估计。
共纳入 219 名健康正常体重孕妇。维生素 D 和 RBC 叶酸浓度以及微量营养素摄入量均持续低于推荐范围。在多调整模型中,母体对最常见的“高肉、动物脂肪、谷物”饮食模式的依从性与携带女胎妊娠的 hepcidin 浓度呈正相关,与分娩时的孕龄呈负相关。hepcidin 血浆水平与胎盘重量进一步呈负相关,而维生素 D 浓度与新生儿体重呈正相关。
在意大利正常体重低危妊娠中发现了一种高依从性的不平衡“高肉、动物脂肪、谷物”模式,进一步与母体促炎状态和分娩时的孕龄相关。这一证据强调了即使在低危妊娠中也需要专门的营养咨询。