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Special Issue "Nutrient Requirements and Dietary Intakes of Women during Pregnancy"

A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (13 June 2018)

Special Issue Editors

Guest Editor
Prof. Lucilla Poston

Department of Women and Children’s Health, Faculty of Life Sciences and Medicine, King’s College London, 10th floor North Wing St Thomas’ Hospital, London SE1 7EH, UK
Website | E-Mail
Interests: women and children’s health; maternal obesity; nutrition in pregnancy; gestational diabetes; pre-eclampsia; lifecourse of health and disease
Guest Editor
Dr. Angela Flynn

Department of Women and Children’s Health, Faculty of Life Sciences and Medicine, King’s College London, 10th floor North Wing St Thomas’ Hospital, London SE1 7EH, UK
E-Mail
Interests: nutrition in pregnancy; antenatal interventions in obese pregnancy; gestational diabetes; micronutrient status in pregnancy

Special Issue Information

Dear Colleagues,

The pivotal role of nutrition in pregnancy is well established, both for short-term pregnancy outcomes, and long-term health of the child. Globally, a concerted effort has been made towards improving the macro and micronutrient nutritional status of pregnant women, especially in low and middle-income countries (LMIC), with varying success. The limited benefits of nutrient supplements in LMIC has prompted a call for pre-conception intervention.

Due to the increasing prevalence of pre-existing maternal disorders which compromise pregnancy outcome and in which nutrition in pregnancy can modify health outcomes, there is a requirement for widely available specialist advice. Foremost amongst these disorders is the increase in the population prevalence of obesity that has resulted in more women being obese at the onset of pregnancy. Obesity is associated with a range of adverse outcomes for both mother and child and the increasing disease burden has prompted a substantive new literature focussing on nutrition in obese pregnant women which has yet to be widely disseminated. Nutritional requirements differ in pregnancy complicated by type 1 diabetes, and also in gestational diabetes (GDM) and polycystic ovary syndrome (PCOS), both of which are frequently associated with obesity. Chronic kidney disease (CKD) is also increasingly prevalent due to heightened prevalence of chronic hypertension and increasing age amongst pregnant women. A Special Issue of Nutrients, which focuses on these conditions, as well as normal pregnancy nutrition would be of immediate value to health care professionals, in providing a state-of-the-art summary of contemporary knowledge.

The objective of this proposed Special Issue on “Nutrient Requirements and Dietary Intakes of Women during Pregnancy” is, firstly, therefore to select papers, which focus on nutrition and its role in maternal health outcomes in low, middle and higher-income countries. Following this, selected papers will evaluate nutrient requirements and  strategies to improve nutrition in pregnancy complicated by Obesity, Type 1 diabetes , GDM, CKD and PCOS. This Special Issue should provide  a useful resource for health care professionals, as well as a general readership.

On this topic, you are invited to submit proposals for manuscripts that fit the objectives and the topics of this Special Issue.

Prof. Lucilla Poston
Dr. Angela Flynn
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Pregnancy
  • Nutrition
  • Obesity
  • Diabetes in pregnancy
  • Renal disease in pregnancy
  • Antenatal interventions
  • Polycystic Ovary syndrome
  • Macronutrients
  • Micronutrients
  • Low and Middle Income Countries
  • High Income Countries

Published Papers (12 papers)

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Research

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Open AccessArticle Adherence to the Mediterranean Diet and Serum Adiponectin Levels in Pregnancy: Results from a Cohort Study in Normal Weight Caucasian Women
Nutrients 2018, 10(7), 928; https://doi.org/10.3390/nu10070928 (registering DOI)
Received: 9 June 2018 / Revised: 10 July 2018 / Accepted: 18 July 2018 / Published: 20 July 2018
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Abstract
The Mediterranean Diet (MedDiet) is significantly associated with anti-inflammatory effects and a favorable health outcome. During pregnancy, both inflammatory changes and oxidative balance are essential for a successful outcome, while an unbalanced inflammatory response can be a key mediator of obstetrical syndromes. The
[...] Read more.
The Mediterranean Diet (MedDiet) is significantly associated with anti-inflammatory effects and a favorable health outcome. During pregnancy, both inflammatory changes and oxidative balance are essential for a successful outcome, while an unbalanced inflammatory response can be a key mediator of obstetrical syndromes. The aim of this study is to investigate the adherence to MedDiet during pregnancy in the 1st and in the 3rd trimester, and to test whether the adherence was associated with serum adiponectin levels. The study was carried out on 99 normal weight Caucasian women. The adherence to MedDiet was measured by a 13-point Mediterranean scale. The whole sample scored 7.2 ± 1.5, with no difference between first and third trimester (p = 0.7). Critical points were: fruit < 3 servings/day in 77% of the sample, beans < 3 times/week in 89%, fish < 2 times/week in 69%, and nut weekly intake < 30 g in 75%. The serum adiponectin levels significantly decreased from the first to the third trimester (−16% ± 4%, p = 0.008), which confirms a low-grade inflammatory condition associated with advancing gestational age. The women who were in the highest tertile of the adherence to MedDiet had a lower percentage decrease, as compared with those in the lowest tertile (10% ± 11% vs. −34% ± 3%, p = 0.01). Even if in pregnancy the adiponectin levels are strongly influenced by the low-grade inflammation, the adherence to MedDiet may modulate this state. Full article
(This article belongs to the Special Issue Nutrient Requirements and Dietary Intakes of Women during Pregnancy)
Open AccessArticle Dietary Determinants of Polyunsaturated Fatty Acid (PUFA) Status in a High Fish-Eating Cohort during Pregnancy
Nutrients 2018, 10(7), 927; https://doi.org/10.3390/nu10070927 (registering DOI)
Received: 13 June 2018 / Revised: 16 July 2018 / Accepted: 18 July 2018 / Published: 20 July 2018
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Abstract
Polyunsaturated fatty acids (PUFA) are essential for neurodevelopment and the developing foetus depends on an optimal maternal status. Fish is a rich source of PUFA. The current study investigated dietary patterns, and associations with PUFA status in a high-fish consuming cohort of pregnant
[...] Read more.
Polyunsaturated fatty acids (PUFA) are essential for neurodevelopment and the developing foetus depends on an optimal maternal status. Fish is a rich source of PUFA. The current study investigated dietary patterns, and associations with PUFA status in a high-fish consuming cohort of pregnant women in the Seychelles. At 28 weeks’ gestation, pregnant women provided a blood sample, from which serum total PUFA concentrations were measured, A Food Frequency Questionnaire (FFQ) and Fish Use Questionnaire (FUQ) were also completed. Principal component analysis (PCA) of dietary information identified four patterns. Regression analyses found dietary pattern 2, containing foods traditionally eaten in the Seychelles e.g., fish, fruit and vegetables was positively associated with serum docosahexaenoic acid (DHA) (β = 0.134; CI = 0.001, 0.022), and serum total n-3 PUFA (β = 0.139; CI = 0.001, 0.023) concentrations. Dietary pattern 1, high in processed foods, snacks, white meat and eggs, was not significantly associated with any of the serum PUFA concentrations. The FUQ indicated that fatty fish was associated with EPA status (β = 0.180; CI = 0.001, 0.005) in high consumers. The second dietary pattern, consisting of higher consumption of fish and fruit, was positively associated with n-3 PUFA status during pregnancy. Full article
(This article belongs to the Special Issue Nutrient Requirements and Dietary Intakes of Women during Pregnancy)
Open AccessArticle Interactions between Vitamin D Status, Calcium Intake and Parathyroid Hormone Concentrations in Healthy White-Skinned Pregnant Women at Northern Latitude
Nutrients 2018, 10(7), 916; https://doi.org/10.3390/nu10070916
Received: 18 June 2018 / Revised: 10 July 2018 / Accepted: 11 July 2018 / Published: 17 July 2018
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Abstract
Adverse effects of low vitamin D status and calcium intakes in pregnancy may be mediated through functional effects on the calcium metabolic system. Little explored in pregnancy, we aimed to examine the relative importance of serum 25-hydroxyvitamin D (25(OH)D) and calcium intake on
[...] Read more.
Adverse effects of low vitamin D status and calcium intakes in pregnancy may be mediated through functional effects on the calcium metabolic system. Little explored in pregnancy, we aimed to examine the relative importance of serum 25-hydroxyvitamin D (25(OH)D) and calcium intake on parathyroid hormone (PTH) concentrations in healthy white-skinned pregnant women. This cross-sectional analysis included 142 participants (14 ± 2 weeks’ gestation) at baseline of a vitamin D intervention trial at 51.9 °N. Serum 25(OH)D, PTH, and albumin-corrected calcium were quantified biochemically. Total vitamin D and calcium intakes (diet and supplements) were estimated using a validated food frequency questionnaire. The mean ± SD vitamin D intake was 10.7 ± 5.2 μg/day. With a mean ± SD serum 25(OH)D of 54.9 ± 22.6 nmol/L, 44% of women were <50 nmol/L and 13% <30 nmol/L. Calcium intakes (mean ± SD) were 1182 ± 488 mg/day and 23% of participants consumed <800 mg/day. The mean ± SD serum albumin-adjusted calcium was 2.2 ± 0.1 mmol/L and geometric mean (95% CI) PTH was 9.2 (8.4, 10.2) pg/mL. PTH was inversely correlated with serum 25(OH)D (r = −0.311, p < 0.001), but not with calcium intake or serum calcium (r = −0.087 and 0.057, respectively, both p > 0.05). Analysis of variance showed that while serum 25(OH)D (dichotomised at 50 nmol/L) had a significant effect on PTH (p = 0.025), calcium intake (<800, 800–1000, ≥1000 mg/day) had no effect (p = 0.822). There was no 25(OH)D-calcium intake interaction effect on PTH (p = 0.941). In this group of white-skinned women with largely sufficient calcium intakes, serum 25(OH)D was important for maintaining normal PTH concentration. Full article
(This article belongs to the Special Issue Nutrient Requirements and Dietary Intakes of Women during Pregnancy)
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Open AccessArticle Dietary Patterns Prior to Pregnancy and Associations with Pregnancy Complications
Nutrients 2018, 10(7), 914; https://doi.org/10.3390/nu10070914
Received: 13 June 2018 / Revised: 10 July 2018 / Accepted: 12 July 2018 / Published: 17 July 2018
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Abstract
Few studies have explored pre-pregnancy diet and its relationship with pregnancy outcomes. The objectives of this study were to: (1) derive pre-pregnancy dietary patterns for women enrolled in a prospective cohort in the province of Alberta, Canada; (2) describe associations between dietary patterns
[...] Read more.
Few studies have explored pre-pregnancy diet and its relationship with pregnancy outcomes. The objectives of this study were to: (1) derive pre-pregnancy dietary patterns for women enrolled in a prospective cohort in the province of Alberta, Canada; (2) describe associations between dietary patterns and socio-demographic characteristics; and (3) describe associations between dietary patterns and pregnancy complications. Upon enrolment into the Alberta Pregnancy Outcomes and Nutrition (APrON) study (median age of gestation, 17 weeks), women (n = 1545) completed a validated 142-item food frequency questionnaire recording food and beverages consumed “in the 12 months prior to pregnancy”. Other assessments included pre-pregnancy body mass index (BMI), gestational weight gain, gestational hypertension, gestational diabetes, and socio-demographic characteristics. Dietary patterns were derived using principal components analysis. Scores were calculated to represent adherence with each dietary pattern retained. Four dietary patterns were retained, accounting for 22.9% of the variation in the overall diet. Dietary patterns were named the “healthy”, “meat and refined carbohydrate”, “beans, cheese and salad” or “tea and coffee” patterns. Higher “healthy” pattern scores prior to pregnancy were associated with lower odds of developing gestational hypertension during pregnancy (adjusted Odds Ratio (OR): 0.6, 95% Confidence Intervals (CI): 0.4, 0.9). Diet prior to pregnancy is an important target for interventions and may reduce the likelihood of developing complications such as gestational hypertension during pregnancy. Full article
(This article belongs to the Special Issue Nutrient Requirements and Dietary Intakes of Women during Pregnancy)
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Open AccessArticle A Vegetarian Diet Is a Major Determinant of Gut Microbiota Composition in Early Pregnancy
Nutrients 2018, 10(7), 890; https://doi.org/10.3390/nu10070890
Received: 11 June 2018 / Revised: 2 July 2018 / Accepted: 3 July 2018 / Published: 12 July 2018
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Abstract
The composition of the gut microbiota can be influenced by dietary composition. In pregnancy, the maternal gut microbiome has associations with maternal and infant metabolic status. There is little known regarding the impact of a vegetarian diet in pregnancy on maternal gut microbiota.
[...] Read more.
The composition of the gut microbiota can be influenced by dietary composition. In pregnancy, the maternal gut microbiome has associations with maternal and infant metabolic status. There is little known regarding the impact of a vegetarian diet in pregnancy on maternal gut microbiota. This study explored the gut microbiota profile in women who were vegetarian or omnivorous in early gestation. Women were selected from participants in the Study of PRobiotics IN Gestational diabetes (SPRING) randomised controlled trial. Nine women identified as vegetarians were matched to omnivorous women in a 1:2 ratio. Microbiota analyses were performed using 16S rRNA gene amplicon sequencing and analysed using the Quantitative Insights Into Microbial Ecology (QIIME) and Calypso software tools. There was no difference in alpha diversity, but beta diversity was slightly reduced in vegetarians. There were differences seen in the relative abundance of several genera in those on a vegetarian diet, specifically a reduction in Collinsella, Holdemania, and increases in the relative abundances of Roseburia and Lachnospiraceae. In this sub-analysis of gut microbiota from women in early pregnancy, a vegetarian as compared to omnivorous diet, was associated with a different gut microbiome, with features suggesting alterations in fermentation end products from a mixed acid fermentation towards more acetate/butyrate. Full article
(This article belongs to the Special Issue Nutrient Requirements and Dietary Intakes of Women during Pregnancy)
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Open AccessArticle Effect of Nutritional Interventions on Micronutrient Status in Pregnant Malawian Women with Moderate Malnutrition: A Randomized, Controlled Trial
Nutrients 2018, 10(7), 879; https://doi.org/10.3390/nu10070879
Received: 10 June 2018 / Revised: 2 July 2018 / Accepted: 5 July 2018 / Published: 7 July 2018
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Abstract
Micronutrient deficiencies during pregnancy are common in Africa and can cause adverse outcomes. The objective was to measure micronutrient status and change in moderately malnourished pregnant Malawian women randomized to one of three nutritional interventions. Serum vitamin B12, 25-hydroxyvitamin D, folate,
[...] Read more.
Micronutrient deficiencies during pregnancy are common in Africa and can cause adverse outcomes. The objective was to measure micronutrient status and change in moderately malnourished pregnant Malawian women randomized to one of three nutritional interventions. Serum vitamin B12, 25-hydroxyvitamin D, folate, retinol, ferritin, zinc, albumin and C-reactive protein were measured in pregnant women with MUAC ≥20.6 cm and ≤23.0 cm at enrollment (n = 343) and after 10 weeks (n = 229) of receiving: (1) ready-to-use supplementary food (RUSF); (2) fortified corn-soy blend (CSB+) with multiple-micronutrient supplement (CSB+UNIMMAP); or (3) CSB+ with iron and folic acid (CSB+IFA). Each provided 100–300% Recommended Dietary Allowance of most micronutrients and 900 kcal/day. Birth length was measured in 272 infants. Enrollment measurements indicated deficiencies in vitamin B12 (20.9%) and zinc (22.3%), low values of ferritin (25.1%) and albumin (33.7%), and elevated CRP (46.0%). Vitamin B12 is known to decrease in the third trimester; the RUSF group had the smallest decrease from enrollment to week 10 (3%), compared to 20% decrease in the CSB+IFA group and 8% decrease in the CSB+UNIMMAP group (p = 0.001). Mean serum 25-hydroxyvitamin D increased most in the RUSF group (+6.4 ng/mL), compared to CSB+IFA (+1.7 ng/mL) and CSB+UNIMMAP (+2.7 ng/mL) (p < 0.001). Micronutrient deficiencies and inflammation are common among moderately malnourished pregnant women and had little improvement despite supplementation above the RDA, with the exception of vitamins B12 and D. Full article
(This article belongs to the Special Issue Nutrient Requirements and Dietary Intakes of Women during Pregnancy)
Open AccessArticle In Overweight or Obese Pregnant Women, Maternal Dietary Factors are not Associated with Fetal Growth and Adiposity
Nutrients 2018, 10(7), 870; https://doi.org/10.3390/nu10070870
Received: 31 May 2018 / Revised: 21 June 2018 / Accepted: 2 July 2018 / Published: 5 July 2018
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Abstract
The aim of our study was to evaluate associations between maternal dietary factors and fetal growth and adiposity in overweight and obese women. Women randomised to the ‘Standard Care’ group of the LIMIT trial were included. Maternal dietary factors including Healthy Eating Index,
[...] Read more.
The aim of our study was to evaluate associations between maternal dietary factors and fetal growth and adiposity in overweight and obese women. Women randomised to the ‘Standard Care’ group of the LIMIT trial were included. Maternal dietary factors including Healthy Eating Index, total energy, fat, carbohydrates, protein, glycaemic load and index were measured using the Harvard semi-quantitative Food Frequency questionnaire at time of study entry, 28 and 36 weeks’ gestation. Fetal ultrasound measurements of biometry and adiposity were obtained at 28 and 36 weeks’ gestation. Linear regression models were used to associate between dietary factors and fetal growth and adiposity measurements. There were 721 women included in this exploratory analysis. A 10 unit increase in the log total energy was associated with a reduction in mid-thigh lean mass by 4.94 mm at 28 weeks (95% CI −9.57 mm, −0.32 mm; p = 0.036) and 7.02 mm at 36 weeks (95% CI −13.69 mm, −0.35 mm; p = 0.039). A 10 unit increase in Healthy Eating Index score was associated with a reduced mean subscapular skin fold measure at 28 weeks by 0.17 mm (95% CI −0.32 mm, −0.03 mm; p = 0.021). We did not identify consistent associations between maternal diet and measures of fetal growth and adiposity in overweight and obese women. Full article
(This article belongs to the Special Issue Nutrient Requirements and Dietary Intakes of Women during Pregnancy)
Open AccessArticle Impact of Dietary Macronutrient Intake during Early and Late Gestation on Offspring Body Composition at Birth, 1, 3, and 5 Years of Age
Nutrients 2018, 10(5), 579; https://doi.org/10.3390/nu10050579
Received: 5 April 2018 / Revised: 3 May 2018 / Accepted: 4 May 2018 / Published: 8 May 2018
Cited by 1 | PDF Full-text (290 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Dietary intake during pregnancy as a possible modifiable risk factor for childhood obesity is poorly explored. In a prospective observational study, two multivariable regression models were therefore used to associate maternal diet at 15 and 32 weeks’ gestation with offsprings’ body composition and
[...] Read more.
Dietary intake during pregnancy as a possible modifiable risk factor for childhood obesity is poorly explored. In a prospective observational study, two multivariable regression models were therefore used to associate maternal diet at 15 and 32 weeks’ gestation with offsprings’ body composition and fat distribution at birth, 1, 3, and 5 years. Mean energy intake was 2157 ± 375 kcal (n = 186) in early and 2208 ± 460 kcal (n = 167) in late gestation. The partition model showed mostly no significant associations between maternal diet in early pregnancy and offspring body composition. In late pregnancy, higher fat intake was negatively associated with clinical outcomes at birth, 1, and 5 years. Protein intake was negatively associated with BMI z score (zBMI) at 3 and 5 years. A 10 g increase in fiber was associated with an increase of 3.50 mm2 abdominal subcutaneous fat at 1, 172.49 g fat mass at 3, and 0.23 zBMI at 5 years. Results were largely comparable in the substitution model. An incremental increase in fat and protein at the expense of carbohydrates in late but not early pregnancy may be associated with lower fat mass up to 5 years. Findings require confirmation by additional prospective studies. Full article
(This article belongs to the Special Issue Nutrient Requirements and Dietary Intakes of Women during Pregnancy)
Open AccessArticle Vitamin D Deficiency Prevalence and Predictors in Early Pregnancy among Arab Women
Nutrients 2018, 10(4), 489; https://doi.org/10.3390/nu10040489
Received: 28 January 2018 / Revised: 29 March 2018 / Accepted: 12 April 2018 / Published: 15 April 2018
Cited by 1 | PDF Full-text (292 KB) | HTML Full-text | XML Full-text
Abstract
Data regarding the prevalence and predictors of vitamin D deficiency during early pregnancy are limited. This study aims to fill this gap. A total of 578 Saudi women in their 1st trimester of pregnancy were recruited between January 2014 and December 2015
[...] Read more.
Data regarding the prevalence and predictors of vitamin D deficiency during early pregnancy are limited. This study aims to fill this gap. A total of 578 Saudi women in their 1st trimester of pregnancy were recruited between January 2014 and December 2015 from three tertiary care antenatal clinics in Riyadh, Saudi Arabia. Information collected includes socio-economic, anthropometric, and biochemical data, including serum vitamin D (25(OH)D) levels, intake of calcium and vitamin D, physical activity, and sun exposure indices. Pregnant women with 25(OH)D levels <50 nmol/L were considered vitamin D deficient. The majority of participants (n = 468 (81%)) were vitamin D deficient. High levels of indoor activity, whole body clothing, multiparity, total cholesterol/HDL ratio(>3.5), low HDL-cholesterol, and living in West Riyadh were significant independent predictors for vitamin D deficiency, with odds ratios (ORs) (95% confidence interval) of 25.4 (5.5–117.3), 17.8 (2.3–138.5), 4.0 (1.7–9.5), 3.3 (1.4–7.9), 2.8 (1.2–6.4), and 2.0 (1.1–3.5), respectively. Factors like increased physical activity, sun exposure at noon, sunrise or sunset, high educational status, and residence in North Riyadh were protective against vitamin D deficiency with ORs 0.2 (0.1–0.5); 0.2 (0.1–0.6); 0.3 (0.1–0.9); and 0.4 (0.2–0.8), respectively. All ORs were adjusted for age, BMI, sun exposure, parity, summer season, vitamin D intake, multivitamin intake, physical activity, education, employment, living in the north, and coverage with clothing. In conclusion, the prevalence of vitamin D deficiency among Saudi women during early pregnancy was high (81%). Timely detection and appropriate supplementation with adequate amounts of vitamin D should reduce the risks of vitamin D deficiency and its complications during pregnancy. Full article
(This article belongs to the Special Issue Nutrient Requirements and Dietary Intakes of Women during Pregnancy)
Open AccessArticle Adherence to the Caffeine Intake Guideline during Pregnancy and Birth Outcomes: A Prospective Cohort Study
Nutrients 2018, 10(3), 319; https://doi.org/10.3390/nu10030319
Received: 25 January 2018 / Revised: 24 February 2018 / Accepted: 5 March 2018 / Published: 7 March 2018
Cited by 1 | PDF Full-text (251 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
The aims of this study were to identify: (i) the proportion of women exceeding the caffeine intake guideline (>200 mg/day) during each trimester, accounting for point of pregnancy awareness; (ii) guideline adherence trajectories across pregnancy; (iii) maternal characteristics associated with trajectories; and (iv)
[...] Read more.
The aims of this study were to identify: (i) the proportion of women exceeding the caffeine intake guideline (>200 mg/day) during each trimester, accounting for point of pregnancy awareness; (ii) guideline adherence trajectories across pregnancy; (iii) maternal characteristics associated with trajectories; and (iv) association between adherence and growth restriction birth outcomes. Typical and maximal intake per consumption day for the first trimester (T1; pre- and post-pregnancy awareness), second (T2), and third trimester (T3) were recorded for a prospective cohort of pregnant Australian women with singleton births (n = 1232). Birth outcomes were birth weight, small for gestational age, and head circumference. For each period, participants were classified as abstinent, within (≤200 mg), or in excess (>200 mg). Latent class growth analyses identified guideline adherence trajectories; regression analyses identified associations between adherence in each trimester and birth outcomes. The percentage of participants who reported caffeine use declined between T1 pre- and post-pregnancy awareness (89% to 68%), and increased in T2 and T3 (79% and 80%). Trajectories were: ‘low consumption’ (22%): low probability of any use; ‘within-guideline’ (70%): high probability of guideline adherence; and ‘decreasing heavy use’ (8%): decreasing probability of excess use. The latter two groups were more likely to report alcohol and tobacco use, and less likely to report planning pregnancy and fertility problems. Exceeding the guideline T1 pre-pregnancy awareness was associated with lower birth weight after covariate control (b = −143.16, p = 0.011). Overall, high caffeine intake pre-pregnancy awareness occurs amongst a significant minority of women, and continued excess use post-pregnancy awareness is more common where pregnancy is unplanned. Excess caffeine consumption pre-pregnancy awareness may increase the risk for lower birth weight. Increasing awareness of the guideline in pregnancy and preconception health care may be warranted. Full article
(This article belongs to the Special Issue Nutrient Requirements and Dietary Intakes of Women during Pregnancy)

Review

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Open AccessReview The Association of Vitamin D Levels with Common Pregnancy Complications
Nutrients 2018, 10(7), 867; https://doi.org/10.3390/nu10070867
Received: 27 May 2018 / Revised: 30 June 2018 / Accepted: 3 July 2018 / Published: 5 July 2018
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Abstract
The association between vitamin D deficiency and various adverse pregnancy outcomes has been extensively investigated in recent years. The pregnant woman is the only source of vitamin D for the foetus. The main sources of vitamin D for pregnant women are sunlight, fortified
[...] Read more.
The association between vitamin D deficiency and various adverse pregnancy outcomes has been extensively investigated in recent years. The pregnant woman is the only source of vitamin D for the foetus. The main sources of vitamin D for pregnant women are sunlight, fortified dairy products, oily fish and dietary supplements. Vitamin D deficiency during pregnancy has been associated with some adverse neonatal outcomes as well as an increased risk of late pregnancy complications. The outcomes of the published studies investigating preeclampsia and gestational diabetes mellitus vary with some large trials suggesting a potential positive effect of vitamin D supplementation during pregnancy on the decreased risk of these complications. Research also suggests a possible connection between lower vitamin D concentrations and increased risk of preterm labour. In our manuscript, we aim to review the existing literature regarding the prevalence of vitamin D deficiency during pregnancy, the factors associated with vitamin D deficiency, and possible pregnancy complications arising from it. Full article
(This article belongs to the Special Issue Nutrient Requirements and Dietary Intakes of Women during Pregnancy)
Open AccessReview Maternal Anemia and Low Birth Weight: A Systematic Review and Meta-Analysis
Nutrients 2018, 10(5), 601; https://doi.org/10.3390/nu10050601
Received: 22 January 2018 / Revised: 28 April 2018 / Accepted: 1 May 2018 / Published: 12 May 2018
PDF Full-text (7809 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Objective: To systematically analyze the relationship between maternal anemia and low birth weight. Methods: A search of studies was conducted in the main databases (Medline, Embase, Scopus, Web of Science, SciELO, and Lilacs), the gray literature, and the reference lists of selected articles.
[...] Read more.
Objective: To systematically analyze the relationship between maternal anemia and low birth weight. Methods: A search of studies was conducted in the main databases (Medline, Embase, Scopus, Web of Science, SciELO, and Lilacs), the gray literature, and the reference lists of selected articles. Cohort and case-control studies that met the eligibility criteria were included in the review. There was no limitation on the language or date of publication. Article selection and data extraction were performed by two independent reviewers. Meta-analyses with random effects, subgroup analyses and meta-regressions were performed. Publication bias was measured using Egger regression and visual funnel plot inspection. Results: A total of 7243 articles were found, of which 71 comprised the systematic review and 68 were included in the meta-analyses. Maternal anemia was associated with low birth weight with an adjusted OR: 1.23 (95% CI: 1.06–1.43) and I2: 58%. The meta-regressions confirmed that the sample size and the methodological quality may partially explain the statistical heterogeneity. Conclusions: Maternal anemia was considered a risk factor for low birth weight. Full article
(This article belongs to the Special Issue Nutrient Requirements and Dietary Intakes of Women during Pregnancy)
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