Nakaki Ayako, Gomez Yvan, Darecka Katarzyna, Borras Roger, Vellvé Kilian, Paules Cristina, Boutet Maria Laura, Basso Annachiara, Casu Giulia, Traversi Paola, Youssef Lina, Casas Irene, Genero Mariona, Benitez Leticia, Larroya Marta, Casas Rosa, Miranda Jezid, Castro-Barquero Sara, Rodríguez-Sureda Víctor, Arranz Angela, Pozo Óscar J, Gomez-Gomez Alex, Vieta Eduard, Estruch Ramon, Izquierdo Renau Montserrat, Eixarch Elisenda, Crispi Fàtima, Crovetto Francesca, Gratacós Eduard
BCNatal | Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona (UB), Barcelona, Spain,
Fundació de Recerca Clínic Barcelona - IDIBAPS, Barcelona, Spain,
Fetal Diagn Ther. 2025;52(1):46-58. doi: 10.1159/000540580. Epub 2024 Jul 30.
We investigated whether structured maternal lifestyle interventions based on Mediterranean diet or stress reduction influence fetal-infant neurodevelopment detected by detailed fetal neurosonography and Ages and Stages Questionnaires 3rd edition (ASQ) at 12 months old.
This was a secondary analysis of a randomized clinical trial (2017-2020), including 1,221 singleton pregnancies at high risk for small-for-gestational age. Participants were randomized into three groups at 19-23 weeks' gestation: Mediterranean diet intervention, stress reduction program, or usual care. A detailed neurosonography was performed on 881 participants at mean (SD) 33.4 (1.1) weeks' gestation. Neurosonographic measurements were done offline. ASQ was performed on 276 infants at 1 year of corrected age.
Biparietal diameter was similar among study groups. Mediterranean diet group fetuses had deeper insula (26.80 [1.68] versus 26.63 [1.75], mm, p = 0.02) and longer corpus callosum (42.98 [2.44] versus 42.62 [2.27], mm, p = 0.04), with a lower rate of suboptimal score infants in ASQ problem-solving domain (6.2 vs. 16.3%, p = 0.03). Stress reduction group fetuses had deeper insula (26.90 [1.75] versus 26.63 [1.75], mm, p = 0.04) and lower rates of suboptimal score infants in ASQ fine motor domain (4.3 vs. 12.8%, p = 0.04), compared to usual care group fetuses.
Maternal structured intervention during pregnancy of the trial has the potential to modify offspring's neurodevelopment.
我们研究了基于地中海饮食或减压的结构化孕产妇生活方式干预措施,是否会影响通过详细的胎儿神经超声检查以及12个月大时的《年龄与阶段问卷》第三版(ASQ)检测到的胎儿-婴儿神经发育情况。
这是一项对随机临床试验(2017 - 2020年)的二次分析,纳入了1221例单胎妊娠且有小于胎龄儿高风险的孕妇。参与者在妊娠19 - 23周时被随机分为三组:地中海饮食干预组、减压计划组或常规护理组。对881名参与者在平均(标准差)妊娠33.4(1.1)周时进行了详细的神经超声检查。神经超声测量是离线进行的。对276名校正年龄为1岁的婴儿进行了ASQ测试。
各研究组间双顶径相似。地中海饮食组胎儿的脑岛更深(26.80 [1.68] 对 26.63 [1.75],毫米,p = 0.02),胼胝体更长(42.98 [2.44] 对 42.62 [2.27],毫米,p = 0.04),并且在ASQ解决问题领域中得分欠佳婴儿的比例较低(6.2% 对 16.3%,p = 0.03)。与常规护理组胎儿相比,减压组胎儿的脑岛更深(26.90 [1.75] 对 26.63 [1.75],毫米,p = 较),并且在ASQ精细运动领域中得分欠佳婴儿的比例较低(4.3% 对 12.8%,p = 0.04)。
试验中孕期的孕产妇结构化干预有可能改变后代的神经发育。