Associations between First Trimester Maternal Nutritional Score, Early Markers of Placental Function, and Pregnancy Outcome

Abstract

This study investigated the associations between maternal adherence to a healthy diet, first trimester placental markers, and pregnancy outcome. Singleton spontaneous pregnancies were enrolled at 11+0–13+6 gestational weeks in a prospective cohort study. A nutritional score (0–10) measuring the adherence to a healthy diet was calculated. A transabdominal ultrasound scan for placental marker assessment was performed (uterine artery (UtA) doppler, placental volume). Biochemical placental markers were recorded (Pregnancy Associated Plasma Protein A (PAPP-A), free β- Human Chorionic Gonadotropin (HCG)). Birth outcomes were obtained from medical records. Associations between the maternal nutritional score, first trimester placental markers, and pregnancy outcome were investigated by using multi-adjusted general linear models. In total, 112 pregnancies were enrolled with a median nutritional score of 7 (range 3–10). Median gestational age at birth was 277 days (range 203–296). The nutritional score was positively associated with PAPP-A concentrations, whereas a negative association was detected with the UtA mean pulsatility index and placental volume. A positive association was detected between nutritional score and gestational age at birth. This study demonstrates that a first trimester nutritional score as a measure of adherence to a healthy diet is significantly associated with early biochemical and ultrasound markers of placental development, with further association with gestational age at birth.

Association of Parental Height With Offspring Stunting in 14 Low- and Middle-Income Countries

“…Maternal short height is also an indicator of her lower health stock and inadequate net nutrition accumulation ( 10 ). Lack of nutrition of pregnant women adversely affects placental growth that causes inadequate nutrient transmission and oxidative stress to the fetus ( 39 , 40 ), which may subsequently trigger epigenetic modification such as DNA methylation to affect fetal programming that leads to fetal growth faltering ( 41 ). All these above conditions can increase the risk of delivering infants with low birth weight and immature immune systems, who are susceptible to infection ( 42 ).…”

Role of Inflammaging on the Reproductive Function and Pregnancy

“…Additionally, a correct dietary intake of essential micronutrients (zinc, copper, selenium) stimulates the immune system and antioxidant enzymes, with a strong epigenetic effect on many genes related to inflammation and oxidative stress, contributing to the rebalancing of the inflammatory state and the integrity of metabolic function [147]. A specific immunomodulatory role has also been demonstrated for vitamin D and many guidelines indicate supplementation with vitamin D during pregnancy for the prevention of pregnancy complications [148] Individual nutritional assessment in the periconceptional period may prove useful in addressing specific nutritional deficiencies with simple scoring systems to provide advice during obstetrical assessment [149]. Besides this, it is mandatory to reduce all potential sources of increased inflammation, such as smoking [21] but also by implementing practices such as oral hygiene [28] Another promising, simple, and safe strategy for reducing inflammaging is the use of probiotics, which provides many advantages during the periconceptional period, pregnancy and breastfeeding, lowering bacterial vaginosis, GDM, Streptococcus B haemolyticus colonization, postpartum depression, and atopic sensitization [150][151][152][153].…”

Maternal Dietary Quality and Dietary Inflammation Associations with Offspring Growth, Placental Development, and DNA Methylation

“…Folate in particular is thought to play a key role in placental angiogenesis (critical for development of a normal placental circulation) by increasing the bioavailability of nitric oxide [17,47]. This is an important endothelium vasodilator, and its decreased bioavailability is associated with the production of reactive oxygen species involved in poor placental development [133,145]. Furthermore, maternal vitamin B 12 deficiency in rats altered placental phospholipid ratios, underscoring the potential of micronutrients in influencing placental development and composition [137].…”