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Maternal, Fetal and Postnatal Nutrition

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Public Health".

Deadline for manuscript submissions: closed (15 March 2021) | Viewed by 26376

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Prof. Dr. Cecilia Martínez-Costa

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Guest Editor

1. Department of Pediatrics, School of Medicine, University of Valencia, Hospital Clínico Universitario of Valencia, Avenida Blasco Ibáñez 15–17, 46010 Valencia, Spain
2. Gastroenterology and Nutrition Unit, Hospital Clínico Universitario, Avenida Blasco Ibáñez 17, 46010 Valencia, Spain
Interests: Clinical Nutrition; Child Nutrition; Nutrition Assessment; Nutrition; Nutritional Epidemiology; Metabolic Syndrome; Human Nutrition; Neonatology; Dietetics; Childhood Obesity

Prof. Dr. Javier Estañ

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Guest Editor

1. Department of Pediatrics, University of Valencia Spain
2. Neonatologist. Hospital Clínico Universitario of Valencia, Spain
Interests: Pediatrics; Obstetrics; Gynaecology

Special Issue Information

Dear Colleagues,

Maternal nutrition is a key point to enhance fetal and neonatal health, and also contributes to shape the perinatal microbiome, which has been identified as an outstanding issue related to maternal–neonatal health outcomes, including preterm delivery. Maternal nutritional status should be monitored even before conception and during pregnancy, considering the great negative impact of malnutrition, increasing the risk of preterm delivery, fetal and neonatal health, as well as long-term consequences in childhood and adulthood. Maternal obesity and micronutrient deficits (vitamins A and D, zinc, calcium, iodine, iron, etc.) increase the risk of developing diseases later in life.

Despite the advances in neonatal care during the last several decades, neonates born very preterm (before 32 weeks’ gestational age) are a significant public health concern because of their high risk of mortality and life-long disability. Postnatal growth failure of the very-low-birthweight infant is commonly reported from neonatal intensive care units (NICUs) around the world. Difficulty in achieving intrauterine growth rates, and consequently a progressive reduction of the body weight percentile, is a persistent problem affecting a large proportion of preterm infants. In general, this appears to be because of the inadequate provision of nutritional requirements, rather than an inability of the preterm infants to grow along their percentiles. The neurodevelopmental outcome of the very-low-birthweight infants (VLBWs) is closely linked to nutritional intakes and growth. Therefore, adequate neonatal nutrition has been suggested as an essential strategy to improve mortality and reduce morbidity in such immature infants. The aim of increasing nutritional intakes using enhanced intravenous and enteral protocols outstanding human milk benefits have been widely adopted in neonatal units. To promote exclusive maternal breastmilk feeding, specific design strategies should be implemented. Human milk banking should also be recommended, but without passing over the importance of donor selection and early individualized fortification.

Nutritional recommendations in VLBW infants focus on early high protein intake, rapid increase in calories, and adequate provision of essential fatty acids, but glucose intolerance during the first days is quite a common issue interfering with a well-balanced energy intake. There is no consensus around what come first—high protein intake or providing enough non-protein calories.

Another topic, the standard of postnatal growth, has been a controversial issue during last several decades as the survival of VLBW infants improves. Is it just a matter of achieving a normal weight, normal proportions, and a normal body composition once the infants arrive at term equivalent age? If so, which are the best references: fetal growth charts or preterm newborn standard growth charts? Maybe a better analysis of the quality of weight gain, rather than the quantity, derived from a measurement of body composition and direct measurement of the nutritional value of breastmilk should be the gold standard, but is it feasible in neonatal clinical practice?

In this Special Issue, we aim to broaden our knowledge of all essential aspects of perinatal nutrition. Potential topics include the following:

Impact of maternal nutrition, obesity, and micronutrient deficiencies in fetal and neonatal health;
The role of perinatal microbiome in postnatal growth;
Strategies to enhance the use human breast milk in NICUs.
Defining “aggressive” neonatal nutrition and its long-term consequences;
How to better define postnatal growth restriction;
Postnatal growth charts.

Prof. Cecilia Martínez-Costa
Prof. Javier Estañ
Guest Editors

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Keywords

maternal nutrition
maternal microbiome
neonatal/infant nutrition
neonatal/infant microbiome
preterm nutritional requirements
postnatal growth charts

Published Papers (8 papers)

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Research

15 pages, 1836 KiB

Open AccessArticle

Breastfeeding Practices Influence the Breast Milk Microbiota Depending on Pre-Gestational Maternal BMI and Weight Gain over Pregnancy

by Erika Cortés-Macías, Marta Selma-Royo, Cecilia Martínez-Costa and Maria Carmen Collado

Nutrients 2021, 13(5), 1518; https://doi.org/10.3390/nu13051518 - 30 Apr 2021

Cited by 16 | Viewed by 4201

Abstract

Breastfeeding is critical for adequate neonatal microbial and immune system development affecting neonate health outcomes in the short and long term. There is a great interest in ascertaining which are the maternal factors contributing to the milk microbiota and the potential relevance for the developing infant. Thus, our study aimed to characterize the effect of mixed and exclusive breastfeeding practices on the milk microbiota and to determine the impact of pre-pregnancy body mass index (BMI) and weight gain over pregnancy on its composition. Breast milk samples from 136 healthy women were collected within the first month post-partum and milk microbiota profiling was analyzed by 16S rRNA gene sequencing. Information on breastfeeding habits and maternal-infant clinical data were recorded. Breastfeeding practices (exclusive vs. mixed), maternal pre-gestational BMI, and weight gain over pregnancy contributed to the milk microbiota variation. Pre-gestational normal-weight women with exclusive breastfeeding habits harbored a significantly higher abundance of Bifidobacterium genus, and also, higher alpha-diversity compared to the rest of the women. Our results confirm the importance of controlling weight during pregnancy and breastfeeding practices in terms of milk microbiota. Further studies to clarify the potential impact of these maternal factors on milk and infant development and health will be necessary. Full article

(This article belongs to the Special Issue Maternal, Fetal and Postnatal Nutrition)

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10 pages, 923 KiB

Open AccessArticle

Effects of Periconceptional Multivitamin Supplementation on Folate and Homocysteine Levels Depending on Genetic Variants of Methyltetrahydrofolate Reductase in Infertile Japanese Women

by Keiji Kuroda, Takashi Horikawa, Yoko Gekka, Azusa Moriyama, Kazuki Nakao, Hiroyasu Juen, Satoru Takamizawa, Yuko Ojiro, Koji Nakagawa and Rikikazu Sugiyama

Nutrients 2021, 13(4), 1381; https://doi.org/10.3390/nu13041381 - 20 Apr 2021

Cited by 4 | Viewed by 4811

Abstract

Methylenetetrahydrofolate reductase (MTHFR) has various polymorphisms, and the effects of periconceptional folic acid supplementation for decreasing neural tube defects (NTDs) risk differ depending on the genotypes. This study analyzed the effectiveness of multivitamin supplementation on folate insufficiency and hyperhomocysteinemia, depending on MTHFR polymorphisms. Of 205 women, 72 (35.1%), 100 (48.8%) and 33 (16.1%) had MTHFR CC, CT and TT, respectively. Serum folate and homocysteine levels in women with homozygous mutant TT were significantly lower and higher, respectively, than those in women with CC and CT. In 54 women (26.3% of all women) with a risk of NTDs, multivitamin supplementation containing folic acid and vitamin D for one month increased folate level (5.8 ± 0.9 to 19.2 ± 4.0 ng/mL, p < 0.0001) and decreased the homocysteine level (8.2 ± 3.1 to 5.8 ± 0.8 nmol/mL, p < 0.0001) to minimize the risk of NTDs in all women, regardless of MTHFR genotype. Regardless of MTHFR genotype, multivitamin supplements could control folate and homocysteine levels. Tests for folate and homocysteine levels and optimal multivitamin supplementation in women with risk of NTDs one month or more before pregnancy should be recommended to women who are planning a pregnancy. Full article

(This article belongs to the Special Issue Maternal, Fetal and Postnatal Nutrition)

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18 pages, 2227 KiB

Open AccessArticle

Gestation Food Restriction and Refeeding Compensate Maternal Energy Status and Alleviate Metabolic Consequences in Juvenile Offspring in a Rabbit Model

by Rosa M. García-García, María Arias-Álvarez, Pilar Millán, María Rodríguez, Ana Sánchez-Rodríguez, Pedro L. Lorenzo and Pilar G. Rebollar

Nutrients 2021, 13(2), 310; https://doi.org/10.3390/nu13020310 - 22 Jan 2021

Cited by 5 | Viewed by 1937

Abstract

Nutritional status during gestation can influence mother and offspring metabolism. Undernutrition in pregnancy affects women in both western and developing countries, and it is associated with a high prevalence of chronic diseases in later life. The present work was conducted in the rabbit model, as a longitudinal study, to examine the effect of food restriction during early and mid-gestation, and re-feeding ad libitum until the end of pregnancy on metabolic status and body reserves of mother and, its association with development and metabolism of fetuses and female offspring to the juvenile stage. Little changes in live body weight (LBW), compensatory feed intake, similar body reserves, and metabolism were observed in dams. Placenta biometry and efficiency were slightly affected, but fetal BW and phenotype were not modified. However, hyperinsulinemia, insulin resistance, and hypertriglyceridemia were demonstrated in pre-term fetuses. In the juvenile period, these changes were not evidenced, and a similar pattern of growth and serum metabolic parameters in offspring of food-restricted mothers were found, except in serum aminotransferases levels, which increased. These were associated with higher liver fibrosis. Maternal food restriction in the early and mid-pregnancy followed by re-feeding in our rabbit model established a compensatory energy status in dams and alleviated potential long-term consequences in growth and metabolism in the offspring, even if fetal metabolism was altered. Full article

(This article belongs to the Special Issue Maternal, Fetal and Postnatal Nutrition)

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14 pages, 334 KiB

Open AccessArticle

Impact of Dietary Habit, Iodine Supplementation and Smoking Habit on Urinary Iodine Concentration During Pregnancy in a Catalonia Population

by Maria-Teresa Torres, Lluis Vila, Josep-María Manresa, Roser Casamitjana, Gemma Prieto, Pere Toran, Gemma Falguera, Lidia Francés and the IODEGEST Study Group

Nutrients 2020, 12(9), 2656; https://doi.org/10.3390/nu12092656 - 31 Aug 2020

Cited by 5 | Viewed by 2634

Abstract

(1) Background: The nutritional status of women during pregnancy can have a considerable effect on maternal and fetal health, and on the perinatal outcome. Aim: to assess the changes occurring in dietary iodine intake, potassium iodide supplementation, and smoking habit, and the impact of these changes on the urinary iodine concentration (UIC) during pregnancy in a population of women in Catalonia (Spain). (2) Methods: Between 2009–2011, an observational study included a cohort of women whose pregnancies were monitored in the public health system in the Central and North Metropolitan areas of Catalonia. Women received individual educational counseling, a dietary questionnaire was completed, and a urine sample was collected for iodine determination at each trimester visit. (3) Results: 633 (67.9%) women answered the questionnaire at all 3 visits. The percentage of women with a desirable UIC (≥150 μg/L) increased from the first to the second trimester and remained stable in the third (57.3%, 68.9%, 68%; p < 0.001). Analysis of the relationship between UIC≥150 μg/L and the women’s dietary habits showed that the percentage with UIC ≥150 μg/L increased with greater consumption of milk in the first trimester, and the same was true for iodized salt use in all three trimesters and iodine supplementation in all three. (4) Conclusion: During pregnancy, increased intake of milk, iodized salt, and iodine supplements were associated with an increase in the UIC. Full article

(This article belongs to the Special Issue Maternal, Fetal and Postnatal Nutrition)

11 pages, 245 KiB

Open AccessArticle

Association between Maternal Pre-pregnancy Body Mass Index and Breastfeeding Duration in Taiwan: A Population-Based Cohort Study

by Chi-Nien Chen, Hung-Chen Yu and An-Kuo Chou

Nutrients 2020, 12(8), 2361; https://doi.org/10.3390/nu12082361 - 07 Aug 2020

Cited by 6 | Viewed by 2900

Abstract

An association between high pre-pregnancy body mass index (BMI) and early breastfeeding cessation has been previously observed, but studies examining the effect of underweight are still scant and remain inconclusive. This study analyzed data from a nationally representative cohort of 18,312 women (mean age 28.3 years; underweight 20.1%; overweight 8.2%; obesity 1.9%) who delivered singleton live births in 2005 in Taiwan. Comprehensive face-to-face interviews and surveys were completed at 6 and 18 months postpartum. BMI status and breastfeeding duration were calculated from the self-reported data in the questionnaires. In the adjusted ordinal logistic regression model, maternal obesity and underweight had a higher odds of shorter breastfeeding duration compared with normal-weight women. The risk of breastfeeding cessation was significantly higher in underweight women than in normal-weight women after adjustments in the logistic regression model (2 m: aOR = 1.11, 95% CI = 1.03–1.2; 4 m: aOR = 1.32, 95% CI = 1.21–1.43; 6 m: aOR = 1.3, 95% CI = 1.18–1.42). Our findings indicated that maternal underweight and obesity are associated with earlier breastfeeding cessation in Taiwan. Optimizing maternal BMI during the pre-conception period is essential, and future interventions to promote and support breastfeeding in underweight mothers are necessary to improve maternal and child health. Full article

(This article belongs to the Special Issue Maternal, Fetal and Postnatal Nutrition)

12 pages, 884 KiB

Open AccessArticle

Are Lipid Profiles in Middle Age Associated with Famine Exposure during Prenatal and Early Postnatal Period?

by Xin-Yue Ding, Zhen-Yu Yang, Li-Yun Zhao and Wen-Hua Zhao

Nutrients 2020, 12(8), 2266; https://doi.org/10.3390/nu12082266 - 29 Jul 2020

Cited by 5 | Viewed by 1828

Abstract

Background: Undernutrition during early life may increase the risk of chronic diseases in adulthood, including dyslipidemia. Few investigations have confirmed the relationship between early life undernutrition and dyslipidemia in adulthood in China. Objectives: To assess the relationship between the Great Chinese Famine exposure during prenatal period or early postnatal period and lipid profiles in adulthood. Design: Data were extracted from the China Nutrition and Health Survey (CNHS) in 2010–2012, which included the participants who experienced the Great Chinese Famine during early life. Results: Participants who experienced the Great Chinese Famine in early postnatal period had a significantly higher prevalence of elevated total cholesterol (TC) (odds ratio: 1.60; 95% CI: 1.27, 2.02) than unexposed participants. Female (odds ratio: 1.71; 95% CI: 1.27, 2.31) were high risk than male (odds ratio: 1.46; 95% CI: 1.01, 2.11) and physical inactivity group (odds ratio: 1.65; 95% CI: 1.18, 2.29) were high risk than adequate physical activity group (odds ratio: 1.58; 95% CI: 1.21, 2.07). Similar effect of famine exposure on elevated low-density lipoprotein cholesterol (LDL-C) was observed, except that no significant difference was found between adequate physical activity group and physical inactivity group. Participants who experienced the Great Chinese Famine in prenatal period had a significantly higher prevalence of lowed high-density lipoprotein cholesterol (HDL-C) (odds ratio: 1.19; 95% CI: 1.03, 1.37) than unexposed. Female were more likely to have lower HDL-C (odds ratio: 1.44; 95% CI: 1.18, 1.74), but not found in male. Participants with physical inactivity were more likely to have lower HDL-C (odds ratio: 1.28; 95% CI: 1.02, 1.61), but not found in adequate physical activity group. Conclusions: People who experienced the Great Chinese Famine during early life, especially in females and people physical inactivity, would impair of lipid profiles in later life. Healthy lifestyle like adequate physical activity may partially alleviate the adverse effects. Full article

(This article belongs to the Special Issue Maternal, Fetal and Postnatal Nutrition)

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20 pages, 1250 KiB

Open AccessArticle

Maternal Microbiota, Cortisol Concentration, and Post-Partum Weight Recovery Are Dependent on Mode of Delivery

by Marta Selma-Royo, Izaskun García-Mantrana, Marta Calatayud, Anna Parra-Llorca, Cecilia Martínez-Costa and María Carmen Collado

Nutrients 2020, 12(6), 1779; https://doi.org/10.3390/nu12061779 - 15 Jun 2020

Cited by 8 | Viewed by 3202

Abstract

The importance of the maternal microbiota in terms of the initial bacterial seeding has previously been highlighted; however, little is currently known about the perinatal factors that could affect it. The aim of this study was to evaluate the effects of various delivery-related factors on the intestinal microbiome at delivery time and on post-partum weight retention. Data were collected from mothers (n = 167) during the first four months post-partum. A subset of 100 mothers were selected for the determination of the salivary cortisol concentration and microbiome composition at birth by 16S rRNA gene sequencing. The maternal microbiota was classified into two distinct clusters with significant differences in microbial composition and diversity. Maternal microbiota was also significantly influenced by the mode of delivery. Moreover, the salivary cortisol concentration was associated with some maternal microbiota genera and it was significantly higher in the vaginal delivery group (p = 0.003). The vaginal delivery group exhibited lower post-partum weight retention than the C-section (CS) mothers at four months post-partum (p < 0.001). These results support the hypothesis that the mode of delivery as well as the codominant hormonal changes could influence the maternal microbiota and possibly impact maternal weight recovery during the post-partum period. Full article

(This article belongs to the Special Issue Maternal, Fetal and Postnatal Nutrition)

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15 pages, 322 KiB

Open AccessArticle

Food Insecurity during Pregnancy in a Maternal–Infant Cohort in Brazilian Western Amazon

by Alanderson A. Ramalho, Cibely M. Holanda, Fernanda A. Martins, Bárbara T.C. Rodrigues, Débora M. Aguiar, Andréia M. Andrade and Rosalina J. Koifman

Nutrients 2020, 12(6), 1578; https://doi.org/10.3390/nu12061578 - 28 May 2020

Cited by 6 | Viewed by 3650

Abstract

The aim of this study was to determine the prevalence and analyze the factors associated with food insecurity during gestation in a maternal–infant cohort in Brazilian Western Amazon. A population-based cross-sectional study was conducted with parturients from a maternal–infant cohort in Rio Branco, located in the Western Brazilian Amazon. The dependent variable food insecurity (FI) was obtained through the Brazilian Scale of Food Insecurity, and associated factors were identified through multiple logistic regression. The prevalence of FI in pregnancy was of 34.8%. Regarding severity, the prevalence of mild food insecurity was 24.6%, moderate food insecurity was 4.8%, and severe food insecurity was 5.4%. The factors directly associated with FI were the presence of open sewage in the peridomestic environment; belonging to the lower economic classes; being an income transfer program beneficiary, while the factors inversely associated with FI were schooling equal to or greater than 8 years; having a partner; primigestation; and regular consumption of fruits and vegetables during pregnancy. These findings reinforce the need for the ratification of actions aimed at the domestic economy in the income transfer programs and the development of actions of food and nutritional education in the gestational period. Full article

(This article belongs to the Special Issue Maternal, Fetal and Postnatal Nutrition)

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