Maternal Diet Influences Fetal Growth but Not Fetal Kidney Volume in an Australian Indigenous Pregnancy Cohort

Abstract

Suboptimal nutrition during pregnancy is recognised as a significant modifiable determinant in the development of chronic disease in offspring in later life. The current study aimed: (i) to assess the dietary intakes of pregnant Indigenous Australian women against national recommendations and (ii) to investigate the associations between maternal nutrition during pregnancy and the growth of the offspring, including kidney development in late gestation in the Gomeroi gaaynggal cohort (n = 103). Maternal dietary intake in the third trimester was assessed using the Australian Eating Survey Food Frequency Questionnaire. Estimated fetal weight (EFW) and kidney size were obtained by ultrasound. Birth weight was retrieved from hospital birth records. Of the five key nutrients for optimal reproductive health (folate, iron, calcium, zinc and fibre), the nutrients with the highest percentage of pregnant women achieving the nutrient reference values (NRVs) were zinc (75.7%) and folate (57.3%), whereas iron was the lowest. Only four people achieved all NRVs (folate, iron, calcium, zinc and fibre) important in pregnancy. Sodium and saturated fat intake exceeded recommended levels and diet quality was low, with a median score of 28 out of 73 points. After adjusting for smoking and pre-pregnancy body mass index, only maternal intake of retinol equivalents and the proportion of energy from nutrient-dense or energy-dense, nutrient-poor (EDNP) foods were associated with fetal growth. EFW decreased by 0.13 g and birth weight decreased by 0.24 g for every µg increase in maternal dietary retinol intake. Interestingly, EFW, but not actual birth weight, was positively associated with percentage energy from nutrient dense foods and negatively associated with percentage energy from EDNP foods. Dietary supplement usage was associated with increased birthweight, most significantly iron and folate supplementation. Current dietary intakes of pregnant Australian women from this cohort do not align with national guidelines. Furthermore, current findings show that maternal retinol intake and diet composition during pregnancy can influence fetal growth, but not fetal kidney growth in late gestation. Strategies that aim to support and optimise nutrient intakes of Indigenous pregnant women are urgently needed. Future studies with long-term follow-up of the children in the current cohort to assess renal damage and blood pressure are imperative.

Exploring the diets of mothers and their partners during pregnancy: Findings from the Queensland Family Cohort pilot study

“…An additional study limitation is the use of the AES FFQ and ARFS tool. Despite being previously used in pregnant women in Australia, 10,[48][49][50] it has not been validated in these populations. Furthermore, the dietary analysis only considered intakes of foods and not supplements which may result in under-reporting of various nutrients, particularly folic acid, iodine, and iron.…”

Associations between maternal iron supplementation in pregnancy and offspring growth and cardiometabolic risk outcomes in infancy and childhood

“…The mechanism of the nutritional programming leading to blood pressure changes in the rat models appear to be at least partially related to altered intrarenal haemodynamic properties [11] and/ or changes in numbers of nephrons [31]. It is possible that alterations in these renal factors underpin the subtle changes in blood pressure that we observed in humans, although the literature is devoid of evidence to that effect, and maternal iron supplementation was not associated with kidney volume in their children in one study [32]. Intriguingly though, in the MINIMat trial in rural Bangladesh, the glomerular filtration rate in children aged around 4.5 years was higher in those whose mothers had received 60 mg iron supplements in pregnancy compared with those whose mothers received half that dose [33].…”

Effect of dehydration during pregnancy on birth weight and length in West Jakarta

“…Deficiencies in the consumption of such intakes; protein, vitamins, PUFAs can cause stunted fetal/offspring development while consuming certain foods can have a beneficial impact on fetal growth and development ( 5 ) . For example, lack of retinol intake in dietary composition impacts fetal growth, but not on fetal kidney growth in late pregnancy ( 6 ) . Another thing to consider is the fulfillment of nutritional intake during preconception ( 7 ) .…”