Maternal nutritional risk factors for pre-eclampsia incidence: findings from a narrative scoping review

Abstract

Background Pre-eclampsia is a leading cause of maternal mortality and morbidity that involves pregnancy-related stressors on the maternal cardiovascular and metabolic systems. As nutrition is important to support optimal development of the placenta and for the developing fetus, maternal diets may play a role in preventing pre-eclampsia. The purpose of this scoping review is to map the maternal nutritional deficiencies and imbalances associated with pre-eclampsia incidence and discuss evidence consistency and linkages with current understandings of the etiology of pre-eclampsia. Methods A narrative scoping review was conducted to provide a descriptive account of available research, summarize research findings and identify gaps in the evidence base. Relevant observational studies and reviews of observational studies were identified in an iterative two-stage process first involving electronic database searches then more sensitive searches as familiarity with the literature increased. Results were considered in terms of their consistency of evidence, effect sizes and biological plausibility. Results The review found evidence for associations between nutritional inadequacies and a greater risk of pre-eclampsia. These associations were most likely mediated through oxidative stress, inflammation, maternal endothelial dysfunction and blood pressure in the pathophysiology of pre-eclampsia. Maternal nutritional risk factors for pre-eclampsia incidence with the strongest consistency, effect and biological plausibility include vitamin C and its potential relationship with iron status, vitamin D (both on its own and combined with calcium and magnesium), and healthy dietary patterns featuring high consumption of fruits, vegetables, whole grains, fish, seafood and monounsaturated vegetable oils. Foods high in added sugar, such as sugary drinks, were associated with increased risk of pre-eclampsia incidence. Conclusion A growing body of literature highlights the involvement of maternal dietary factors in the development of pre-eclampsia. Our review findings support the need for further investigation into potential interactions between dietary factors and consideration of nutritional homeostasis and healthy dietary patterns. Further research is recommended to explore gestational age, potential non-linear relationships, dietary diversity and social, cultural contexts of food and meals.

Current perspectives on perinatal mental health and neurobehavioral development: focus on regulation, coregulation and self-regulation

“…We refer to [73 ▪▪ ,123] for recent overviews. We cite recent reviews addressing these complex, multifacted processes involving: mother-fetus-placenta unit [78]; HPA axis and cortisol [120,124 ▪ ,125]; autonomic nervous system [125]; iron deficiency [126]; maternal inflammation and offspring microglial activity [127]; mitochondria [128]; microbiome [10,129–131]; maternal metabolic risk factors including diabetes, obesity, undernutrition, specific macro- and micronutrient intake (e.g., long-chain polyunsaturated fatty acids (PUFAs) [132–135]; epigenetic changes, epigenome wide associations studies, relevant for e.g., the HPA axis or oxytocin system [136] including DNA methylation, histone modification, microRNA and other-non coding RNA [73 ▪▪ ,135,137–139] or multiomics data (transcriptomics, proteomics, metabolomics, and microbiomics [140]); telomere length [57]; paternal mediated effects [141,142]; oxidative stress [143], breast milk composition [78]; oxytocin system [73 ▪▪ ]; serotonin functions (e.g., SCL6A4) [73 ▪▪ ]; brain-derived neurotrophic factor (BDNF) [73 ▪▪ ]; structural and functional brain alterations beyond regions previously identified as relevant (i.e., prefrontal cortex, hippocampus, amygdala (limbic system)) additionally including basal ganglia, anterior cingulate cortex, thalamus, middle and superior frontal gyri, occipital gyrus and precentral gyrus [9,31,108].…”

Meta-analysis of the effects of lifestyle interventions during pregnancy to prevent hypertensive disorders of pregnancy

“…Large amounts of metabolites produced from different tryptophan metabolic pathways show both bene cial and harmful effects [50] the application of a healthy dietary pattern to women during pregnancy can reduce hypertensive disorders, while inadequate eating habits can affect women's health, worsening hypertensive disorders, leading to the birth of PE and small-for-gestational-age infants (SGA) [51] . low intake of fruits, green leafy vegetables, poultry and sh, Western dietary patterns (with high intake of red meat, processed meats, re ned grain products, high fats and/ or highsugar processed foods) may be associated with an increased risk of HDP and GDM [52] . Milk probiotics have also been found to be bene cial in at risk pregnant women [53] , Sodium butyrate in drinking water may prevent maternal TF-induced hypertension in offspring by modulating the gut microbiota, its derived metabolites, and RAS [50] .…”

Hubungan antara kadar homosistein (Hcy) dengan kejadian ketuban pecah dini (KPD) pada kehamilan preterm

“…Hcy menarik perhatian untuk diteliti karena potensinya yang dapat memprediksi terjadinya keadaan patologis pada kehamilan, seperti preeklampsia, keguguran berulang, berat badan lahir rendah, pertumbuhan janin terhambat, persalinan preterm spontan, abrupsio plasenta, serta kematian fetus. 10 Kadar Hcy rendah dalam serum pada tahap awal kehamilan. Kemudian, kadar Hcy meningkat secara bertahap hingga 60% pada bulan ketiga kehamilan.…”