RESUMO
In 2013-2014 we undertook a randomised controlled trial (RCT) to determine whether the daily ingestion of dark chocolate during pregnancy could reduce the incidence of pre-eclampsia in primigravidae. However, after two years we had not succeeded in recruiting more than 3.5% of the number of participants required to answer the research question, and the trial was halted. We also reviewed the literature on this topic and found it to be limited. We report here our findings and discuss the difficulties facing researchers in this area.
Assuntos
Chocolate , Seleção de Pacientes , Pré-Eclâmpsia/dietoterapia , Fatores de Confusão Epidemiológicos , Feminino , Humanos , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de PesquisaRESUMO
Objectives A number of interventions to reduce disparities in maternal health have been introduced and implemented without concrete evidence to support them. In Korea, a universal voucher scheme for antenatal care and birth services was initiated in December 2008 to improve Korea's fertility rate. This study explores the risk of preeclampsia after the introduction of a universal voucher scheme. Methods Population-based cohort data from the National Health Insurance Service-National Sample Cohort (NHIS-NSC) covering 2002-2013 were analysed. A generalized linear mixed model (GLMM) was used to estimate the relationship between the risk of preeclampsia and voucher scheme introduction. Results The annual age-adjusted incidence of preeclampsia showed no significant unidirectional change during the study period. In the GLMM analysis, the introduction of a voucher scheme was associated with a reduced risk of preeclampsia, controlling for potential confounding factors. The interaction between household income level and voucher scheme was not significant. Conclusions for Practice This finding suggests that the introduction of a voucher scheme for mothers is related to a reduced risk of preeclampsia even under universal health coverage.
Assuntos
Serviços de Saúde Materna/normas , Pré-Eclâmpsia/prevenção & controle , Cuidado Pré-Natal/métodos , Adolescente , Adulto , Feminino , Programas Governamentais/métodos , Programas Governamentais/normas , Humanos , Serviços de Saúde Materna/estatística & dados numéricos , Pré-Eclâmpsia/dietoterapia , Pré-Eclâmpsia/epidemiologia , Gravidez , Cuidado Pré-Natal/normas , Cuidado Pré-Natal/estatística & dados numéricos , República da Coreia/epidemiologia , Fatores de Risco , Comportamento de Redução do Risco , Cobertura Universal do Seguro de Saúde , Populações Vulneráveis/estatística & dados numéricosRESUMO
Complications of pregnancy are associated with adverse outcomes for mother and baby in the short and long term. The gut microbiome has been identified as a key factor for maintaining health outside of pregnancy and could contribute to pregnancy complications. In addition, the vaginal and the recently revealed placental microbiome are altered in pregnancy and may play a role in pregnancy complications. Probiotic supplementation could help to regulate the unbalanced microflora composition observed in obesity and diabetes. Here, the impact of probiotic supplementation during pregnancy and infancy is reviewed. There are indications for a protective role in preeclampsia, gestational diabetes mellitus, vaginal infections, maternal and infant weight gain and allergic diseases. Large, well-designed randomised controlled clinical trials along with metagenomic analysis are needed to establish the role of probiotics in adverse pregnancy and infancy outcomes.
Assuntos
Diabetes Gestacional/prevenção & controle , Placenta/microbiologia , Pré-Eclâmpsia/prevenção & controle , Complicações na Gravidez/prevenção & controle , Probióticos/uso terapêutico , Aumento de Peso , Adulto , Diabetes Gestacional/dietoterapia , Suplementos Nutricionais , Feminino , Humanos , Recém-Nascido , Pré-Eclâmpsia/dietoterapia , Gravidez , Complicações na Gravidez/dietoterapia , Complicações na Gravidez/microbiologia , Fenômenos Fisiológicos da Nutrição Pré-Natal , Resultado do TratamentoRESUMO
Preeclampsia may be due to an excess of circulating anti-angiogenic growth factors derived from the placenta, but metabolic syndrome-like disorders may also set off a cascade of placental and systemic inflammation and oxidative stress. We present a case of severe superimposed preeclampsia with obesity, diabetes and a mild imbalance of angiogenic factors, in which diet therapy ameliorated the preeclamptic signs while improving the adiponectin level. A 41-year-old pregnant woman with obesity and diabetes was referred to our hospital because of severe proteinuria and hypertension at 22 weeks of gestation. After administration of insulin and hydralazine with diet therapy, her hypertension and proteinuria were ameliorated with a 15-kg weight loss. Her adiponectin level was low and her leptin level was high, but her angiogenic factor levels were within the normal ranges for pregnant women at admission. The diet therapy ameliorated her hypertension and proteinuria while improving her adiponectin level as she achieved weight loss. This case suggests that diet therapy for obese preeclampsia patients with a mild imbalance of anti-and pro-angiogenic factors may play an important role in managing preeclampsia. Measurements of maternal adipocytokines and angiogenic factors may be important to distinguish the main cause of preeclampsia, i.e., poor placentation or maternal constitutional factors, for managing preeclampsia in patients with obesity.
Assuntos
Adipocinas/sangue , Indutores da Angiogênese/sangue , Obesidade/complicações , Pré-Eclâmpsia/sangue , Gravidez em Diabéticas/sangue , Adulto , Feminino , Humanos , Obesidade/sangue , Obesidade/dietoterapia , Pré-Eclâmpsia/dietoterapia , Pré-Eclâmpsia/etiologia , Gravidez , Gravidez em Diabéticas/dietoterapiaRESUMO
Current guidelines lack sufficient evidence to recommend a specific blood pressure lowering strategy to prevent cardiovascular disease after preeclampsia. We conducted a double-blind cross-over trial to identify the most potent antihypertensive strategy: renin-angiotensin-aldosterone system (RAAS) inhibition (losartan), sympathoinhibition (moxonidine), low sodium diet and placebo (n = 10). Due to low inclusion rate our study stopped prematurely. Initiatory analyses showed no significant effect of antihypertensive strategy on office blood pressure and 24-hour blood pressure. However, nocturnal dipping was significantly higher on RAAS inhibition and low sodium diet compared to placebo and sympathoinhibition. Optimal cardiovascular prevention after preeclampsia should be further explored.
Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II/administração & dosagem , Doenças Cardiovasculares/prevenção & controle , Imidazóis/administração & dosagem , Losartan/administração & dosagem , Pré-Eclâmpsia , Adulto , Pressão Sanguínea , Estudos Cross-Over , Abordagens Dietéticas para Conter a Hipertensão/métodos , Método Duplo-Cego , Feminino , Idade Gestacional , Humanos , Período Pós-Parto , Pré-Eclâmpsia/dietoterapia , Pré-Eclâmpsia/tratamento farmacológico , Gravidez , Sistema Renina-Angiotensina/efeitos dos fármacosRESUMO
Preeclampsia is a devastating hypertensive pregnancy disorder that currently affects 2%-8% of pregnancies worldwide. It is associated with maternal and fetal mortality and morbidity and adverse health outcomes both in mom and offspring beyond pregnancy. The pathophysiology is not completely understood, and there are no approved therapies to specifically treat for the disease, with only few therapies approved to manage symptoms. Recent advances suggest that aberrations in the composition of the microbiome may play a role in the pathogenesis of various diseases including preeclampsia. The maternal and uteroplacental environments greatly influence the long-term health outcomes of the offspring through developmental programming mechanisms. The current review summarizes recent developments on the role of the microbiome in adverse pregnancy outcomes with a focus on preeclampsia. It also discusses the potential role of the maternal microbiome in fetal programming; explores gut-targeted therapeutics advancement and their implications in the treatment of preeclampsia.
Assuntos
Desenvolvimento Fetal/fisiologia , Microbiota/fisiologia , Pré-Eclâmpsia/fisiopatologia , Efeitos Tardios da Exposição Pré-Natal/fisiopatologia , Animais , Feminino , Humanos , Pré-Eclâmpsia/diagnóstico , Pré-Eclâmpsia/dietoterapia , Prebióticos/administração & dosagem , Gravidez , Efeitos Tardios da Exposição Pré-Natal/diagnóstico , Efeitos Tardios da Exposição Pré-Natal/dietoterapia , Probióticos/administração & dosagemRESUMO
BACKGROUND: Evidence on the potential roles that dietary patterns play in the risk of preeclampsia remains limited. OBJECTIVE: To examine the associations between dietary patterns during pregnancy and the risk of preeclampsia. STUDY DESIGN: We analyzed data from a cluster randomized controlled trial among 987 healthy pregnant women in three rural counties in northwestern China. Maternal diet during the whole pregnancy was assessed using a 107-item food frequency questionnaire with proportion size administered before delivery. Principal component factor analysis with varimax rotation was used to identify common dietary patterns. Preeclampsia was diagnosed by trained clinicians and recorded in delivery records. RESULTS: Nineteen participants (1.9%) were diagnosed with preeclampsia. Gestational hypertension and proteinuria were only weakly correlated with each other (Kappaâ¯=â¯0.06): 10.7% participants with gestational hypertension only, 8.8% with proteinuria only, 1.9% with both, and 78.6% with neither. Five common dietary patterns were identified: vegetable, meat, fruit, snack, and wheat staple patterns. After adjusting for calories, other dietary pattern scores and baseline blood pressure, a higher vegetable pattern scores was associated with lower risk of preeclampsia (P for trendâ¯=â¯0.041; the highest vs lowest quartile, adjusted relative riskâ¯=â¯0.20 [95% confidence interval, 0.04-0.98]). A similar association was also observed for the risk of proteinuria (P for trendâ¯=â¯0.015): the highest vs lowest quartiles of the vegetable pattern score, adjusted relative riskâ¯=â¯0.44 (95% confidence interval, 0.24-0.80). The other four pattern scores were not associated with preeclampsia. CONCLUSIONS: Adherence to vegetable dietary pattern may be associated with the lower risk of preeclampsia, possibly through reducing development of proteinuria. The original full study was registered at clinicaltrials.gov as NCT02537392.
Assuntos
Dieta , Pré-Eclâmpsia/dietoterapia , Verduras , Adulto , China , Feminino , Humanos , Pré-Eclâmpsia/urina , Gravidez , Proteinúria , Fatores de Risco , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND: Preeclampsia is the major problem and the main leading cause of fetal and maternal mortality worldwide. The early prediction of preeclampsia in pregnant women is required to prevent the occurrence of preeclampsia. The mean arterial pressure (MAP) and roll-over test (ROT) are the combination of measurement which can be used to predict preeclampsia. On the contrary, Ajwa dates were reported to have an enormous activity which contributes to its role in improving health conditions. In this study, we aimed to evaluate the effect of daily consumption of seven Ajwa dates on prevention of preeclampsia, through MAP and ROT changes. METHODS: Forty pregnant women (n = 40) were randomly assigned into the control group (n = 10) and the intervention group which received a daily intake of Ajwa dates (n = 30). The MAP and ROT were assessed before and after the 8-week intervention period. RESULTS: The intervention group showed the significant reduction in MAP and ROT following the 8-week intervention period (p < 0.05). CONCLUSION: Daily consumption of seven Ajwa dates has a remarkable potential to decrease the MAP and ROT in pregnant women at risk of developing preeclampsia, and thus, it can contribute to prevent the development of preeclampsia.
Assuntos
Pressão Arterial/efeitos dos fármacos , Phoeniceae , Pré-Eclâmpsia/dietoterapia , Adulto , Feminino , Humanos , Pré-Eclâmpsia/fisiopatologia , Pré-Eclâmpsia/prevenção & controle , Gravidez , Cuidado Pré-NatalRESUMO
AIM: Disturbed placentation results in pregnancy complications like preeclampsia. Placental development is influenced by apoptosis during trophoblast differentiation and proliferation. Increased oxidative stress upregulates placental apoptosis. We have earlier reported increased oxidative stress, lower omega-3 fatty acids and vitamin E levels in women with preeclampsia. Current study examines effect of maternal omega-3 fatty acids and vitamin E supplementation on apoptotic markers across gestation in a rat model of preeclampsia. MAIN METHODS: Pregnant Wistar rats were randomly assigned to control; early onset preeclampsia (EOP); late onset preeclampsia (LOP); early onset preeclampsia + omega-3 fatty acid + vitamin E supplementation (EOP + O + E) and late onset preeclampsia + omega-3 fatty acid + vitamin E supplementation (LOP + O + E) groups. Animals (Control, EOP, EOP + O + E) were sacrificed at d14 and d20 of gestation while animals (LOP, LOP + O + E) were sacrificed at d20 to collect blood and placentae. Protein and mRNA levels of apoptotic markers were analyzed by ELISA and RT-PCR respectively. KEY FINDINGS: Protein levels of proapoptotic markers like Bcl-2 associated X-protein (BAX) (pâ¯<â¯0.05), caspase-8 and 3 (pâ¯<â¯0.01 for both) and malondialdehyde (pâ¯<â¯0.01) were higher only in the EOP group as compared to control. However, the antiapoptotic marker, B cell lymphoma 2 (Bcl-2) protein levels were lower in both the subtypes of preeclampsia (pâ¯<â¯0.01 for both). SIGNIFICANCE: Our findings suggest that supplementation was beneficial in reducing the caspase-8 and 3 in early onset preeclampsia but did not normalize BAX and Bcl-2 levels. This has implications for reducing placental apoptosis in preeclampsia.
Assuntos
Ácidos Graxos Ômega-3/uso terapêutico , Pré-Eclâmpsia/dietoterapia , Vitamina E/uso terapêutico , Animais , Apoptose/fisiologia , Biomarcadores/metabolismo , Caspase 3/análise , Caspase 3/sangue , Caspase 8/análise , Caspase 8/sangue , Suplementos Nutricionais , Modelos Animais de Doenças , Ácidos Graxos Ômega-3/metabolismo , Feminino , Masculino , Fenômenos Fisiológicos da Nutrição/fisiologia , Estresse Oxidativo/fisiologia , Placenta/metabolismo , Pré-Eclâmpsia/metabolismo , Gravidez , Efeitos Tardios da Exposição Pré-Natal/metabolismo , RNA Mensageiro/metabolismo , Ratos , Ratos Wistar , Vitamina E/metabolismo , Proteína X Associada a bcl-2/análise , Proteína X Associada a bcl-2/sangueRESUMO
This study was carried out to elucidate the role of asymmetric dimethylarginine (ADMA) and nitric oxide (NO) in preeclampsia development, and to investigate the effect of L-arginine supplementation in rats. Preeclampsia was induced in pregnant rats using a stress model. L-arginine was administered orally and ADMA, urinary nitrate, and protein levels were measured on the 20th day of pregnancy. Compared with the group of rats that are normally pregnant, the levels of blood pressure (BP), protein excretion, and ADMA were significantly increased in preeclampsia which returned to normal levels following the supplementation of L-arginine. Both group of rats had similar urine nitrate levels. Arginine-ADMA-NO pathway is affected in preeclampsia. L-arginine supplementation decreased hypertension (HT), proteinuria, and ADMA levels indicating that taking L-arginine may be beneficial in preeclampsia treatment.
Assuntos
Arginina/análogos & derivados , Arginina/administração & dosagem , Suplementos Nutricionais , Hipertensão/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Pré-Eclâmpsia/dietoterapia , Pré-Eclâmpsia/metabolismo , Proteinúria/metabolismo , Administração Oral , Animais , Arginina/antagonistas & inibidores , Arginina/metabolismo , Arginina/fisiologia , Modelos Animais de Doenças , Feminino , Hipertensão/dietoterapia , Hipertensão/fisiopatologia , Estresse Oxidativo/fisiologia , Pré-Eclâmpsia/fisiopatologia , Gravidez , Proteinúria/dietoterapia , Proteinúria/fisiopatologia , Ratos , Ratos Wistar , Transdução de Sinais/efeitos dos fármacosRESUMO
Vitamin D is produced in response to the exposure of skin to sunlight through UV-B synthesis. It can also be obtained from diet and dietary supplements. Vitamin D is essential for strong bones as it helps to absorb calcium from diet. Vitamin D deficiency mainly occurs if strict vegetarian diet is followed as mostly the source of vitamin D is animal based; therefore, exposure to sunlight is restricted or having dark skin color. Low vitamin D levels results in increased possibility of gestational diabetes among pregnant women, low birth weight and pre-eclampsia in infants, and mothers may suffer bone impairment, osteoporosis, hypocalcaemia, and hypertension. Vitamin D deficiency is directly linked with severe complication in mothers and neonates, causing rickets, poor fetal growth and infantile eczema in neonates. Higher prevalence rate of vitamin D deficiency has led professionals to emphasize on development of relevant precautionary measures.
Assuntos
Diabetes Gestacional/sangue , Suplementos Nutricionais , Hipocalcemia/sangue , Osteoporose/sangue , Pré-Eclâmpsia/sangue , Deficiência de Vitamina D/sangue , Vitamina D/análogos & derivados , Animais , Criança , Pré-Escolar , Complicações do Diabetes , Diabetes Gestacional/dietoterapia , Diabetes Gestacional/fisiopatologia , Feminino , Humanos , Hipocalcemia/complicações , Hipocalcemia/dietoterapia , Hipocalcemia/fisiopatologia , Lactente , Recém-Nascido , Mães , Osteoporose/complicações , Osteoporose/dietoterapia , Osteoporose/fisiopatologia , Pré-Eclâmpsia/dietoterapia , Pré-Eclâmpsia/fisiopatologia , Gravidez , Luz Solar , Vitamina D/administração & dosagem , Vitamina D/sangue , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/dietoterapia , Deficiência de Vitamina D/fisiopatologiaRESUMO
It was hypothesized that primary renal sodium retention blunted the reactivity of the renin-angiotensin-aldosterone system to changes in salt intake in preeclampsia (PE). A randomized, cross-over, double-blinded, dietary intervention design was used to measure the effects of salt tablets or placebo during low-salt diet in PE patients (n = 7), healthy pregnant women (n = 15), and nonpregnant women (n = 13). High-salt intake decreased renin and angiotensin II concentrations significantly in healthy pregnant women (P < .03) and in nonpregnant women (P < .001), but not in PE (P = .58), while decreases in aldosterone and increases in brain natriuretic peptid (BNP) were similar in the groups. In PE patients, uterine and umbilical artery indices were not adversely changed during low-salt diet. Creatinine clearance was significantly lower in PE with no change by salt intake. PE patients displayed alterations of plasma renin and angiotensin II in response to changes in dietary salt intake compatible with a primary increase in renal sodium reabsorption in hypertensive pregnancies.
Assuntos
Aldosterona/metabolismo , Canais Epiteliais de Sódio/efeitos dos fármacos , Pré-Eclâmpsia/dietoterapia , Sistema Renina-Angiotensina/efeitos dos fármacos , Cloreto de Sódio na Dieta/efeitos adversos , Adulto , Aldosterona/sangue , Angiotensina II/sangue , Determinação da Pressão Arterial , Creatinina/sangue , Dieta Hipossódica , Método Duplo-Cego , Feminino , Humanos , Pré-Eclâmpsia/urina , Gravidez , Reabsorção Renal , Renina/sangue , Cloreto de Sódio na Dieta/metabolismo , Artéria Uterina/fisiologiaRESUMO
Environmental and lifestyle factors are known to play an important role during gestation, determining newborns' health status and influencing their risk of being subject to certain noncommunicable diseases later in life. In particular, maternal nutritional patterns characterized by a low intake of plant-derived foods could increase the risk of gestation-related issues, such as preeclampsia and pregravid obesity, increase genotoxicant susceptibility, and contribute to the onset of pediatric diseases. In particular, the risk of pediatric wheeze, diabetes, neural tube defects, orofacial clefts, and some pediatric tumors seems to be reduced by maternal intake of adequate amounts of vegetables, fruits, and selected antioxidants. Nevertheless, plant-based diets, like any other diet, if improperly balanced, could be deficient in some specific nutrients that are particularly relevant during gestation, such as n-3 (ω-3) fatty acids, vitamin B-12, iron, zinc, and iodine, possibly affecting the offspring's health state. Here we review the scientific literature in this field, focusing specifically on observational studies in humans, and highlight protective effects elicited by maternal diets enriched in plant-derived foods and possible issues related to maternal plant-based diets.
Assuntos
Dieta Vegetariana , Comportamento Alimentar , Fenômenos Fisiológicos da Nutrição Materna , Adutos de DNA/efeitos dos fármacos , Diabetes Gestacional/dietoterapia , Diabetes Gestacional/prevenção & controle , Feminino , Frutas , Humanos , Micronutrientes/administração & dosagem , Mutagênicos/toxicidade , Obesidade/dietoterapia , Obesidade/prevenção & controle , Estudos Observacionais como Assunto , Pré-Eclâmpsia/dietoterapia , Pré-Eclâmpsia/prevenção & controle , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto , VerdurasRESUMO
INTRODUCTION: Observational studies confirm a higher incidence of preeclampsia in patients with low erythrocyte concentrations of omega-3 fatty acids. Observations point to an association of disorders of pregnancy, such as intrauterine growth restriction (IUGR) and preeclampsia, with excessive apoptosis. One potential mechanism of action of docosahexaenoic acid (DHA) promoting a reduction in the risk of pathological pregnancy may be by influencing these processes in the placenta. MATERIALS AND METHODS: We investigated 28 pregnant women supplemented with a fish oil product containing 300 mg DHA starting from pregnancy week 20 until delivery (DHA group). The control group consisted of 50 women who did not receive such supplementation (control group). We determined the expression of Ki-67 and p21 as markers of proliferation and caspase 3 activity as a marker of apoptosis and DHA levels in umbilical cord blood. RESULTS: Caspase 3 activity was significantly lower in the DHA group in comparison to the control group. Umbilical cord blood DHA concentration was higher in the DHA group. The expression of the proteins p21 and Ki-67 did not differ significantly between the groups. CONCLUSIONS: We observed an association between DHA supplementation and inhibition of placental apoptosis. We did not find an association between DHA and proliferation process in the placenta.
Assuntos
Suplementos Nutricionais , Ácidos Docosa-Hexaenoicos/administração & dosagem , Placenta/efeitos dos fármacos , Pré-Eclâmpsia/dietoterapia , Adulto , Apoptose/efeitos dos fármacos , Caspase 3/biossíntese , Proliferação de Células/efeitos dos fármacos , Feminino , Regulação da Expressão Gênica , Humanos , Antígeno Ki-67/biossíntese , Placenta/metabolismo , Placenta/patologia , Pré-Eclâmpsia/genética , Pré-Eclâmpsia/patologia , GravidezRESUMO
Calcium supplementation during pregnancy has been provided either to increase the intake in those with a deficiency or to obtain a pharmacologic, perhaps nonnutritional, effect in individuals with an adequate calcium intake. A systematic review, including only randomized, double-blind, controlled trials of calcium supplementation during pregnancy was prepared independently for the Cochrane Library and updated by us for this paper. In view of the heterogeneity of results included in the meta-analysis, a stratified analysis by baseline dietary calcium intake (mean calcium intake in the population < or >/=900 mg/d) was conducted. On the basis of the results of the 5 randomized, controlled trials available, the risk of high blood pressure was lower in women with low baseline dietary calcium [typical relative risk (TRR): 0.49; 95% CI: 0.38, 0.62]. Of the 4 trials in which subjects had adequate dietary calcium, the TRR of high blood pressure was 0.90 (95% CI: 0.81, 0.99). The risk of preeclampsia was considerably reduced in the 6 trials conducted in populations with low-calcium diets (TRR: 0.32; 95% CI: 0.21, 0.49) but was not reduced as much in women enrolled in the 4 trials with adequate-calcium diets (TRR: 0.86; 95% CI: 0.71, 1.05). On the basis of these results, it seems clear that calcium supplementation during pregnancy for women with deficient calcium intake is a promising preventive strategy for preeclampsia. Calcium supplementation in pregnancy should be evaluated definitively in an adequately sized trial conducted in a population with a low calcium intake because this is the most likely population to benefit from such a nutritional intervention. Long-term health benefits for the offspring are also an attractive possibility.
Assuntos
Cálcio da Dieta/administração & dosagem , Suplementos Nutricionais , Hipertensão/prevenção & controle , Pré-Eclâmpsia/prevenção & controle , Complicações Cardiovasculares na Gravidez/prevenção & controle , Ensaios Clínicos como Assunto , Fatores de Confusão Epidemiológicos , Feminino , Humanos , Hipertensão/dietoterapia , Pré-Eclâmpsia/dietoterapia , Gravidez , Complicações Cardiovasculares na Gravidez/dietoterapiaRESUMO
The National Cholesterol Education Program recommends that healthy Americans aged > 2 y reduce energy intake to maintain ideal body weight, saturated fat to 10% of energy, fat intake to 30% of energy, and cholesterol consumption to < 300 mg/d. Although these guidelines exclude pregnant or lactating women, nursing infants, and very young children, women with gestational diabetes, preeclampsia, and familial hyperlipidemias may benefit from them. In a normal pregnancy, serum cholesterol and triglycerides rise 25-40% and 200-400%, respectively. Multiparous middle-aged women may have an increased incidence of angina and cholesterol gallstones from the hypercholesterolemia of pregnancy. Few studies support the safety of maternal low-fat diets for the developing fetus or demonstrate benefits to the mother. Polyunsaturated fatty acids lower serum lipids, and n-3 fatty acids may improve some obstetric complications. Arachidonic acid (20:4) and docosahexaenoic acid (22:6) may benefit the psychomotor and visual development of children.
Assuntos
Gorduras na Dieta/administração & dosagem , Lactação/metabolismo , Gravidez/metabolismo , Adulto , Animais , Diabetes Gestacional/dietoterapia , Feminino , Humanos , Hiperlipidemia Familiar Combinada/dietoterapia , Hiperlipidemias/etiologia , Hiperlipidemias/metabolismo , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Trabalho de Parto Prematuro/dietoterapia , Pré-Eclâmpsia/dietoterapia , Complicações na Gravidez/dietoterapiaRESUMO
To study whether balance between antiaggregatory, vasodilatory prostacyclin (PGI2) and proaggregatory, vasoconstrictory thromboxane A2 (TXA2) could be affected by dietary manipulation, 18 pre-eclamptic women were treated in randomized order between 31 and 36 weeks of gestation either with primrose oil (n = 7), with fish oil (n = 5), or with placebo (n = 6). Urinary excretions of the degradation products of PGI2 (6-keto-PGF1 alpha, 2,3-dinor-6-keto-PGF1 alpha) and TXA2 (TXB2, 2,3-dinor-TXB2) were measured in 24 h urines before and serially during the supplementation. Fatty acid supplementation did not affect urinary prostanoid excretions or clinical signs of pre-eclampsia.
Assuntos
Epoprostenol/urina , Ácidos Graxos Essenciais/farmacologia , Óleos de Peixe/farmacologia , Pré-Eclâmpsia/dietoterapia , Tromboxano A2/urina , Feminino , Humanos , Ácidos Linoleicos , Oenothera biennis , Óleos de Plantas , Pré-Eclâmpsia/urina , Gravidez , Resultado da Gravidez , Ácido gama-LinolênicoRESUMO
New knowledge of maternal and infant nutrition has resulted in several changes within the past decade. Major changes in recommendations for maternal and infant nutrition have been highlighted. These recommendations are important to update dietitians, extension nutritionists, home economists, nurses, and other health professionals and paraprofessionals on the current maternal and infant nutrition recommendations.
Assuntos
Fenômenos Fisiológicos da Nutrição do Lactente , Fenômenos Fisiológicos da Nutrição , Gravidez , Peso Corporal , Feminino , Humanos , Lactente , Necessidades Nutricionais , Pré-Eclâmpsia/dietoterapiaRESUMO
This article reviews the major milestones in obstetric research in the past 90 years, which have lead to the wide-spread use of salt restriction during pregnancy. Possibly the most ardent advocate of the view that salt plays a crucial role in eclampsia was De Snoo (1877-1949), a Dutch obstetrician. However, despite many enthusiastic clinical reports, no convincing evidence has ever been produced that salt restriction helps in the prevention of hypertension during pregnancy.
Assuntos
Eclampsia/história , Obstetrícia/história , Pré-Eclâmpsia/história , Sódio na Dieta/administração & dosagem , Eclampsia/prevenção & controle , Feminino , História do Século XX , Humanos , Hipertensão/prevenção & controle , Países Baixos , Pré-Eclâmpsia/dietoterapia , Pré-Eclâmpsia/prevenção & controle , Gravidez , Complicações Cardiovasculares na Gravidez/prevenção & controleRESUMO
OBJECTIVE: To study the effect of calcium supplementation on reduction of pre-eclampsia in Iranian women at high risk of pre-eclampsia. METHODS: Thirty pregnant women at high risk of developing pre-eclampsia were randomized to 2 g of daily calcium and placebo. Subjects and investigators were blinded to treatment allocation. The inclusion criteria were positive rollover test, having at least one risk factor for pre-eclampsia, between 28 and 32 weeks of pregnancy, and blood pressure less than 140/90 (mm Hg). Exclusion criteria were having any chronic condition. Pre-eclampsia was defined as systolic/diastolic blood pressure over 140/90 plus proteinuria. All the subjects were followed up to delivery. RESULT: A sevenfold reduction in the occurrence of pre-eclamsia were seen among the calcium group compared with the placebo group (7 out of 15 developed pre-eclampsia in control group vs. 1 out of 15 in calcium group, P=0.014). No major effect on pregnancy induced hypertension was seen (66% in placebo and 76% in calcium group developed hypertension) but the onset of hypertension was delayed 3 weeks in the calcium group. A longer duration of pregnancy was seen in calcium than placebo (mean+/-S.D.=37+/-2 for calcium and 34+/-2 for placebo, P<0.05). Infants born to the calcium group, on average, were 552 g heavier than infants born to the placebo group, P<0.05. CONCLUSION: Calcium supplementation is beneficial for preventing pre-eclampsia among Iranian women at high risk of developing pre-eclampsia.