Mandò Chiara, Novielli Chiara, Nuzzo Anna Maria, Parisi Francesca, Moretti Laura, Lisso Fabrizia, Revelli Alberto, Savasi Valeria M, Laoreti Arianna, Anelli Gaia M, Rolfo Alessandro, Cetin Irene
Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, Italy.
Department of Woman, Mother and Neonate, "Vittore Buzzi" Children's Hospital, ASST Fatebenefratelli Sacco, 20154 Milan, Italy.
Nutrients. 2025 Aug 9;17(16):2590. doi: 10.3390/nu17162590.
Maternal nutrition and pregestational BMI are critical determinants of pregnancy outcomes. This prospective multicenter observational study investigated the interplay between prepregnancy BMI, dietary patterns, and oxidative/inflammatory status in 153 Italian healthy pregnant women with normal weight (NW), overweight (OW), or obesity (OB). Detailed clinical, biochemical, placental, and neonatal data were measured at third trimester and delivery. Dietary intake was assessed via a validated questionnaire, and dietary patterns were derived using principal component analysis. OW and OB women had significantly higher levels of inflammatory (CRP, hepcidin) and oxidative stress biomarkers (DNA/RNA damage, catalase activity) than NW. Multivariate models confirmed independent associations between BMI and these biomarkers (CRP: β = 0.297, = 0.000; hepcidin: β = 1.419, = 0.006; DNA/RNA damage: β = 409.9, = 0.000; catalase activity: β = 1.536, = 0.000). Superoxide dismutase activity and total antioxidant capacity were not associated with BMI. Nutritional intake across BMI groups was largely suboptimal relative to national recommendations, with insufficient levels of polyunsaturated fats and key micronutrients. Four dietary patterns were identified, with adherence varying by BMI. A "prudent-style" pattern (high plant, low animal) was positively associated with gestational age (β = 0.243, = 0.033) and inversely with neonatal head circumference (β = -0.414, = 0.050). A "Western-like" pattern (high sugars, snacks, animal fats) was linked to reduced maternal ferritin (β = -2.093, = 0.036) and increased neonatal head circumference (β = 0.403, = 0.036). However, not all deviations from the "prudent-style" pattern were metabolically equivalent: while Pattern 3 (high-protein, carbohydrate) may offer partial protective effects, Pattern 4 (moderate protein/plant/sugar) displayed elements of nutritional imbalance with signs of placental inefficiency (β = -0.384, = 0.023). These findings underscore the dual impact of maternal BMI and diet quality on oxidative-inflammatory balance and perinatal outcomes, supporting the need for early, individualized nutritional strategies in pregnancy. This is further emphasized by the variability in dietary adherence across BMI categories.
孕期营养和孕前体重指数是妊娠结局的关键决定因素。这项前瞻性多中心观察性研究调查了153名体重正常（NW）、超重（OW）或肥胖（OB）的意大利健康孕妇的孕前体重指数、饮食模式与氧化/炎症状态之间的相互作用。在孕晚期和分娩时测量了详细的临床、生化、胎盘和新生儿数据。通过一份经过验证的问卷评估饮食摄入量，并使用主成分分析得出饮食模式。超重和肥胖女性的炎症（CRP、铁调素）和氧化应激生物标志物（DNA/RNA损伤、过氧化氢酶活性）水平显著高于体重正常女性。多变量模型证实了体重指数与这些生物标志物之间的独立关联（CRP：β = 0.297，P = 0.000；铁调素：β = 1.419，P = 0.006；DNA/RNA损伤：β = 409.9，P = 0.000；过氧化氢酶活性：β = 1.536，P = 0.000）。超氧化物歧化酶活性和总抗氧化能力与体重指数无关。相对于国家建议，各体重指数组的营养摄入在很大程度上未达最佳水平，多不饱和脂肪和关键微量营养素水平不足。确定了四种饮食模式，其依从性因体重指数而异。一种“谨慎型”模式（高植物性食物、低动物性食物）与孕周呈正相关（β = 0.243，P = 0.033），与新生儿头围呈负相关（β = -0.414，P = 0.050）。一种“西式”模式（高糖、零食、动物脂肪）与孕妇铁蛋白降低有关（β = -2.093，P = 0.036），与新生儿头围增加有关（β = 0.403，P = 0.036）。然而，并非所有偏离“谨慎型”模式的情况在代谢上都是等效的：虽然模式3（高蛋白、碳水化合物）可能具有部分保护作用，但模式4（中等蛋白质/植物性食物/糖）显示出营养失衡的迹象以及胎盘效率低下的迹象（β = -0.384，P = 0.023）。这些发现强调了孕妇体重指数和饮食质量对氧化-炎症平衡及围产期结局的双重影响，支持在孕期采取早期、个性化营养策略的必要性。不同体重指数类别在饮食依从性方面的差异进一步强调了这一点。
