BCNatal, Barcelona Center for Maternal and Fetal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona, Spain.
Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.
JAMA Netw Open. 2023 Aug 1;6(8):e2330255. doi: 10.1001/jamanetworkopen.2023.30255.
Maternal suboptimal nutrition and high stress levels are associated with adverse fetal and childhood neurodevelopment.
To test the hypothesis that structured interventions based on a Mediterranean diet or mindfulness-based stress reduction (MBSR) during pregnancy improve child neurodevelopment at age 2 years.
DESIGN, SETTING, AND PARTICIPANTS: This was a prespecified analysis of the parallel-group Improving Mothers for a Better Prenatal Care Trial Barcelona (IMPACT BCN) randomized clinical trial, which was conducted at a university hospital in Barcelona, Spain, from February 2017 to March 2020. A total of 1221 singleton pregnancies (19 to 23 weeks' gestation) with high risk of delivering newborns who were small for gestational age were randomly allocated into 3 groups: a Mediterranean diet intervention, an MBSR program, or usual care. A postnatal evaluation with the Bayley Scales of Infant and Toddler Development, 3rd Edition (Bayley-III), was performed. Data were analyzed from July to November 2022.
Participants in the Mediterranean diet group received monthly individual and group educational sessions and free provision of extra virgin olive oil and walnuts. Those in the stress reduction group underwent an 8-week MBSR program adapted for pregnancy. Individuals in the usual care group received pregnancy care per institutional protocols.
Neurodevelopment in children was assessed by Bayley-III at 24 months of corrected postnatal age.
A total of 626 children (293 [46.8%] female and 333 [53.2%] male) participated at a mean (SD) age of 24.8 (2.9) months. No differences were observed in the baseline characteristics between intervention groups. Compared with children from the usual care group, children in the Mediterranean diet group had higher scores in the cognitive domain (β, 5.02; 95% CI, 1.52-8.53; P = .005) and social-emotional domain (β, 5.15; 95% CI, 1.18-9.12; P = .01), whereas children from the stress reduction group had higher scores in the social-emotional domain (β, 4.75; 95% CI, 0.54-8.85; P = .02).
In this prespecified analysis of a randomized clinical trial, maternal structured lifestyle interventions during pregnancy based on a Mediterranean diet or MBSR significantly improved child neurodevelopmental outcomes at age 2 years.
ClinicalTrials.gov Identifier: NCT03166332.
母体亚最佳营养和高压力水平与胎儿和儿童神经发育不良有关。
测试以下假设，即在怀孕期间进行基于地中海饮食或正念减压（MBSR）的结构化干预是否可以改善 2 岁儿童的神经发育。
设计、地点和参与者：这是巴塞罗那改善产前护理母亲的平行组试验（IMPACT BCN）随机临床试验的预先指定分析，该试验于 2017 年 2 月至 2020 年 3 月在西班牙巴塞罗那的一家大学医院进行。共有 1221 名单胎妊娠（妊娠 19 至 23 周），有分娩小于胎龄儿的高风险，被随机分配到 3 组：地中海饮食干预组、MBSR 计划组或常规护理组。在产后进行了婴儿和幼儿发展评估第 3 版（Bayley-III）。数据分析于 2022 年 7 月至 11 月进行。
地中海饮食组的参与者每月接受一次个人和小组教育课程，并免费提供特级初榨橄榄油和核桃。减压组的参与者接受了为期 8 周的适应妊娠的 MBSR 计划。常规护理组的参与者接受了机构协议规定的妊娠护理。
通过 Bayley-III 在纠正出生后 24 个月龄时评估儿童的神经发育。
共有 626 名儿童（293 名[46.8%]女性和 333 名[53.2%]男性）在平均（SD）24.8（2.9）月龄时参与了研究。干预组之间在基线特征方面没有差异。与常规护理组的儿童相比，地中海饮食组的儿童在认知域的得分更高（β，5.02；95%CI，1.52-8.53；P=0.005），社会情感域的得分更高（β，5.15；95%CI，1.18-9.12；P=0.01），而减压组的儿童在社会情感域的得分更高（β，4.75；95%CI，0.54-8.85；P=0.02）。
在这项随机临床试验的预先指定分析中，基于地中海饮食或 MBSR 的母亲结构化生活方式干预在 2 岁时显著改善了儿童的神经发育结果。
ClinicalTrials.gov 标识符：NCT03166332。
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