Influence of Nutrients on Biomarkers of Placental Development In the 1st Trimester of Pregnancy
Sunday, June 26, 2011
Discipline: Women’s Health (WH), Childbearing (CB)
Learning Objectives:
- Identify the actions of nutrients for supporting placental development
- Identify biomarkers of placental development
- Discuss the implications of maternal nutrient intake in the 1st trimester on potential pregnancy outcomes
Objective: A pregnant woman’s dietary quality has a profound effect on placental development yet minimal research exists that assesses dietary intake during the 1st trimester when the developing placenta is particularly susceptible to alterations in maternal nutrition. The objective of this study is to provide foundational knowledge on the role that 1st trimester nutrition plays on placental development. The specific aim is to explore the relationships of maternal nutrient intake to makers of placental development that, if insufficient, may result in adverse pregnancy outcomes.
Design: An observational design was used in a clinic-based sample of low-income women in their 1st trimester of pregnancy.
Setting: Five clinics that provide free or low-cost pregnancy testing in Central Texas.
Patients/Participants: 70 women who received a confirmation of pregnancy from the clinics.
Methods: After screening, eligible women came to a Wellness Center, operated by the School of Nursing, completed some questionnaires, received training on estimating portion-size, completed a 24-hour dietary recall, had height and weight measured, and had blood drawn for dietary and placental biomarkers. Two additional 24-hour dietary recalls were obtained over the next two weeks.
Results: Women were on average 24.7 years old and 8 ½ weeks pregnant at the time of testing. Most of the women were unmarried, obese or overweight, and having an unintended pregnancy. Women consumed less than the recommended amounts of fruits, vegetables, meats, and dairy products, and had lower than recommended intake of proteins, iron and folate. Intake of Vitamin A was positively related to angiogenic VEGF (r =.25) and negatively related to antiangiogenic sFlt-1 (r = -.29). Intake of vitamin B6 , iron and zinc was negatively related to antiangiogenic sFlt-1 (r = -.25, r = -.24, r = -.25 respectively) and endoglin (r = -.28, r = -.32, r = -.28 respectively). Levels of antiangiogenic endoglin were negatively related to intake of B vitamins (B2 = -.34, B3 = -. 28; B12 = -.32) and positively related to intake of omega-6 fatty acids (r = .25) and transfatty acids (r = -.24).
Conclusion/Implications for nursing practice: Early placental development may be influenced by maternal nutrient intake, such that adequate intake of vitamins A, B and iron may promote placental development. Low-income women are likely to have inadequate intake of nutrients that contribute to positive pregnancy outcomes. Concentrated & consistent assessment of dietary intake and nutrition counseling is needed throughout pregnancy, especially in women with low resources. Early access to food subsidy programs should be promoted.
Design: An observational design was used in a clinic-based sample of low-income women in their 1st trimester of pregnancy.
Setting: Five clinics that provide free or low-cost pregnancy testing in Central Texas.
Patients/Participants: 70 women who received a confirmation of pregnancy from the clinics.
Methods: After screening, eligible women came to a Wellness Center, operated by the School of Nursing, completed some questionnaires, received training on estimating portion-size, completed a 24-hour dietary recall, had height and weight measured, and had blood drawn for dietary and placental biomarkers. Two additional 24-hour dietary recalls were obtained over the next two weeks.
Results: Women were on average 24.7 years old and 8 ½ weeks pregnant at the time of testing. Most of the women were unmarried, obese or overweight, and having an unintended pregnancy. Women consumed less than the recommended amounts of fruits, vegetables, meats, and dairy products, and had lower than recommended intake of proteins, iron and folate. Intake of Vitamin A was positively related to angiogenic VEGF (r =.25) and negatively related to antiangiogenic sFlt-1 (r = -.29). Intake of vitamin B6 , iron and zinc was negatively related to antiangiogenic sFlt-1 (r = -.25, r = -.24, r = -.25 respectively) and endoglin (r = -.28, r = -.32, r = -.28 respectively). Levels of antiangiogenic endoglin were negatively related to intake of B vitamins (B2 = -.34, B3 = -. 28; B12 = -.32) and positively related to intake of omega-6 fatty acids (r = .25) and transfatty acids (r = -.24).
Conclusion/Implications for nursing practice: Early placental development may be influenced by maternal nutrient intake, such that adequate intake of vitamins A, B and iron may promote placental development. Low-income women are likely to have inadequate intake of nutrients that contribute to positive pregnancy outcomes. Concentrated & consistent assessment of dietary intake and nutrition counseling is needed throughout pregnancy, especially in women with low resources. Early access to food subsidy programs should be promoted.
Keywords: Diet, Pregnancy, Placenta, Low-Income
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