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

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.

Download Full-text

27 Defining a robust sow: swine nutrition perspective on reproduction and lactation

Journal of Animal Science ◽

10.1093/jas/skz122.023 ◽

2019 ◽

Vol 97 (Supplement_2) ◽

pp. 13-13

Author(s):

Joel M DeRouchey ◽

Mike D Tokach ◽

Robert D Goodband ◽

Jason C Woodworth ◽

Steve S Dritz ◽

...

Keyword(s):

Birth Weight ◽

Milk Production ◽

Body Condition ◽

Fetal Growth ◽

Feed Intake ◽

Energy Requirement ◽

Meta Analysis ◽

Mammary Development ◽

Late Gestation ◽

Embryo Survival

Abstract Improvements in modern sow prolificacy have markedly increased the number of pigs weaned, thus the ability of sows to provide nutrients to support fetal growth and milk production has been enhanced. The goals of the gestation nutrition program consist of meeting the nutrient requirements for maintenance and growth and for adequate conceptus development, while managing body condition. Early gestation represents the best opportunity for replenishing body reserves, whereas in late gestation, both estimated protein deposition and energy requirement are exponentially increased and directed towards fetal growth and mammary development. Increased feed intake after breeding has been presumed to be detrimental to embryo survival; however, data with modern line sows demonstrates to feed thin sows to recover body condition as quickly as possible while avoiding feed deprivation immediately after breeding. Importance of body condition scoring remains unchanged: feed thin sows to bring back to adequate body condition and prevent over-conditioned sows at farrowing. A recent meta-analysis showed increasing late gestation feed intake seems to modestly improve piglet birth weight by 28 g per piglet in gilts and sows. Also, recent findings in gestating sows suggest modern genotypes have improved feed efficiency and propensity for growth. Therefore, increasing energy intake during late gestation has a modest effect on piglet birth weight and a negative effect on stillborn rate. Historically, lactation catabolism impacted subsequent reproductive performance of sows, particularly in first-parity. However, contemporary sows appear to be increasingly resistant to the negative effects of lactational catabolism. Even so, continued emphasis on maximizing lactation feed intake is critical to support milk production and prevent excessive lean tissue mobilization. Research data suggests that ad libitum feeding and offering lactation diets during the wean-to-estrus interval is not needed. Modern genetic sow lines appear to be more robust from a nutritional perspective than in the past.

Download Full-text

Fetal Thyroid Hormone Level at Birth Is Associated with Fetal Growth

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2010-2814 ◽

2011 ◽

Vol 96 (6) ◽

pp. E934-E938 ◽

Cited By ~ 60

Author(s):

Beverley M. Shields ◽

Beatrice A. Knight ◽

Anita Hill ◽

Andrew T. Hattersley ◽

Bijay Vaidya

Keyword(s):

Birth Weight ◽

Thyroid Hormone ◽

Cord Blood ◽

Thyroid Function ◽

Fetal Growth ◽

Late Gestation ◽

Third Trimester ◽

Free T4 ◽

Skeletal Size ◽

Fetal Thyroid

Context: Thyroid function is known to play an important role in fetal neurological development, but its role in regulating fetal growth is not well established. Overt maternal and fetal thyroid disorders are associated with reduced birth weight. We hypothesized that, even in the absence of overt thyroid dysfunction, maternal and fetal thyroid function influence fetal growth. Aim: In normal, healthy pregnancies, we aimed to assess whether fetal thyroid hormone at birth (as measured in cord blood) is associated with fetal growth. We also aimed to study whether fetal thyroid hormone at birth is associated with maternal thyroid hormone in the third trimester. Methods: In 616 healthy mother-child pairs, TSH, free T4 (FT4), and free T3 (FT3) were measured in mothers at 28 wk gestation and in umbilical cord blood at birth. Birth weight, length, head circumference, and tricep and bicep skinfold thicknesses were measured on the babies. Results: Cord FT4 was associated with birth weight (r = 0.25; P < 0.001), length (r = 0.17; P < 0.001), and sum of skinfolds (r = 0.19; P < 0.001). There were no associations between birth measurements and either cord TSH or cord FT3. Maternal FT4 and cord FT4 were correlated (r = 0.14; P = 0.0004), and there were weaker negative associations between maternal TSH and cord FT4 (r = −0.08; P = 0.04) and FT3 (r = −0.10; P = 0.01). Conclusion: Associations between cord FT4 and birth size suggest that fetal thyroid function may be important in regulating fetal growth, both of skeletal size and fat. The correlation between third-trimester maternal FT4 and cord FT4 supports the belief that maternal T4 crosses the placenta even in late gestation.

Download Full-text

316. MATERNAL DIETARY ARGININE SUPPLEMENTATION DURING LATE GESTATION IMPROVES REPRODUCTIVE EFFICIENCY IN PIGS

Reproduction Fertility and Development ◽

10.1071/srb10abs316 ◽

2010 ◽

Vol 22 (9) ◽

pp. 116

Author(s):

M. J. De Blasio ◽

C. T. Roberts ◽

K. Kind ◽

R. Smits ◽

M. Nottle ◽

...

Keyword(s):

Blood Flow ◽

Birth Weight ◽

Fetal Growth ◽

Umbilical Vein ◽

Late Gestation ◽

Critical Periods ◽

Placental Development ◽

Pregnant Rats ◽

Growth And Survival ◽

Arginine Supplementation

Arginine (a non-essential amino acid) and its conversion to nitric oxide (NO) can promote formation of new blood vessels and cause vasodilation. This may reduce resistance and increase blood flow to the uterus and placenta, and the delivery of nutrients for fetal growth and survival. In pregnant rats, dietary arginine deficiency causes IUGR and increases fetal death and perinatal mortality, whereas dietary arginine supplementation reverses this. Human IUGR is associated with impaired NO synthesis, and eNOS activity in umbilical vein endothelial cells, but maternal arginine supplements have produced inconclusive results. We hypothesised that maternal arginine supplementation (MAS) in the pig (a species with naturally occurring IUGR), during late gestation, when placental angiogenesis and vascularity increase, would increase birth and placental weights. Large White (LW) and Landrace (LR) gilts (n = 285) and sows (n = 326), were fed either a control or arginine supplemented (+25 g/d arginine, Nutreco Progenos premix) diet (2.5 kg/d) in late gestation (d75-term at ~114 days). Number born, born alive, still born and mummified, birth weight and d10 weight of progeny were measured. Data were analysed using Univariate ANOVA. MAS in late gestation in gilts and sows reduced the number of still born (Con: 1.17 ± 0.13 piglets/litter; Arg: 0.84 ± 0.09 piglets/litter; P = 0.046). In LW gilts, MAS increased birth weight (Con: 1.21 ± 0.05kg; Arg: 1.34 ± 0.05kg; P < 0.05), and litter birth weight (Con: 13.38 ± 0.72 kg; Arg: 15.27 ± 0.73 kg; P < 0.05). MAS also increased birth weight in LW (Con: 1.17 ± 0.06 kg; Arg: 1.30 ± 0.06 kg; P < 0.05) and LR (Con: 1.47 ± 0.05 kg; Arg: 1.60 ± 0.05 kg; P < 0.05) sows, and reduced still borns in LW sows (Con: 1.12 ± 0.14 piglets/litter; Arg: 0.77 ± 0.09 piglets/litter; P < 0.05). MAS in late gestation improves pregnancy outcomes in terms of piglet survival and birth weight, in LW and LR gilts and sows. MAS during critical periods of placental development may enhance placental-fetal blood flow and nutrient transfer, thereby improving fetal growth and survival.

Download Full-text

Fetal kidney volume and urine production in cases of fetal growth retardation

Journal of Perinatal Medicine ◽

10.1515/jpme.1987.15.3.307 ◽

1987 ◽

Vol 15 (3) ◽

pp. 307-315 ◽

Cited By ~ 29

Author(s):

Josef Deutinger ◽

Wolfgang Bartl ◽

Christian Pfersmann ◽

Julius Neumark ◽

Gerhard Bernaschek

Keyword(s):

Fetal Growth ◽

Growth Retardation ◽

Kidney Volume ◽

Fetal Growth Retardation ◽

Fetal Kidney ◽

Urine Production

Download Full-text

Nutrient partitioning during adolescent pregnancy

Reproduction ◽

10.1530/rep.0.1220347 ◽

2001 ◽

pp. 347-357 ◽

Cited By ~ 78

Author(s):

J Wallace ◽

D Bourke ◽

P Da Silva ◽

R Aitken

Keyword(s):

Birth Weight ◽

Pregnancy Outcome ◽

Adolescent Mothers ◽

Fetal Growth ◽

Adverse Pregnancy Outcome ◽

Late Gestation ◽

Gravid Uterus ◽

Maternal Body ◽

Increased Risk ◽

Nutrient Partitioning

Human adolescent mothers have an increased risk of delivering low birth weight and premature infants with high mortality rates within the first year of life. Studies using a highly controlled adolescent sheep paradigm demonstrate that, in young growing females, the hierarchy of nutrient partitioning during pregnancy is altered to promote growth of the maternal body at the expense of the gradually evolving nutrient requirements of the gravid uterus and mammary gland. Thus, overnourishing adolescent dams throughout pregnancy results in a major restriction in placental mass, and leads to a significant decrease in birth weight relative to adolescent dams receiving a moderate nutrient intake. High maternal intakes are also associated with increased rates of spontaneous abortion in late gestation and, for ewes delivering live young, with a reduction in the duration of gestation and in the quality and quantity of colostrum accumulated prenatally. As the adolescent dams are of equivalent age at the time of conception, these studies indicate that nutritional status during pregnancy rather than biological immaturity predisposes the rapidly growing adolescents to adverse pregnancy outcome. Nutrient partitioning between the maternal body and gravid uterus is putatively orchestrated by a number of endocrine hormones and, in this review, the roles of both maternal and placental hormones in the regulation of placental and fetal growth in this intriguing adolescent paradigm are discussed. Impaired placental growth, particularly of the fetal component of the placenta, is the primary constraint to fetal growth during late gestation in the overnourished dams and nutritional switch-over studies indicate that high nutrient intakes during the second two-thirds of pregnancy are most detrimental to pregnancy outcome. In addition, it may be possible to alter the nutrient transport function of the growth-restricted placenta in that the imposition of a catabolic phase during the final third of pregnancy in previously rapidly growing dams results in a modest increase in lamb birth weight.

Download Full-text

Infant birth weight is related to maternal arterial oxygenation at high altitude

Journal of Applied Physiology ◽

10.1152/jappl.1982.52.3.695 ◽

1982 ◽

Vol 52 (3) ◽

pp. 695-699 ◽

Cited By ~ 72

Author(s):

L. G. Moore ◽

S. S. Rounds ◽

D. Jahnigen ◽

R. F. Grover ◽

J. T. Reeves

Keyword(s):

Birth Weight ◽

High Altitude ◽

Fetal Growth ◽

Growth Retardation ◽

Hemoglobin Concentration ◽

Late Gestation ◽

Fetal Growth Retardation ◽

Arterial Oxygenation ◽

Maternal Characteristics ◽

Infant Birth

Infant birth weight is reported to decrease at high altitude as a reulst of fetal growth retardation (McCullough, Reeves, and Liljegren. Arch. Environ, Health. 32: 36--39, 1977) but not all babies born at high altitude are small. We hypothesized that maternal characteristics acting to lower arterial O2 content would contribute to smaller infant birth weight. To test this hypothesis, we measured arterial oxygenation serially during pregnancy and again postpartum in 44 residents of Leadville, CO (elevation 3,100 m). We identified three maternal characteristics--ventilation, hemoglobin concentration, and smoking habits--that were related to the birth weight of the offspring. Mothers of smaller babies (less than 2,900 g) compared to mothers of larger babies (greater than 3,500 g) were characterized by hypoventilation, no change or a decrease in ventilation and arterial O2 saturation from early to late gestation, and a falling hemoglobin concentration that combined to lower arterial O2 content in the 3rd trimester. Maternal smoking at 3,100 m was associated with a two to threefold greater reduction in infant birth weight (-546 g) than reported from sea level. Thus, maternal arterial oxygenation during pregnancy may be important for predicting fetal growth retardation and the process of adaptation to high altitude.

Download Full-text

Circulating maternal cytokines influence fetal growth in pregnant women with rheumatoid arthritis

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2012-202539 ◽

2012 ◽

Vol 72 (12) ◽

pp. 1995-2001 ◽

Cited By ~ 18

Author(s):

Florentien D O de Steenwinkel ◽

Anita C S Hokken-Koelega ◽

Yaël A de Man ◽

Y B de Rijke ◽

Maria A J de Ridder ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Birth Weight ◽

Disease Activity ◽

Pregnant Women ◽

Fetal Growth ◽

First Trimester ◽

Maternal Serum ◽

Time Points ◽

Lower Birth Weight ◽

Cytokine Levels

BackgroundHigh rheumatoid arthritis (RA) disease activity during pregnancy is associated with a lower birth weight. Active RA is characterised by high circulating levels of cytokines, which can mediate placental growth and remodelling.ObjectivesTo assess the influence of maternal serum cytokine levels on birth weight in RA pregnancy.MethodsThis study is embedded in the PARA Study, a prospective study on RA and pregnancy. In the present study, 161 pregnant women with RA and 32 healthy pregnant women were studied. The main outcome measures were birth weight SD score (birth weight SDS) in relation to maternal serum levels of interleukin-10 (IL-10), interleukin-6 (IL-6) and tumour necrosis factor-α (TNFα) at three different time points: preconception and during the first and third trimester. Single-nucleotide polymorphisms (SNPs) in the corresponding cytokine genes were also studied.ResultsDuring the first trimester, IL-10 was detectable in 16% of patients with RA, IL-6 in 71%, and TNFα in all patients with RA. Mean birth weight SDS of children born to mothers with RA was higher when IL-10 level was high compared with low (difference=0.75; p=0.04), and lower when IL-6 was high compared with low (difference=0.50; p<0.01) in the first trimester. No correlation was seen at the other time points studied or with TNFα. Cytokine levels were not related to their corresponding SNPs.ConclusionsMaternal IL-10 and IL-6 levels are associated with fetal growth in RA. In the first trimester, high IL-10 levels are associated with higher birth weight SDS, and high IL-6 levels are associated with lower birth weight SDS, even after correction for disease activity.

Download Full-text

FACTORS AFFECTING BIRTH WEIGHT

PEDIATRICS ◽

10.1542/peds.84.3.a90 ◽

1989 ◽

Vol 84 (3) ◽

pp. A90-A90

Author(s):

Student

Keyword(s):

Birth Weight ◽

Pregnant Women ◽

Fetal Growth ◽

Research Group ◽

Maternal Smoking ◽

Low Birthweight ◽

District General Hospital ◽

Maternal Height ◽

Socioeconomic Conditions ◽

Factors Affecting

Maternal smoking, stress, and poor socioeconomic conditions during pregnancy have been linked with low birthweight babies. Is there any way of deciding which of these related potential causes is the most important? In an attempt to do that a research group. . . studied over 1500 pregnant women delivering at a district general hospital in inner London. They showed that the most important influence on fetal growth was smoking, which was associated with a 5% reduction in birth weight after adjustment for maternal height and parity, gestation, and the baby's sex. Of over 40 socioeconomic and psychosocial factors examined, only four were significantly related to a reduction in birth weight, and these became non-significant after adjustment for smoking. The authors conclude that any effects of stress and poor environment on fetal growth are small compared with the effect of smoking.

Download Full-text

Dietary intake and nutritional adequacy prior to conception and during pregnancy: a follow-up study in the north of Portugal

Public Health Nutrition ◽

10.1017/s1368980008003595 ◽

2009 ◽

Vol 12 (7) ◽

pp. 922-931 ◽

Cited By ~ 51

Author(s):

Elisabete Pinto ◽

Henrique Barros ◽

Isabel dos Santos Silva

Keyword(s):

Vitamin E ◽

Dietary Intake ◽

Pregnant Women ◽

Gestational Age ◽

Public Hospitals ◽

Antenatal Visit ◽

Dietary Intakes ◽

National Guidelines ◽

Nutritional Adequacy

AbstractObjectiveTo assess maternal diet and nutritional adequacy prior to conception and during pregnancy.DesignFollow-up of a cohort of pregnant women with collection of questionnaire data throughout pregnancy and after delivery.SettingAntenatal clinics at two public hospitals in Porto, Portugal.SubjectsTwo hundred and forty-nine pregnant women who reported a gestational age below 13 weeks at the time they attended their first antenatal visit.ResultsIntakes of energy and macronutrients were within recommended levels for most women. Pregnancy was accompanied by increases in the dietary intake of vitamins A and E, riboflavin, folate, Ca and Mg, but declines in the intake of alcohol and caffeine. The micronutrients with higher inadequacy prevalences prior to pregnancy were vitamin E (83 %), folate (58 %) and Mg (19 %). These three micronutrients, together with Fe, were also those with the highest inadequacy prevalences during pregnancy (91 %, 88 %, 73 % and 21 %, respectively, for folate, Fe, vitamin E and Mg). Ninety-seven per cent of the women reported taking supplements of folic acid during the first trimester, but the median gestational age at initiation was 6·5 (interquartile range 5, 9) weeks. Self-reported prevalences of Fe and Mg supplementation were high, and increased throughout pregnancy.ConclusionThe study identified low dietary intakes of vitamin E, folate and Mg both in the preconceptional period and during pregnancy, and low intake of Fe during pregnancy only. The low dietary intake of folate and the late initiation of supplementation indicate that current national guidelines are unlikely to be effective in preventing neural tube defects.

Download Full-text

PRETERM BIRTH AND FETAL GROWTH RESTRICTION IN HIV-INFECTED BRAZILIAN PREGNANT WOMEN

Revista do Instituto de Medicina Tropical de São Paulo ◽

10.1590/s0036-46652015000200003 ◽

2015 ◽

Vol 57 (2) ◽

pp. 111-120 ◽

Cited By ~ 12

Author(s):

Helena Lucia Barroso DOS REIS ◽

Karina da Silva ARAUJO ◽

Lilian Paula RIBEIRO ◽

Daniel Ribeiro DA ROCHA ◽

Drielli Petri ROSATO ◽

...

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Low Birth Weight ◽

Hiv Infection ◽

Pregnant Women ◽

Fetal Growth ◽

Low Income ◽

Fetal Growth Restriction ◽

Growth Restriction ◽

Southeastern Brazil

Introduction: Maternal HIV infection and related co-morbidities may have two outstanding consequences to fetal health: mother-to-child transmission (MTCT) and adverse perinatal outcomes. After Brazilian success in reducing MTCT, the attention must now be diverted to the potentially increased risk for preterm birth (PTB) and intrauterine fetal growth restriction (IUGR). Objective: To determine the prevalence of PTB and IUGR in low income, antiretroviral users, publicly assisted, HIV-infected women and to verify its relation to the HIV infection stage. Patients and Methods: Out of 250 deliveries from HIV-infected mothers that delivered at a tertiary public university hospital in the city of Vitória, state of Espírito Santo, Southeastern Brazil, from November 2001 to May 2012, 74 single pregnancies were selected for study, with ultrasound validated gestational age (GA) and data on birth dimensions: fetal weight (FW), birth length (BL), head and abdominal circumferences (HC, AC). The data were extracted from clinical and pathological records, and the outcomes summarized as proportions of preterm birth (PTB, < 37 weeks), low birth weight (LBW, < 2500g) and small (SGA), adequate (AGA) and large (LGA) for GA, defined as having a value below, between or beyond the ±1.28 z/GA score, the usual clinical cut-off to demarcate the 10th and 90th percentiles. Results: PTB was observed in 17.5%, LBW in 20.2% and SGA FW, BL, HC and AC in 16.2%, 19.1%, 13.8%, and 17.4% respectively. The proportions in HIV-only and AIDS cases were: PTB: 5.9 versus 27.5%, LBW: 14.7% versus 25.0%, SGA BW: 17.6% versus 15.0%, BL: 6.0% versus 30.0%, HC: 9.0% versus 17.9%, and AC: 13.3% versus 21.2%; only SGA BL attained a significant difference. Out of 15 cases of LBW, eight (53.3%) were preterm only, four (26.7%) were SGA only, and three (20.0%) were both PTB and SGA cases. A concomitant presence of, at least, two SGA dimensions in the same fetus was frequent. Conclusions: The proportions of preterm birth and low birth weight were higher than the local and Brazilian prevalence and a trend was observed for higher proportions of SGA fetal dimensions than the expected population distribution in this small casuistry of newborn from the HIV-infected, low income, antiretroviral users, and publicly assisted pregnant women. A trend for higher prevalence of PTB, LBW and SGA fetal dimensions was also observed in infants born to mothers with AIDS compared to HIV-infected mothers without AIDS.

Download Full-text