Teo Shevaun M, Murrin Celine M, Mehegan John, Douglas Alexander, Hébert James R, Segurado Ricardo, Kelleher Cecily C, Phillips Catherine M
School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.
Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.
Front Nutr. 2023 Feb 8;10:1060709. doi: 10.3389/fnut.2023.1060709. eCollection 2023.
Individual macronutrient and micronutrient effects on placental growth have been widely investigated. However, the influence of overall maternal diet is relatively unknown. Therefore, the aim of this study is to examine associations between a range of maternal dietary scores during early pregnancy with placental outcomes, and to investigate whether there is evidence of sexual dimorphism.
This analysis of the Lifeways Cross-Generational Cohort includes 276 mother-child pairs. A validated 148-item semi-quantitative food frequency questionnaire assessed maternal diet in early pregnancy. Dietary scores reflecting dietary quality [Healthy Eating Index (HEI-2015), Dietary Approaches to Stop Hypertension (DASH)], dietary inflammatory potential [Dietary Inflammatory Index (DII) and the energy adjusted DII (E-DII)], dietary antioxidant status [Dietary Antioxidant Quality (DAQ)], and glycemic and insulinemic loads/indices (GL/GI, IL/II) were calculated. Linear regression analyses assessed maternal dietary score relationships with untrimmed placental weight (PW) and birth weight:placental weight (BW:PW) ratio.
In fully adjusted models, maternal E-DII and GI were positively associated, and HEI-2015 and DAQ were negatively associated with PW (B: 12.31, 95% CI: 0.41, 24.20, = 0.04, B: 4.13, 95% CI: 0.10, 8.17, = 0.04, B: -2.70, 95% CI: -5.03, -0.35, = 0.02 and B: -15.03, 95% CI: -28.08, -1.98, = 0.02, for E-DII, GI, HEI-2015 and DAQ respectively). Maternal DAQ associations with BW:PW ratio were attenuated. When stratified by sex, maternal GI and pregnancy-specific DAQ were associated with PW in female offspring (B: 5.61, 95% CI: 0.27, 10.96, = 0.04 and B: -15.31, 95% CI: -30.35, -0.27, = 0.046). Maternal E-DII and HEI-2015 were associated with PW in males (B: 24.31, 95% CI: 5.66, 42.96, = 0.01 and B: -3.85, 95% CI: -7.47, -0.35, = 0.03 respectively).
The results of this novel investigation suggest that maternal diet may influence placental development. Female fetuses may be more sensitive to increased glucose levels whereas male fetuses may be more susceptible to stresses that are regulated by inflammatory pathways and overall diet quality. Hence, early pregnancy offers an opportune time for a mother to prioritize dietary changes that focus on reducing inflammatory and glycemic responses.
已广泛研究了个体常量营养素和微量营养素对胎盘生长的影响。然而，母体整体饮食的影响相对未知。因此，本研究的目的是检查孕早期一系列母体饮食评分与胎盘结局之间的关联，并调查是否存在性别差异的证据。
对“生活方式跨代队列”的分析包括276对母婴。一份经过验证的包含148个条目的半定量食物频率问卷评估了孕早期的母体饮食。计算了反映饮食质量的饮食评分[健康饮食指数（HEI - 2015）、终止高血压饮食方法（DASH）]、饮食炎症潜能[饮食炎症指数（DII）和能量调整后的DII（E - DII）]、饮食抗氧化状态[饮食抗氧化质量（DAQ）]以及血糖和胰岛素负荷/指数（GL / GI，IL / II）。线性回归分析评估了母体饮食评分与未修剪胎盘重量（PW）以及出生体重与胎盘重量（BW：PW）比值之间的关系。
在完全调整模型中，母体E - DII和GI呈正相关，HEI - 2015和DAQ与PW呈负相关（E - DII、GI、HEI - 2015和DAQ的B值分别为12.31，95%置信区间：0.41，24.20，P = 0.04；B值为4.13，95%置信区间：0.10，8.17，P = 0.04；B值为 - 2.70，95%置信区间： - 5.03， - 0.35，P = 0.02；B值为 - 15.03，95%置信区间： - 28.08， - 1.98，P = 0.02）。母体DAQ与BW：PW比值的关联减弱。按性别分层时，母体GI和孕期特异性DAQ与女性后代的PW相关（B值为5.61，95%置信区间：0.27，10.96，P = 0.04；B值为 - 15.31，95%置信区间： - 30.35， - 0.27，P = 0.046）。母体E - DII和HEI - 2015与男性后代的PW相关（B值分别为24.31，95%置信区间：5.66，42.96，P = 0.01；B值为 - 3.85，95%置信区间： - 7.47， - 0.35，P = 0.03）。
这项新研究的结果表明，母体饮食可能影响胎盘发育。雌性胎儿可能对血糖水平升高更敏感，而雄性胎儿可能更容易受到由炎症途径和整体饮食质量调节的应激影响。因此，孕早期为母亲提供了一个合适的时机，可优先进行注重减少炎症和血糖反应的饮食改变。
