Previous studies have shown that maternal consumption of polyphenol-rich foods after the third trimester of pregnancy may interfere with the anatomical and functional activity of the fetal heart as, to our knowledge, there are no validated instruments to quantify total polyphenols in pregnant women. The aim of this study was evaluate the reproducibility and validity of a food frequency questionnaire (FFQ), with 52 items, to assess the intake of polyphenol-rich foods in pregnant women in Brazil. This cross-sectional study included 120 pregnant women who participated in nutritional interviews in two moments. The intake of polyphenols estimated by the developed FFQ was compared with the average of two 24-h recalls (24HR), with the average intake measured by a 3-day food diary (D3days) and with the urinary excretion of total polyphenols. The triangular method was applied to calculate Pearson's correlation coefficients, intraclass correlation and Bland-Altman plots for the FFQ, using an independent biochemical marker, in addition to classification by quarters of consumption. The questionnaires were log transformed, adjusted for body mass index and gestational age. The adjustment for energy was applied only of 24HR and D3days. Analysis of the reproducibility between the FFQ showed a very high correlation (r = 0.72; P < 0.05). A low but significant association was observed between the FFQ and urinary excretion (0.23; P = 0.01). The association between the dietary survey methods was moderate to very high (r = 0.36 to r = 0.72; P < 0.001). In conclusion, this questionnaire showed reproducibility and validity for the quantification of consumption of total polyphenols in pregnant women.
This study in fetal lambs shows a cause and effect relationship between experimental maternal exposure of green tea and fetal ductus arteriosus constriction in late pregnancy.
Dietary intervention for maternal restriction of polyphenol-rich foods in the third trimester of pregnancy is accompanied by increase in plasma levels of PGE2 and reversal of fetal ductal constriction. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
BackgroundWe have recently demonstrated reversal of fetal ductal constriction after dietary maternal restriction of polyphenol-rich foods (PRF), due to its inhibitory action on prostaglandin synthesis. ObjectiveTo test the hyphotesis that normal third trimester fetuses also improve ductus arteriosus dynamics after maternal restriction of polyphenols. MethodsOpen clinical trial with 46 fetuses with gestational age (GA) ≥ 28 weeks submitted to 2 Doppler echocardiographic studies with an interval of at least 2 weeks, being the examiners blinded to maternal dietary habits. A validated food frequency questionnaire was applied and a diet based on polyphenol-poor foods (<30mg/100mg) was recommended. A control group of 26 third trimester fetuses was submitted to the same protocol. Statistics used t test for independent samples. ResultsMean GA was 33±2 weeks. Mean daily maternal estimated polyphenol intake (DMPI) was 1277mg, decreasing to 126mg after dietary orientation (p=0.0001). Significant decreases in systolic (SDV) and diastolic (DDV) ductal velocities, and RV/LV diameters ratio, as well as increase in ductal PI were observed [DSV=1.2±0.4m/s (0.7-1.6) to 0.9±0.3m/s (0.6-1.3) (p=0.018); DDV=0.21±0.09m/s (0.15-0.32) to 0.18±0.06m/s (0.11-0.25) (p=0.016); RV/LV ratio =1.3±0.2 (0.9-1.4) to 1.1±0.2 (0.8-1.3) (p=0.004); ductal PI=2.2±0.03 (2.0-2.7) to 2.4±0.4(2.2-2.9) (p=0.04)]. In the control group, with GA of 32±4 weeks, there were no significant differences in DMPI, mean SDV, DDV, PI and RV/LV ratio. ConclusionThe oriented restriction of third trimester maternal ingestion of polyphenol-rich foods for a period of 2 weeks or more improve fetal ductus arteriosus flow dynamics and right ventricular dimensions.
Objectives: Since we have already established that maternal consumption of polyphenol-rich foods (PRF) interferes with fetal ductus arteriosus (DA) flow in humans, probably mediated by prostaglandin E2 (PGE2) inhibition, and that restriction of PRF reverses ductal constriction, we aimed to assess experimentally the interrelations of ductal dynamics, oxidative damage and polyphenol excretion after a controlled diet of PRF in pregnant sheep. Methods: Nine > 120-days pregnant sheep were fed for 2 weeks with a normal diet (basal polyphenol intake, n = 2) and with a standardized amount of PRF (study group, basal intake +3100 mg/day, n = 7). Fetal DA systolic and diastolic flow velocities (SV and DV) and pulsatility index (PI) obtained by Doppler echocardiography, lipid peroxidation (LP) represented by plasma TBARS and urinary excretion of total polyphenols were assessed, before and 14 days after dietary intervention. Multiple comparison tests were used. Results: A significant increase of ductal SV and DV and a decrease in PI was shown after 14 days of intervention when compared to the basal state (SV:1.34 ± 0.01 versus 0.75 ± 0.05 m/s, P < 0.001, DV:0.28 ± 0.02 versus 0.18 ± 0.01 m/s, P < 0.001, PI:2.04 ± 0.11 versus 2.54 ± 0.07, P < 0.001), whereas no significant differences were observed in controls. Urinary total polyphenol excretion increased significantly after intervention (687.47 ± 106.47 versus 316.79 ± 30.31 mg GAE/g creatinine, P < 0.001) but not in controls. High TBARS levels (13.74 ± 0.53 mM) and no significant lipid peroxidation alteration were shown in controls, but TBARS tended to increase after 14 days. (15.50 ± 0.20 mM). There were no changes in oxidative status in the study group, but TBARS showed a tendency toward reduction (P = 0.051). Conclusions: Late pregnancy intake of PRF is followed by an increase in total polyphenol urinary excretion and by ductus arteriosus constriction in fetal lambs. Lipid peroxidation could not be ascribed to polyphenol intake, possibly due to higher ROS production in late pregnancy. OC08.03Brain metabolism assessed by magnetic resonance spectroscopy in fetuses with major congenital heart defects N. Objectives: To assess brain metabolism using magnetic resonance spectroscopy (MRS) in term fetuses with major congenital cardiac defects (CHD) compared with controls. Methods: A total of 34 fetuses with major CHD and 38 controls underwent a 3T MRS exam using a voxel on the frontal lobe and another on the basal ganglia (BG) using short echo time (TE) at 37 weeks. Of these, 25 CHD and 25 controls met quality criteria for spectroscopic analysis, the remaining being excluded due to fetal motion artefacts. Spectroscopic data were analyzed using LC Model.Metabolic information from both areas was calculated using choline (Cho) ratios. Statistical analysis was performed with multivariate analysis of covariance adjusted for gestational age at MRI, maternal smoking and body mass index. Results: We found significant differences in the metabolic spectra in frontal lobe and BG of fetuses...
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